Marsh Affinity Group Services

You Spoke. We Listened.

New features and expanded coverage added to Nurses Professional Liability Program.
By Joan F. O'Sullivan, Senior Vice President - Marsh Affinity Group Services, a service of Seabury & Smith, Inc.

Malpractice claims have always been a part of providing healthcare. But whereas charges in the past were aimed principally against doctors and healthcare institutions, today's claims cast a much wider net.

Patients who sue, and their attorneys, are now likely to name the entire healthcare team as defendants in a liability suit. The courts then decide which parties are truly liable. The process is both time consuming and costly for those professionals charged, whether at fault or not.

Many nurses think they will never personally be named in a professional liability lawsuit, and if they are, they believe their employer's coverage will provide all the protection they need. Unfortunately, this is not always the case.

Nurses are being sued today, and coverage provided by an employer may not always be adequate. The coverage limits available under an employer provided plan must often be shared by multiple parties.

When nurses carry their own professional liability protection, they are assured that the full per incident amount of coverage will be available to cover indemnities placed against them as well as providing a defense. And if an incident occurs outside an employment setting, the nurse may have no coverage under the employer's plan.

With individual professional liability coverage a nurse's protection is in force 24 hours a day. There's no interruption in coverage even during a job change or a period away from nursing duties.

Your association sponsors the Nurses Professional Liability Insurance Plan offered through Marsh Affinity Group Services, a service of Seabury & Smith, Inc., underwritten by Chicago Insurance Company. The plan offers affordable coverage to nurses nationwide and has just announced many new features and enhanced coverage levels, and, for some nursing practice areas, reduced rates as well. (Insurance is contingent upon approval by your state insurance department.)

Below are questions regarding the changes to the Nurses Plan, which are answered by Joan O'Sullivan, senior vice president of Marsh Affinity Group Services, a service of Seabury & Smith, Inc.:

Q. First of all, why have you improved one of the leading coverage plans for nurses?

A. We talked to nurses about what they felt was needed to give them better protection and greater peace of mind. They told us that they need coverage that protects them against a broad range of legal actions. In today's healthcare environment and volatile legal climate, many nurses are looking for increased security.

Q. The plan has always provided coverage for professional liability, but what other legal actions do nurses face? How have you addressed their concerns?

A. Nurses are often called to give testimony or depositions for cases in which they are not named as a defendant, perhaps as a witness to an event. Many nurses have told us that they would be much more comfortable with a legal advisor. So we have added specific new coverage. The Maginnis plan now provides reimbursement for legal counsel in giving a deposition.

We have also expanded coverage for licensing board inquiries. If a nurse is called before any entity responsible for regulating professional conduct, the plan now provides reimbursement for investigation costs or attorney fees.

Q. With the high cost of a lawsuit today, what coverage limits are available?

A. We offer a choice of professional liability limits. Most nurses choose limits of $1 million/$3 million. This provides $1 million coverage per incident to pay claims, $3 million coverage per certificate period. Defense costs are paid in addition to the limits of liability. We also offer $2 million/$4 million limits for those nurses who need increased protection. Coverage also includes supplemental liability coverage for individual nurses, equal to the selected professional liability limits.

And the plan now offers increased reimbursement for lost wages. When an insured is required by the company to attend a trial, hearing or arbitration proceeding, the plan will pay for wages lost or reasonable expense reimbursement.

Q. What about group practices? What do you offer them?

A. In addition to the professional liability limits I just mentioned and the new and expanded reimbursement features, we now offer separate annual aggregate limits for each professional member of an insured group. We are also offering optional entity coverage, which provides separate limits of liability for the entity, equal to those selected for the professional members.

Q. How have you addressed the Managed Care environment?

A. For both self-employed nurses and group practices, we have now specifically addressed Managed Care contracts in the certificate. If an insured assumes liability in a contract, they will be covered for negligent acts for which they are solely responsible.

Q. Have you added any other features or increased coverage?

A. Yes. We have added a new leave of absence option for nurses who are away from their duties between 30 days and 6 months. The plan also has added locum tenes coverage that provides coverage when another professional temporarily assumes the nurse's duties for a specific period of time.

We have increased reimbursement for first-aid expenses. When an insured provides emergency care, the plan now provides increased reimbursement for medical supplies.

And we have increased assault coverage limits and now cover travel to and from the workplace. This feature applies to all insureds, whether employed, self-employed or part of a group practice.

Q. How about good Samaritan Acts? Are they covered?

A. Yes. The certificate language has been clarified to clearly define coverage provided to an insured in the course of providing good Samaritan aid.

I might also add that the certificate language has been clarified concerning limits and exclusions with respect to professional liability and supplemental liability coverage.

Q. Okay. I'm sure everyone is saying the coverage sounds great, but don't these new features drive up the cost? Is coverage now more expensive?

A. Actually, no. Rates remain the same for most nurses and in fact, with some practice areas, we have been able to reduce premiums. Our rates are based on the field of practice of an inured and the loss experience within that group.

We also now offer a part-time premium credit for those nurses who work 20 hours or less a week. And we have added a new premium credit for group practices, ranging from 4% to 12% depending on the number of professionals insured.

And nurses who participate in an approved risk management program or seminar, or who are certified by specific certifying entities, earn a 10% premium credit.

Q. How can nurses find out more about the plan?

A. Simply call our Customer Service Center toll-free at 1-800-503-9230. Our service representatives can answer specific questions and send enrollment materials by mail. We encourage all nurses to compare the new Marsh plan to their current coverage. And we urge any nurse who does not have coverage or is unhappy with his or her plan upon renewal to enroll in the Marsh plan right away. The costs and consequences of a professional liability lawsuit can be a financial hardship, but the Marsh plan can provide valuable protection and peace of mind.