What Should an Anesthesiologist Expect to Pay in Malpractice Insurance?

Your medical specialty determines how often doctors get sued for malpractice. For example, a dermatologist is less likely to be sued than a neurosurgeon. Insurance companies take this data to determine the price the doctor will pay for malpractice insurance. If you’re an anesthesiologist, then you well know that your job comes with a moderate level of risk. The patient could have an adverse reaction or suffer from extreme nausea and vomiting. And let’s not forget human errors. You may misread the dose being administered or the hospital overlooked medical records which stated the patient is not to receive anesthesia. For all these reasons and more, anesthesiologists must purchase malpractice insurance coverage. The question is: What does anesthesiologist malpractice insurance cost?

Anesthesiologist Malpractice Insurance Cost

The cost of malpractice insurance for doctors depends on several factors, such as where you live.

State tort laws

Tort laws vary by state (tort is a civil wrong that causes a patient to suffer loss or harm). Half the states in America have tort law that limits the amount of money a plaintiff can receive in a settlement. The cap on settlements is for non-economic damages only, which is when a patient wants to be paid for pain and suffering caused by the doctor. California, Colorado, Kansas, and Texas have a cap between $250k–$300k on non-economic damages cited in a malpractice lawsuit. Here are the average medical malpractice payouts by state. Insurance companies will determine the premium you pay for malpractice insurance as an anesthesiologist based on which state you are practicing.

Rate of malpractice suits in your state

According to research from the National Practitioner Data Bank, compiled by Zippia for the year 2015, Louisiana had the most malpractice lawsuits filed for every 100,000 people, coming in at 44 lawsuits. That is compared to 5 lawsuits out of every 100k people in Hawaii and 22 lawsuits filed for every 100k people in Pennsylvania. Insurance companies use this data to determine your annual premium. This information is also used by medical malpractice insurance companies to determine what your annual premium should be.

Why Anesthesiologists Need Medical Malpractice Insurance

Before anything more, we should clarify what medical malpractice is in the first place. Medical malpractice are claims of alleged negligence or omissions in medical care that result in injury or even death for the patient. Anesthesiologists must purchase medical malpractice insurance because an “error” could simply mean you administered too much anesthesia, not enough, or somehow administered it incorrectly. The primary reasons anesthesiologists get sued for malpractice are the following:

• Brain damage
• Nerve injury
• Aspiration
• Awareness during general anesthesia
• Poor patient monitoring
• Failure to administer an anesthetic plan
• Failure to review medical history pre-operation
• Critical events, such as coma or death

The reason you need medical malpractice insurance is to cover the costs associated with a lawsuit: lawyers, trial expenses, time you’re forced to take off work, settlements, damages, etc. One look at some of the more famous and largest medical malpractice cases will tell you how expensive this type of lawsuit can get.

Types of Medical Malpractice Insurance for Anesthesiologists

There are a few different types of malpractice coverage for anesthesiologists to consider.

Occurrence Coverage

An occurrence policy will cover you for any claims made against you during the policy term. For example, let’s say you paid premium on an occurrence policy between 2010 and 2015, then cancelled the coverage. A former patient sues you in 2018 for something that happened in 2014. The occurrence policy you paid into between 2010 and 2015 will cover the claim, even though it was filed in 2018. Occurrence coverage is the preferred type of malpractice insurance for most medical professionals. The problem is it’s not available in all states.

Claims-made Coverage

A claims-made policy only provides coverage for the period when premiums are paid. So using the example above, the doctor who was sued in 2018 would not be covered under a claims-made policy because the doctor cancelled the plan in 2015. If you have the choice of claims-made vs occurrence malpractice coverage, go with occurrence. That said, claims-made coverage is more readily available and there are some companies who ONLY offer this option.

Claims-paid Coverage

A third, less-common type of coverage is claims-paid malpractice insurance. This type of coverage is less expensive than the two main types, but also more restrictive. On a claims-paid policy, the insurer only covers you if you are still insured at the time the claim is paid. It does not matter when the incident occurred, nor does it matter when the patient made the claim of malpractice. Premiums for claims-paid policies are based on claims settled during the previous year or claims anticipated to be settled over the next year.

Tail and Nose Coverage

What happens if your claims-made policy lapses and then a former patient sues? You would be liable for damages. But there are two ways to obtain coverage for incidents that occurred in the past.

• Purchase an extended reporting endorsement on your current claims-made policy, this is the “tail”
• Purchase a prior acts coverage from your new insurer which is the “nose”

Tail coverage malpractice insurance allows you to report claims in the future. If you purchase tail coverage on a policy that is lapsing, all future claims that occurred while the policy was in effect will be covered. Tail coverage is good if you move from a private practice to a hospital that offers group coverage (where past claims won’t be covered) or if you are moving to another state. Nose coverage is essentially getting coverage (if you pay the premium) before the policy’s official effective date.

How Anesthesiologists Can Reduce the Risk of Malpractice

As an anesthesiologist, you can reduce your risk of malpractice by sticking to the basic principles you learned in your training. Since the late 1980s and early 1990s, the advancements to improve patient safety in the practice of anesthesiology have been remarkable. The incorporation of real-time continuous monitoring of oxygen delivery and patient ventilation, anesthesia machine checkout protocol and the pharmacological improvements in anesthesia medications are all far superior and should help reduce your risk of making a mistake.

As you work with patients, document everything. Add a chronological list of progress notes as you care for a patient during surgery and when administering local anesthetic. If an incident does occur, write down every possible detail about that day and about that case, including what you did and didn’t do — even what you wish you had done. These journals can be submitted as evidence in a trial and help you win the medical malpractice lawsuit. It will help you to review prior to a case which might come up in a courtroom years down the road. You may need a way to refresh your memory.

Medical Malpractice Insurance Companies for Anesthesiologists

You may be ready to purchase malpractice insurance but where to start? Which companies are the best and offer the best coverage for doctors? Here are a few options that LeverageRx recommends:

MedPro Group

Founded in 1899, Medical Protective Group (MedPro) is the oldest professional liability carrier in America. Today, the company remains an industry force as one of the top writers of medical malpractice insurance in the country. Learn more: MedPro Malpractice Review

The Doctors Company

The Doctors Company is the nation’s largest physician-owned medical malpractice insurer. It has roughly 80,000 members and over $4 billion in assets. As a member-owned insurer, The Doctors Company regularly pays dividends to those it insures. Learn more here: The Doctors Company Insurance Review

MAG Mutual Insurance

MagMutual has kept 95 percent of claims brought against its insured physicians and hospitals from going to trial. Of those that did end up in court, it has won 80 percent of cases. However, it is only available in the following states: AL, AR, FL, GA, KY, NC, SC, TN, VA. Learn more here: MAG Mutual Insurance Review

NORCAL Group

The NORCAL Group (also known as NORCAL Mutual Insurance Company) is the 8th largest malpractice insurer in the country based on direct written premium. The policies are only available in the following states: ID, MT, WY, ND, SD, NY, ME, VT, NH, MA, HI. Learn more here: NORCAL Group Malpractice Insurance Review

ProAssurance Group

ProAssurance offers claims-made policies with automatic tail coverage for death or disability. Its policyholders receive tail coverage at full retirement if they have five years of continuous coverage. Learn more here: ProAssurance Group Malpractice Review

MLMIC Insurance Company

In 2018, the company was acquired by National Indemnity Company, a subsidiary of Berkshire Hathaway. MLMIC provides excess coverage at no additional cost under its Excess Liability Program. It provides an additional layer of insurance protection, over and above the required primary limits of $1.3 million for each person and $3.9 million total. Learn more here: MLMIC Malpractice Insurance Review.