Frequently Asked Questions – Emergency Medicine Malpractice Insurance

• How much does malpractice insurance cost for emergency medicine physicians?

  The cost of emergency medicine malpractice insurance varies greatly depending on your scope of practice and locality, with premiums varying widely based on state and practice details. High malpractice costs contribute to workforce and retention concerns in emergency medicine, which is one reason professional societies advocate liability reforms. Working with Cunningham Group’s brokers who have access to every major carrier can help you save money by finding the best-suited policies for your unique needs at the lowest cost.

  Cost Comparison Examples:
  

  • Low-Liability States (e.g., MN, WI, VA): $8,000 – $18,000

  • Moderate-Liability States (e.g., CA, CO, MI, TX): $18,000 – $32,000

  • High-Liability States (e.g., FL, PA, IL, NY): $35,000 – $70,000+

  • Pediatric EM / Urban Level 1 Call Coverage: $60,000 – $110,000+

• Why is emergency medicine considered a high-risk specialty for insurance?

  Due to the nature of its practice, emergency medicine is considered a high-risk specialty with patient encounters that are short, cases that are diverse and unpredictable, and no chance to establish consistent patient relationships. Together, these factors contribute to higher rates of malpractice claims against emergency medicine physicians.. The specialty requires quick thinking and diligence in treating everything from life-threatening incidents to common ailments, creating multiple opportunities for liability.

• What Illinois study findings affect emergency medicine premiums?

  A study published in The Journal of Emergency Medicine examined malpractice cases in Illinois and found the average indemnity was more than $200,000, with cases involving infants under one year taking the longest to resolve and resulting in the highest indemnity payments. These high indemnity payments and extended resolution times for pediatric cases contribute to the elevated premiums emergency physicians face. Understanding these risk factors helps explain why emergency medicine carries higher insurance costs than many other specialties.

• Can emergency physicians reduce their malpractice insurance costs?

  Yes, emergency physicians can reduce premiums by qualifying for discounts if they are new to practice, have not had recent claims, or complete online risk management courses with their carrier. Additional savings come from working with brokers who shop coverage to every major malpractice insurance company, as agent commissions are already included in premiums, whether you purchase directly or through a broker. Supporting tort reform efforts through professional societies may also help reduce long-term premium costs industry-wide.

• What specific risks does emergency medicine malpractice insurance cover?

  Emergency medicine malpractice insurance covers the diverse range of situations ER physicians face, from major life-threatening incidents like car accidents and heart attacks to common conditions like flu and accidental injuries. Coverage protects against claims of missed or mistaken diagnosis (particularly chest pain, abdominal pain, and fractures), failure to acknowledge symptoms, premature discharge, failure to admit, and delayed testing or treatment. The policy covers defense costs for lawsuits related to these claims, protecting both career and finances.

• Why are diagnosis-related claims so common in emergency medicine?

  Missed or mistaken diagnosis, particularly for chest pain, abdominal pain, and fractures, are among the most common causes of emergency medicine malpractice claims. The short patient encounters, diverse and unpredictable cases, and inability to establish consistent relationships make accurate diagnosis challenging in the emergency setting. Combined with time pressures and high patient volumes, these factors create significant diagnostic error risk requiring robust coverage.

• Do emergency physicians need special coverage for pediatric cases?

  While standard emergency medicine policies cover pediatric cases, the Illinois study showing cases involving infants (under one year) are associated with the highest indemnity payments and the longest resolution times, highlighting this elevated risk.Emergency physicians should ensure adequate liability limits given the potential for high-value pediatric claims with extended resolution times. Discuss with your broker whether your coverage limits adequately protect against catastrophic pediatric emergency cases.

• What coverage options are available for emergency physicians?

  Emergency docs can buy both claims-made and occurrence coverage, with the choice depending on career stage and practice stability. Claims-made policies are initially less expensive but require tail coverage when changing jobs or retiring, while occurrence policies cost more upfront but provide permanent coverage. Consider your employment situation, likelihood of changing positions, and long-term career plans when selecting policy type.

• What are the most common causes of emergency medicine litigation?

  Common litigation causes include missed or mistaken diagnosis, failure to acknowledge all symptoms, discharging patients too early, failure to admit to hospital, failure to consider patient medical history, and delayed testing or treatment. These errors often stem from the challenging emergency environment with time constraints, high patient volumes, and limited information about patient history. Implementing systematic approaches to patient evaluation and documentation helps minimize these risks.

• How can emergency physicians manage risk in high-pressure situations?

  Effective risk management includes developing systematic evaluation protocols for common presentations like chest pain and abdominal pain, ensuring thorough documentation despite time pressures, and implementing clear discharge instructions with return precautions. Consider completing risk management courses offered by carriers for both education and premium discounts. The inability to establish patient relationships makes clear communication and documentation even more critical for defending potential claims.

• What role does medical history play in emergency medicine liability?

  Failure to take patient medical history into account is a specific litigation cause for emergency physicians, despite the challenging circumstances of obtaining complete histories in emergency situations. Document efforts to obtain history, including when patients are unable or unwilling to provide information, and clearly note any history limitations affecting clinical decisions. Electronic health records that provide access to previous visits can help mitigate this risk when available.

• How does the application process work for emergency medicine malpractice insurance?

  You submit information through a secure quote form or call to speak with an agent immediately, after which a veteran emergency medical malpractice insurance broker is assigned to your case. Your broker shops your Emergency Physician Malpractice Insurance to every major malpractice insurance company, taking time to explain all options to ensure you make the right decision. At renewal, the shopping process repeats with quotes from all major companies to ensure proper pricing, with this service costing you nothing.

• Why is understanding employment situations important for ER physicians?

  Emergency medical physicians practice across a wide variety of settings and specialties, with states varying in rules and regulations, making it important for agents to understand your unique practice and employment situation. Hospital-employed physicians may have different coverage needs than those working for staffing companies or as independent contractors. This understanding helps brokers find the most appropriate emergency doctor malpractice insurance policy to ensure adequate coverage.

• Should emergency physicians support tort reform efforts?

  Emergency physicians concerned about high malpractice costs should support their professional societies’ tort reform efforts, as research suggests tort reform legislation may help reduce liability pressures and support physician supply. The American College of Emergency Physicians maintains a medical liability reform position statement recommending limits on non-economic damages, joint liability reforms, structured payments, reduced statutes of limitations, and attorney fee limits. Visit the ACEP website to learn how to get involved in advancing these reforms.

• How does shift work affect emergency medicine malpractice coverage?

  Emergency physicians who work shifts at multiple facilities, moonlight, or take locum tenens assignments should confirm their policy (or employer’s policy) explicitly covers those settings; separate coverage or endorsements are often required. Ensure your policy covers the 24/7 nature of emergency practice and any locum tenens or per diem work you perform.

• What about emergency physicians leaving the specialty?

  High malpractice premiums are driving many physicians out of emergency medicine, with the possibility of a shortage becoming a serious issue for the healthcare system. Physicians leaving emergency medicine need tail coverage to protect against claims from their ER practice, which can be particularly expensive given the high-risk nature of the specialty. Those transitioning to lower-risk specialties may see significant premium reductions in their new practice area.

• Do emergency physicians need different coverage in different states?

  States vary in rules and regulations for emergency medicine practice and malpractice insurance requirements, making location a critical coverage consideration. Premium variations between states can be substantial, with tort reform states generally offering lower rates than those without damage caps. Emergency physicians working in multiple states through locum tenens or telemedicine need to ensure coverage in each jurisdiction.