Malpractice Coverage for a PT Working in Several States

Professional liability coverage is easy to forget when licensing is going well. The privilege issues, the employer is ready, the first patient is scheduled. The malpractice policy, meanwhile, may have been written around a single state and a single job, and nobody has told the carrier anything has changed.

Notify the carrier before the first patient

A policy's declarations and terms often describe where and how you practice. Some policies are limited to certain states or settings. Adding a state by license or privilege, starting telehealth with patients in another state, or picking up per diem work elsewhere can all fall outside what the carrier understood when it priced your coverage.

Before treating anyone in a new state, contact the carrier or broker. Ask whether that state is covered, whether an endorsement is needed, and whether the premium changes. Get the answer in writing and keep it with your credentialing records.

Occurrence and claims-made in plain terms

An occurrence policy covers incidents that happen during the policy period, regardless of when a claim is eventually filed. If you leave that policy, work you did while it was in force stays covered.

A claims-made policy covers claims that are made while the policy is active, generally for incidents after a retroactive date. If the policy ends, a claim filed later about earlier work may not be covered unless you have tail coverage, sometimes called an extended reporting endorsement, or a new policy that includes prior acts coverage. Terms vary by carrier, so read yours and ask questions about anything unclear.

Gaps during relocation

Moves and job changes are where coverage quietly breaks. A therapist leaves an employer whose claims-made policy covered them, starts a travel assignment in a new state, and assumes the new employer's policy reaches backward. It may not. A therapist who carries an individual policy may let it lapse between jobs for a few weeks and treat a friend in the meantime.

Before the old coverage ends, confirm its type and what, if anything, you need to arrange. Make sure the new coverage starts no later than your first day of practice and lists every state where you will work.

Keep copies of every policy you have held, with its dates and type. If a question about past care ever comes up, you will need to know which policy was in force and whether it responds.

Employer coverage has limits

Many employed therapists are covered under the employer's policy. Ask for specifics: whether you are named or covered as an employee, which states and settings apply, what the limits are, and what happens to coverage for your past work when you leave. Some therapists carry an individual policy in addition. Whether that makes sense is a question for a broker who can read both policies.

Board complaints in more than one state

Practicing in several states means more than one board could receive a complaint about your care. Ask your carrier whether the policy includes coverage for defending a licensing board matter, whether that coverage applies in every state you hold, and what its limits are. Employer policies often focus on malpractice claims and may not help with a board inquiry directed at you personally.