Interviewing Strategies and Liability Insurance: Important Considerations for Nurse Practitioners

1. Interviewing Strategies and Liability Insurance: Important Considerations for Nurse Practitioners Pat McMullen, PhD, JD, CNS, WHNP-BC FAANP Dean – School of Nursing The Catholic University of America mcmullep@cua.edu

2. Competencies • Explain why liability insurance is important to NPs • Differentiate between types of liability insurance • Apply knowledge of liability insurance principles to selected cases

3. Source: Miller, K.P. (2011) Malpractice: Nurse Practitioners and Claims Reported to the National Practitioner Data Bank.Journal of Nurse Practitioners, 7(9), 761-67.

4. National Practitioner Data Bank – Nurse Practitioner Claims Source: Miller, K.P. (2011) Malpractice: Nurse Practitioners and Claims Reported to the National Practitioner Data Bank.Journal of Nurse Practitioners, 7(9), 761-67.

5. NP 2012 Liability Update from NSO (www.nso.com)

6. NSO Liability, p. 15

7. Types of Liability Insurance • Occurrence Insurance-Provides coverage for a claim based on an episode that occurred during the policy period. • Claims Made Insurance-Provides coverage ONLY for suits and claims that are filed or made during the period when the policy was active.

8. Other Important Terms • Tail-Coverage when a claims-made policy ends. It extends the period of coverage for incidents that happened when the policy was active. Usually costs 150-%-200% of the annual claims-made premium. • Nose-Insurance to cover prior acts. Usually needed when you leave a job where there was no tail coverage available.

9. Examples-Case One • You worked as an NP at X Primary Care. You had occurrence insurance as follows: • May 1, 2011-May 31, 2012 Insured by The Saint Paul Insurance Company • June 1, 2012-Present Insured by NSO. • Named as a defendant for an incident that happened on July 17, 2011. Who should you contact?

10. Example Two • You are an NP at Friendly Hospital’s Clinic. You have claims-made insurance as follows: • May 1, 2011-May 31, 2012 The Saint Paul • June 1, 2012-Present NSO • Who do you contact?

11. Keep in Mind…. • When you are negotiating your employment contract, discuss: • Who will pay the premiums? • Who will pay the tail when you leave or retire? • Are you covered for “outside” work? • Can you select the attorney who will represent you if a claim is filed?

12. Keep in Mind • Can you select an insurer who is different from the insurer for the practice? • Have you investigated the rating of the insurer (National Association of Insurance Commissioners- http://www.naic.org/state_web_map.htm) • If you must pay for the premiums and/or tail, can you use a payment plan?

13. Keep in Mind • Most payments on malpractice insurance are a tax deductible business expense. Check with your accountant or the IRS on how to include this on your tax return.

14. QUESTIONS?

15. Strategies to Improve Patient Care and Diminish Liability • Update policies/procedures regularly. • Primary care to increase continuity and establish rapport. • Encourage patient/significant other input.

16. NP Strategies • Document patient deviations from the norm, your interventions and PATIENT’S RESPONSE TO YOUR INTERVENTIONS. • When in doubt, “check it out”. And, go up the chain of command, if necessary.

17. NP Strategies • Chart calls or consultations and note physician response. • Use teaching materials to reinforce information you provide and chart them.