Malpractice Insurance Rate Increases

Our thanks to past Professional Issues Committee Chair Linda Carlson, MS, RN, CPNP for providing the answer to this question.

Question: I recently received my renewal application for my malpractice insurance and was shocked to see that my premium had more than doubled. I have never had any claims against me. Can you tell me anything about this?

Answer: NAPNAP has been receiving some calls and e-mails about this issue. In checking around, we have found that some of the insurance companies have raised their premiums and that others are contemplating doing so. NAPNAP is investigating the reasons for these increases in premiums and we will keep you informed as to what is happening in this area. We have hosted an online survey for members to find out more about these issues. To view the results of the Malpractice Survey please click here. In the interim, it would be wise to shop around to compare premiums, as there is variability in rates. Include malpractice coverage in your contract negotiation package so that you will not have to pay this expense out of your won pocket. Also, it is prudent to carry individual coverage and to never let your coverage lapse. When looking for a policy, it is important to know what type of coverage your policy includes. There are many different options and benefits. For a glossary of terms related to malpractice, see http://www.camedicalmalpractice.net/glossary.htm.

We are all aware of the skyrocketing malpractice premiums that physicians are having to pay and the fact that it places many in a difficult financial situation. Be assured that NAPNAP is being vigilant about NP malpractice premium increases and our Washington Representative Allison Shuren from Arent Fox is monitoring this issue. We are also working with other organizations, including the ACNP to address this concern.

Cathryn Wright, MSN, RN, CFNP suggests that PNPs write a letter or ask for an official complaint form to report an "excessive rate increase" to the state insurance commission if your malpractice premium increases. In this letter or on the complaint form, suggest that the insurance commission request accounting of the actuarial data that supports the requested increase from the insurance company. If the insurance company can show from their data that there has been an increase of costs to them because a larger number of PNPs in your state are losing law suits (or costing them in settlements), they may be able to show the need for the increase. If they cannot show any such data (or choose not to because they want to keep their data confidential) this may result in a lower rate increase. The insurance commission must approve rate increases above a certain percent in many states and by sending them a letter or formal complaint, they may find that the increase is larger than the state law or rule allows. This is therefore considered "excessive" and gives you the right to ask for actuarial data to help determine if the requested increase is valid or not.

We do need to hear from you to let us know what is happening with malpractice premiums and claims against PNPs in your area. Please contact Rosemary Liguori or Dolores Jones at info@napnap.org for more information.