Frequently Asked Question:

How Does Tail Coverage Work When a Physician Leaves a Practice?

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Medical Malpractice

The Short Answer

Tail, or extended reporting, coverage keeps a claims-made malpractice policy open for new claims tied to care a physician provided before leaving, even after the policy or employment relationship ends. Without it, a departing physician’s past care may have no ongoing coverage under the group’s program.

The Full Answer

When a physician leaves and your malpractice is written on a claims-made basis, you must decide who will cover future claims arising from their past care under your program. Tail (extended reporting) coverage keeps the old policy open for new claims that allege incidents during that physician’s employment period, even after the policy or relationship ends. 

Key considerations for tail coverage: 

Contract obligations matter. Employment agreements should clearly state who buys tail, under what circumstances (voluntary departure, termination with or without cause, retirement), and whether cost-sharing applies. 

Multiple tail options exist. You can purchase tail from the incumbent carrier, negotiate “free” retirement tails when physicians meet age and years-of-service conditions, or place stand-alone tail if the original carrier’s terms aren’t acceptable. 

Alternatives to tail include “nose” (prior-acts) coverage, where a new carrier picks up past exposure on a new claims-made policy. This requires careful limit and retroactive-date review to avoid gaps. 

Governance and budgeting are essential. Tail costs can be significant, so many groups treat tail as a governance and capital decision, planning for it in advance rather than handling it reactively at separation. 

Liberty’s tail management expertise: Liberty helps you align contracts, carrier options, and tail/prior-acts strategies so physician transitions, mergers, and retirements don’t leave your organization or providers exposed.

Related Questions

If you’re covered under an employer’s policy, you may not need one. Many NPs and PAs buy an individual policy anyway for coverage outside work and protection the employer’s policy doesn’t give.

Only a few states require it by statute. In practice, nearly every hospital, health system and many payers require it before you can work or bill.

Usually, while you’re employed there and acting within your job duties. It typically does not cover moonlighting, volunteer work, or claims filed after you leave.

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