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What Is Tail Coverage Malpractice?
Everything You Need to Know

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Insurance coverage is important in a medical malpractice case, as it is in many different types of lawsuits. But what happens if a plaintiff files a claim after the malpractice insurance policy of a healthcare provider has run out? 

Over the years, I have worked on medical malpractice cases, and it turns out that it's crucial to know if the provider has extra insurance for claims made after the policy expires. 

In this article, I will describe the process of what is frequently referred to as "tail coverage."

Summary of the Key Findings

  • Contrary to a standard policy, tail coverage offers a defense for medical malpractice lawsuits filed after the provider's insurance coverage has already ended or been canceled.
  • The policyholder must pay an additional premium to the insurance company for tail coverage insurance.
  • The majority of healthcare providers are protected by "claims-made policy" malpractice policies.

Standard Insurance Policies for Claims

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To understand what tail coverage is, you must first comprehend what typical claims-made insurance policies cover in relation to an alleged medical error that serves as the basis for a medical malpractice lawsuit.

ًWhat is Tail Coverage?

Tail coverage is an insurance policy endorsement that enables you to submit a claim against your policy even after it has expired or been canceled. It pertains to insurance policies with a claims-made provision and typically entails paying a surcharge to your insurer [1].

In claims-made policies, you can find liability coverage for things like professional liability, errors and omissions, and directors and officers insurance.

Based on my experience, for occurrence-based policies, free tail coverage is not applicable.

For occurrence-based policies, tail protection is not necessary because occurrence coverage is still available if the insured event took place while the policy was still in effect, even if you later canceled it.

What is Tail Malpractice Coverage?

A businessman using a laptopTail malpractice coverage is a liability protection insurance policy for doctors that goes beyond any prior medical malpractice insurance claims [2].

Tail malpractice coverage defends doctors when a former patient alleges malpractice while a prior insurance plan covers the doctor.

A claims-made insurance policy limits the insurance company's responsibility to pay medical malpractice to those that are made while you actively practice medicine during the policy's active period. 

Former patients may file a medical malpractice claim against you months or even years after the alleged malpractice occurred and far after your effective policy period expires. In these situations, you'll require purchasing tail coverage from the insurance company to shield your liability.

Who Needs Malpractice Tail Coverage?

Those who need tail coverage insurance work as general practitioners or surgeons in private practices. In other words, people in the medical field who are not working as employees of hospitals, medical clinics, or surgical centers.

Certain healthcare professional liability insurance policies provide free tail coverage to retiring doctors who have met certain age requirements and have been customers for a predetermined period of time.

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Why Does One Need Tail Coverage?

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One needs tail coverage to avoid liability for medical malpractice claims made against them due to your previous claims-made policy coverage.

There are a variety of reasons you might change plans or discontinue your coverage, including:

  • Changing your practice.
  • Deciding to work in a hospital instead of a solo or group practice.
  • Combining a solo or independent practice with another practice.
  • Starting a solo practice after leaving a hospital job or independent group practice.
  • Transferring from one hospital or group practice to another.
  • Beginning to retire.

However, it would be best if you kept in mind that your claims-made insurance is only valid while you are still employed.

Suppose you are switching jobs or insurance companies but aren't retiring. In that case, you must either carry forward your current retroactive date and buy prior acts coverage or buy an extended reporting endorsement.

Both will give you the protection you require, but prior acts coverage, in my opinion, is usually a less expensive option.

The majority of doctors will eventually receive malpractice tail coverage, either during their careers or after. 

By doing this, they will make sure they are protected financially and in terms of their reputation if they are the target of a medical malpractice lawsuit even though they had prior claims-made insurance.

"...Suppose a physician was insured under a claims-made policy prior to hospital employment. In that case, hospitals will often require the physician to purchase tail malpractice coverage to cover any claims that might arise from the physician's prior practice."
- Erik Leander, Chief Technology Officer at a Medical Malpractice Insurance Agency

Cost of Tail Malpractice Insurance

A person holding a credit cardThe policyholder is obligated to pay an additional premium for tail coverage. The majority of policies that cover claims-made must offer the doctor the choice to purchase tail coverage to pay claims if and when the policy is canceled.

However, depending on the medical specialization and the region, the tail malpractice insurance cost is between 150 or even 200 percent more than a fully developed claims-made insurance.

To buy tail coverage, you need to do your research before choosing the first choice that comes your way, contact other insurance providers and try to understand more before you purchase tail malpractice coverage.

What Are the Alternatives to Tail Coverage?

Some insurers offer other options in addition to tail coverage. One of the choices an insurance provider gives medical professionals is an "extended reporting" endorsement, which costs less than regular tail coverage.

"Nose coverage" is a different alternative to tail insurance. It provides coverage for actions that had taken place before a doctor's new policy went into effect. Although it essentially provides the same kind of coverage as tail insurance, it does not come with the same restrictions.

FAQs

How long does malpractice tail coverage last?

Malpractice tail coverage can last from one year after your current plan ends to an unlimited length of time.

How does malpractice tail coverage work?

Malpractice tail coverage works by shielding you from responsibility for medical malpractice lawsuits resulting from your previous claims-made policy's coverage period.

Do You Have a Medical Malpractice Case?

Tail malpractice coverage is designed to indemnify an insured healthcare provider for a malpractice loss incurred while treating a patient when the treatment was performed with reasonable care, skill and diligence. 

If you believe you have a medical malpractice case, you should contact Schmidt & Clark and seek consultation from our experienced medical malpractice attorneys to assess the merits of your claim in a free consultation session.


References:

  1. https://www.lawinsider.com/dictionary/tail-insurance 
  2. https://www.irmi.com/term/insurance-definitions/tail-coverage

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