Do Nurse Practitioners Need Malpractice Insurance?: A Guide

Being a nurse practitioner (NP) gives you the opportunity to serve patients in a variety of settings, but it also means you’re at risk of being named in a malpractice claim even if you met the standard of care. Still, you might ask: do nurse practitioners need malpractice insurance? NPs can get named in claims based on their own interactions with patients and based on their larger team’s decisions. Claims are increasing, and patients and families wanting large payouts are growing.

This article explains possible reasons why nurse practitioners need malpractice insurance, the types of policies available, and what coverages are offered. We also go over nurse practitioner malpractice insurance requirements and explain why many NPs choose to buy an individual policy in addition to their employer-provided one.

Why Is Nurse Practitioner Malpractice Insurance Important?

Malpractice insurance protects nurse practitioners from alleged liability of wrongful practices resulting in bodily injury or medical expenses that resulted from the course of their care. It includes the cost of legally defending the NP and any necessary settlements.

Malpractice insurance for nurse practitioners protects you from having to pay all that out of pocket and provides legal counsel to act as your personal advocate. It’s nice to know someone will be there to handle the details if you’re unexpectedly served with a claim.

But how common are claims against NPs and how much do they cost? Insurance Journal reports that diagnosis claims are number one for NPs who run their own practices, followed by prescription errors, complaints about treatment and care management, and wrongful death suits. And based on 2022 data, the average total expense for defending NP-owned practice claims was $26,349. This does not include any settlement payments. Meanwhile the cost of the most common claims (false diagnosis, prescription errors, care management, and wrongful death) had average total costs between $290,164 and $652,294.

But malpractice insurance isn’t only for NP entrepreneurs. According to Minority Nurse, claims of a wrong diagnosis are the most common claims brought against nurse practitioners who work in any type of setting. So malpractice insurance can be vital no matter where you work, or who you work for.

Do Nurse Practitioners Need Malpractice Insurance?

While not always legally mandated, it’s incredibly important for nurse practitioners to have malpractice insurance. Think about it this way: In your role as a nurse practitioner, you’re often responsible for the care of and decision making for numerous patients at a time. This level of care requires close attention to detail across cases and often carries significant risk. Mistakes can happen. And so can false accusations of mistakes.

Malpractice insurance provides a little extra peace of mind that if your worst-case scenario happens and you make a mistake — or you’re accused of one — you are legally and financially protected. This way, you can focus on doing your job and providing the best care possible.

Whether you work in a clinical setting, have contract-based hours, or run your own practice, malpractice policies include:

Protections:

• Good Samaritan coverage
• HIPAA defense
• Licensing board actions
• Malpractice claims
• Negligence claims

Financial coverages:

• Expert testimony fees
• Legal and court fees
• Lost wages and travel
• Settlement charges
• Pre- and post-judgment interest (extra settlement fines based on interest from date the claim arose to the judgment date)

Real Stories of Nurse Practitioners Needing Malpractice Insurance

Never heard of an NP getting sued for malpractice? The following four cases highlight real stories of claims filed against nurse practitioners. One NP even explains why she couldn’t tell anyone at work that she was battling a malpractice claim and trial for four years.

1. Cardiac NP sued for wrongful death. This contract-based NP was named in a wrongful death lawsuit along with the hospital and several hospital employees. The hospital informed him they would not be representing him, and he was responsible for his own defense.
2. NP received three board actions from the same family. This story describes a psych NP whose patient’s family was left distraught and needed someone to blame. As a result, she was forced repeatedly to protect her license to practice.
3. NP faced four-year fight. An ER NP admitted a patient and never saw her again. A few months later, the patient died and the nurse was sued for failure to diagnose. She refused to settle and, over four years, fought for her name and professional reputation.
4. NP was forced to break HIPAA. When this psychiatric NP had to report her patient’s actions, she was left with a licensing board action and threats of a lawsuit.

Nurse Practitioner Malpractice Insurance Requirements

Currently, the laws requiring nurse practitioners to carry malpractice insurance vary state to state. This might change over time, though, so be sure to check your state and local regulations to determine nurse practitioner malpractice insurance requirements in your area.

NPs who run their own practices may be required to carry other types of business liability insurance. As a small business owner, you can count on extra peace of mind when you add malpractice insurance to your list of must-have policies.

Types of Nurse Practitioner Malpractice Policies

As you shop for malpractice insurance, you need to consider which type of policy makes the most sense for your situation. Some common types include:

• Claims-made. Malpractice insurance that covers claims patients bring against you during your policy period. You may be able to add what’s known as a “retro date” to cover claims resulting from past incidents, too, as long as you also had malpractice insurance during that period.
• Occurrence. A policy that covers claims from any alleged incident that happened during the time you carried the policy. This includes coverage for claims made after the policy expires.
• Tail coverage. A rider that modifies a claims-made policy to extend coverage to claims filed beyond the policy’s expiration. You may want to add tail coverage as your claims-made policy is expiring. Keep in mind that this tail policy will cover only claims relating to incidents that occurred when your claims-made policy was active.
• Group policy. A malpractice insurance policy you’d get through an employer, including when you are the employer. It can be purchased to cover yourself and your employees if you run your own business.
• Supplemental. A type of policy you can purchase in addition to carrying coverage from your employer. Supplemental malpractice insurance includes coverage for work that falls outside the scope of your employer’s policy, provides additional financial support for claims beyond the limits of liability, and ensures you get your own lawyer if you face a claim or board action.

What limits of liabilities should NPs have?

All malpractice policies come with limits of liability, which show the total amount the insurance company will pay per claim or per policy period to cover the costs associated with claims.

When comparing policies, you’ll see two numbers that represent these limits. The first is for each claim or each occurrence, depending on the type of policy.

The second number shows the total payout provided for the duration of the policy, which is usually one year. This is also called the “aggregate” amount.

To determine how much coverage you need, consider the level of risk associated with the duties you perform on the job and the typical costs of claims and legal fees in your area. Insurance providers can make recommendations to help you decide what limits of liability to choose.

An example of NP limits of liability

Say you’re an NP with malpractice insurance policy limits of $1M/$3M. This means you have $1 million per claim and $3 million per policy period.

In one year, you are sued by two different patients claiming misdiagnosis. For each claim, you would have up to $1 million for each lawsuit.

But say one of these claims is dismissed and the other settles for $1.2 million. For the claim that goes over the $1 million mark, you would be responsible for $200,000.

As for $3 million aggregate, this acts as a cap on the total payout per policy period regardless of the number of claims, incidents, or occurrences. So, if you bought your policy in March 2025, you can’t use more than $3 million in settlement funds before March 2026.

In the example above, you had one claim that didn’t have a settlement, leaving you with your $3 million intact. The next claim cost $1.2 million, with your insurance paying the $1 million and you paying $200,000. So, you still have $2 million to settle remaining disputes.

Additional coverages NPs may add to a medical malpractice policy

A nurse practitioner medical malpractice policy may not meet all the requirements to cover every possible claim you could face on the job. Depending on your situation, you may need to add one or more of these coverages:

• Billing errors & omission coverage to handle claims relating to billing mistakes or alleged fraud.
• Medical director coverage if your job involves overseeing a medical facility, working with providers, managing budgets and operations, and other director’s duties.
• General liability to cover claims of bodily injury (not a result of patient care), property damage, and reputational or advertising injury that aren’t related to malpractice. Having general liability insurance is a good idea if you own a practice or provide care services as an independent contractor.

Employer vs. Personal Nurse Practitioner Malpractice Policies

You may be wondering: do nurse practitioners need malpractice insurance if they’re already covered by their employer’s policy? While it’s not legally required, carrying your own insurance is incredibly smart because employer-provided policies often exclude coverage for:

• Licensing board actions
• HIPAA violations
• Reputation protection services
• Lost wages

Relying only on your employer’s policy could also mean that your interests may come second to your employer’s, so you may not be free to make decisions like whether to settle in a claims case. Other reasons many NPs choose to supplement their employer’s policy with their own medical malpractice policy include:

1. Contract workers often aren’t covered at all.
2. There could be gaps in coverage.
3. If you leave the job, you might leave yourself exposed.
4. Depositions aren’t always covered.
5. Supplemental insurance gives you your own attorney and advocate.
6. Individual med mal insurance boosts the financial resources available to you.

This is where a supplemental policy can help. When you purchase your own malpractice insurance, you get to choose coverage tailored to the needs and risks of your role as a nurse practitioner. The legal counsel these policies provide is yours and yours alone, so you can be sure your concerns will be heard, considered, and addressed.

Get Affordable NP Malpractice Insurance With Berxi

Whether you’re looking for a primary policy or something to supplement what your employer provides, you can save an average of 20% if you purchase malpractice coverage directly from Berxi instead of buying through a broker.

With Berxi, you have the option of either a claims-made or occurrence policy with limits of liability that range from $500,000 per claim/$1 million aggregate to $2 million per claim/$6 million aggregate. If you’re a nurse practitioner with your own business, you can get policies to cover yourself and your employees — all with no deductible.

Every policy is backed by the financial strength ratings of A++ from AM Best and AA+ from Standard & Poor’s that come from working with a company that’s part of Berkshire Hathaway Specialty Insurance. Start by getting a quick quote today to find out how affordable it is to protect yourself, your finances — and your career.

 

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