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Medical Malpractice Insurance Coverage Basics


Healthcare professionals often carry some type of medical malpractice insurance to cover claims of services that result in a patient’s injury or death. 

Types of Medical Malpractice Insurance

There are two basic types of medical malpractice insurance:


With this type of policy, medical malpractice insurance will cover claims made and reported while the policy is in effect. This is the most common type of medical malpractice insurance. If a claim is made after the policy has expired, a medical provider can purchase an extended reporting period (also called an ERP or tail coverage), which provides between one to five years, or longer, to report claims resulting from acts committed before the policy ended. However, it will not cover acts committed after the policy has ended. 


This type of policy covers claims made for occurrences within the policy period, regardless of when the claim is filed, even if the policy has been canceled. 

What Does Medical Malpractice Insurance Cover?

Healthcare providers can utilize medical malpractice insurance to pay for claims related to: 

  • Care-related injuries
  • Errors in treatment
  • Misdiagnoses
  • Medication errors
  • Unnecessary surgery
  • Premature discharge from a clinic

The insurer will pay up to policy limits and will also cover expenses related to defending and settling medical malpractice claims, such as settlements, portions of awards for damages, attorney’s fees, arbitration costs, and court costs. 

Medical Malpractice Insurance Exclusions

Exclusions to medical malpractice insurance coverage include claims involving criminal acts, incidents of sexual misconduct, unacceptable changes to or unauthorized release of medical records, and acts where the insured was under the influence of alcohol or drugs. Additionally, auto accidents involving company vehicles, some medical procedures such as anesthesia, and any business owned by the healthcare practitioner that is not named as insured on the policy. 

Do All Medical Providers Have Medical Malpractice Insurance?

New York State does not legally require medical providers to carry medical malpractice insurance. Therefore, whether a medical professional has liability insurance will depend on the provider and their employer. Many general hospitals in New York require physicians to carry medical malpractice insurance if they want privileges. The liability amount required is typically $1,300,000 per claim/$3,900,000 aggregate. The aggregate limit is the total claim costs an insurer will pay for during a policy period. 

Why Medical Malpractice Insurance Matters to Patients

If you or a loved one suffers an injury or illness caused by the negligent actions of a medical professional, you may be able to file a medical malpractice lawsuit in White Plains and recover compensation for your losses. When you file a claim, it will likely be against the medical professional’s medical malpractice insurer. Your attorney will examine what type of insurance policy the medical provider has or had and work diligently to recover maximum compensation on your behalf. In the event the policy has lapsed or the provider does not carry medical malpractice insurance, you may have to look at other options for obtaining compensation. For instance, suing the medical provider personally if they have assets, or their employer.