Medical malpractice insurance is sometimes referred to as medical liability insurance or just malpractice insurance. It’s a type of professional liability coverage that protects physicians and other medical professionals, including doctors or physicians, dentists, and nurses, from financial liability caused by professional mistakes (malpractice) that result in bodily harm to patients or death. It pays legal and settlement costs when patients or their families sue medical professionals or practices for malpractice, whether they’re found guilty or not.
Most physicians and other medical professionals in Pennsylvania know they need medical malpractice insurance, but aren’t sure how much and what types of coverage are required or how to get it. In this article, we’ll review everything you need to know to get the coverage that’s right for your practice and also share our recommendations of the 6 best medical malpractice insurers in Pennsylvania.
- What is medical malpractice?
- What does medical malpractice insurance cover?
- Medical malpractice laws in Pennsylvania
- Medical Care Availability and Reduction of Error Fund (MCARE) Act in Pennsylvania
- Claims-made vs occurrence medical malpractice insurance
- Who needs medical malpractice insurance in Pennsylvania?
- How do I purchase medical malpractice coverage in Pennsylvania?
- How much medical malpractice insurance coverage do I need in Pennsylvania?
- How much does medical malpractice insurance cost in Pennsylvania?
- What are the medical malpractice insurance premiums for?
- Top 6 medical malpractice insurers in Pennsylvania
What is medical malpractice insurance?
A medical malpractice insurance policy, or also called medical professional liability insurance policy, covers harm to patients that occurs because a physician or other medical professional makes an error while providing healthcare services. The definition of harm is quite broad and can include things like pain and mental anguish. Your legal costs are covered even when a patient believes you caused them harm, but you’re found to be not responsible for the injury or were not negligent in providing medical services to them.
What does medical malpractice insurance cover?
Malpractice policies normally cover a broad range of expenses associated with defending and settling malpractice suits, such as attorney fees, court costs, arbitration, settlement costs, and medical expenses, along with punitive and compensatory damages.
Medical malpractice usually does not cover liability that arises from criminal activities, cyber threats, injuries related to workplace accidents, or sexual misconduct.
It’s critical to completely understand what your medical malpractice insurance policy covers and what it doesn’t to make sure you have adequate protection against the risks you face. It’s also important that you know the amount of coverage for each incident (usually referred to as an occurrence) and all claims that may be made against you in a given one year policy period.
Some states require minimum levels of coverage for each claim and the total of all of the claims that may be made during a given year. It’s important to discuss the potential need for additional coverage above the minimums with a professional malpractice insurance consultant or institutional risk manager to ensure that your personal assets are protected if you’re sued.
Medical malpractice laws in Pennsylvania
Pennsylvania has some unique laws that could have an impact on your medical malpractice insurance decisions. Three of the top ones include:
- Pennsylvania statute of limitations. A patient must file a malpractice claim within two years of the date the injury or medical harm occurred. However, that two year period could be overridden if the patient doesn’t realize they’re injured until after that time. If that’s the case, the two year clock begins immediately after the discovery of the injury or harm.
- Certificate of merit. In Pennsylvania, a patient or their attorney must sign a certificate of merit that states that they believe they have actually been harmed by a medical practitioner. The purpose of this is to prevent false malpractice claims.
- No malpractice cap in Pennsylvania. There is no limit to how much someone can sue for in a malpractice suit in Pennsylvania. That means you have to be prepared to pay clients a large amount of money if you’re ever sued and found guilty of gross malpractice.
In some cases, Pennsylvania medical malpractice laws are favorable to medical professionals. In others, they’re not. Use this information when you decide the type of policy you get and your level of coverage.
Medical Care Availability and Reduction of Error Fund (MCARE) Act in Pennsylvania
Pennsylvania has the second highest medical malpractice insurance rates, second only to New York.
Because of the high rates, PA introduced the Medical Care Availability and Reduction of Error Fund (MCARE) Act, which requires that health care providers to carry liability insurance, if at least 50% of their patients are from PA. It mandates that the minimum coverage of medical malpractice insurance for doctors must be $1M per claim and $3M in annual aggregate.
You can see what you will pay here. Individual policies must cover at least $500,000 per occurrence and $1.5M per claim, and after that, MCARE will cover any losses over that, up to $1M.
Claims-made vs. occurrence in medical malpractice insurance
There are two basic kinds of malpractice insurance: Claims-made vs. occurrence.
Claims-made medical malpractice insurance:
With this type of coverage, the malpractice policy that’s in effect when a claim is made pays legal and settlement expenses no matter when the medical incident occurred. For example, if an incident happened in 2019 and a medical professional is sued in 2022, the malpractice insurance in effect in 2022 pays legal and settlement costs related to the suit.
Many claims-made policies allow you to purchase a “tail” which offers continued coverage for a defined time, often five years, in case you’re sued for malpractice after your claims-made policy expires or you cancel it (oftentimes because you’re moving on to a new job). If your policy does not come with a tail option, you may be able to purchase tail coverage from another provider. The price of tail insurance is typically a one time assessment that is a multiplier of an annual malpractice insurance premium, typically 1.5 to 2 times the cost.
Occurrence medical malpractice insurance:
With this type of coverage, the medical malpractice insurance that was in effect when the incident happened pays costs no matter when the healthcare practitioner is sued. Going back to the previous example, if the event happened in 2019 and the lawsuit is initiated in 2022, the insurance policy from 2019 would cover costs.
Who needs medical malpractice insurance in Pennsylvania?
Medical liability insurance is required in most states and virtually every healthcare organization or system requires the coverage for healthcare professionals to practice in them.
In Pennsylvania, all healthcare professionals , especially doctors, are required to have medical malpractice insurance. This is mandate by the MCARE Act in Pennsylvania. Learn more about the MACARE Act below.
How do I purchase medical malpractice coverage in Pennsylvania?
Malpractice coverage is usually purchased through traditional insurance companies or medical risk retention groups, which are mutual organizations made up of healthcare professionals that are organized to offer malpractice coverage. They are often sponsored by state medical societies.
One other medical malpractice insurance purchase option: Some large medical systems are self-insured. A medical liability trust fund is created. The funds in it are used to pay for malpractice defense and settlement costs against their healthcare workers.
Individual and group malpractice coverage plans are available for independent or small healthcare practices. For many physicians and other medical professionals, malpractice insurance is often offered as part of a group plan purchased by the hospital or health system they work for.
How much medical malpractice insurance coverage do I need in Pennsylvania?
In Pennsylvania, the minimum coverage you need to have for your medical malpractice insurance is $1M/$3M as per MCARE Act. However, your individual medical malpractice insurance policy must be at least $500K per occurrence and MCARE will cover the rest.
At a minimum, you need to secure the amount and type of insurance required by your state and employer. However, that’s typically nowhere near enough for most medical practitioners. Many physicians and other healthcare workers have significant assets that need to be protected. If you don’t have enough malpractice insurance coverage, a disgruntled patient or their family could come after your home, car, investments, and other things.
If you have significant assets to protect, you should meet with an insurance agent with malpractice experience, insurance company representative, or institutional risk manager to discuss your financial situation and malpractice insurance needs.
How much does medical malpractice insurance cost in Pennsylvania?
The price of medical malpractice varies. It’s dependent on many factors, including type of practice, size of the operation, years of experience, claims history, location, and other things.
Below are the average costs of medical malpractice insurance for different specialties (annual premiums). Here is the source of data.
|Specialty||Approximate Rate||Minimum Rate||Maximum Rate|
|Cardiovascular Disease Minor Surgery||$22,000||$12,000||$35,000|
|Family Practice No Surgery||$14,000||$8,000||$21,000|
|Gastroenterology No Surgery||$14,000||$8,000||$23,000|
|Internal Medicine No Surgery||$14,000||$8,000||$21,000|
|Neurology No Surgery||$19,000||$11,000||$31,000|
|Obstetrics and Gynecology Major Surgery||$68,000||$33,000||$100,000|
|Ophthalmology No Surgery||$9,000||$4,000||$16,000|
|Orthopedic Surgery No Spine||$42,000||$20,000||$68,000|
|Pediatrics No Surgery||$14,000||$8,000||$21,000|
|Radiology – Diagnostic||$19,000||$10,000||$30,000|
As you can see there is a big gap between the minimum and maximum rate. Different insurance companies will always provide you with different quotes. The best way to make certain you’re paying a fair price for your medical malpractice coverage is to get quotes from multiple providers. That way, you can compare coverages and costs to find the best combination for you.
What are the medical malpractice insurance premiums for?
Most of the malpractice premium dollars collected by insurers go toward legal defense costs and cost containment expenses. Relatively little goes toward patient care and settlement costs. That’s because the process of discovering, proving, and defending against legal negligence in healthcare situations is complex and time consuming.
Medical liability insurance companies spend large amounts of money investigating and defending legal claims where there is an adverse patient outcome that is not caused by medical malpractice. In those cases all the money goes toward legal-related costs and none to the patient.
Top 6 medical malpractice insurers in Pennsylvania
- CoverWallet: Best for doctors in Pennsylvania who want to compare several online quotes
- Integris Group: Best for practices that want the backing of a dedicated team
- CM&F: Best for medical professionals that have unique insurance needs
- MD Advantage: A firm focused on coverage for medical professionals
- Coverys: Best for helping medical practices control malpractice risks
- Berxi: Best for a simple insurance buying experience
CoverWallet: Best for doctors in Pennsylvania who want to compare several quotes online
If your main goal is to find an affordable medical malpractice insurance policy and you want to make sure you are able to compare several quotes online to select the best one, you may want to start with CoverWallet. They are a digital broker and work with several insurance companies.
After you fill you the quote form on their website, you will be able to provide you with several quotes for you to compare and select the best one for you. The whole process takes just about 10 minutes. In some cases where there are nuances and complications in the quotes and the industries, they are not able to provide online quotes. However they are able to discuss several options of your situations on the phone to help you select the best one.
Once you buy a medical malpractice insurance policy from them, you will be able to manage your policy entirely digitally. It is as simple and fast as you do everything else nowadays.
Integris Group: Best for practices that want the backing of a dedicated team
Integris Group has been providing top tier medical liability insurance since 1984.
You can expect a high level of service when you trust your practice to Integris Group. They will provide you with a team of specialists, including a dedicated underwriter, claims professional, and risk management expert. They are all there to help you safeguard your medical practice.
Another plus with Integris Group is that they’re not in it to make a profit off selling malpractice coverage. Instead, everyone on their board is a practicing medical professional who understands the realities of running a healthcare practice in today’s world. The company makes it their mission to keep pace with changing mandates and regulations in Pennsylvania and across the United States.
It’s easy to do business with Integris Group. You can always login to their member portal to:
- View and pay your bill
- Print a certificate of insurance
- View your CME transcript
- Contact an insurance expert.
Integris Group is also unique in that it offers a loyalty program that can pay off for physicians that stay with the insurer over the long term.
CM&F: Best for medical professionals that have unique insurance needs
If you have unique medical malpractice insurance needs, CM&F could be the right provider for you. They offer malpractice coverage for more than 200 specialized areas of medicine.
CM&F is unique because it’s been family owned and operated since 1919, providing insurance to millions of healthcare professionals since. The firm has a long history of innovation, going back to 1947, when it offered the very first liability insurance policy for nurses.
Even though CM&F has been in business a long time, it continues to invest in service and technology to help support clients any place, any time. They allow you to buy insurance online, access policy documents instantly, or get answers to your questions over the phone.
MD Advantage: A firm focused on coverage for medical professionals
MD Advantage offers business and other coverage exclusively for people in the medical profession and medical practices all over the northeast, including in Pennsylvania.
One of the things that makes MD Advantage stand out is it’s complete offering of podcasts and other resources that can help you keep your practice safe, by taking steps to prevent insurance claims.
MD Advantage makes it easy to get a quote from an experienced insurance broker. You can get connected with one through the firm’s website.
Coverys: Best for helping medical practices control malpractice risks
Coverys is an A rated insurer according to A.M. Best, a company that reviews insurance companies for financial security. They’ve been in business for more than 45 years.
They are unique because they provide top quality insurance protection coupled with cutting edge risk analysis services that can help keep you from ever needing to use your malpractice insurance in the first place. They are also known for their world class claims services.
Coverys has an extraordinary amount of research and thought leadership material on their website, available for clients and non-clients alike.
It’s easy to purchase a policy through an insurance agent. You can find agents affiliated with Coverys on the insurer’s website.
Berxi: Best for a simple digital insurance buying experience
Purchasing malpractice insurance can sometimes be challenging and time consuming. Berxi makes it relatively easy. Their policies are quite simple to understand and they offer direct to consumer pricing to help you save money on your coverage.
Despite being lower-cost and a provider that’s simple to work with, Berxi offers enhanced coverage options to help you get protection for the unique risks face by you and your practice.
>>MORE: The Best Medical Malpractice Insurance Companies
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