Malpractice and business insurance - The Practice Owner's Guide

Malpractice: the one decision that matters

Malpractice policies come in two shapes, and the difference only shows up when you leave:

Type	Covers	The catch
Occurrence	Any incident that happened while the policy was active, forever	20-40% pricier; nothing owed at exit
Claims-made	Claims filed while the policy is active	Cheaper now, but leaving requires tail coverage, often 1.5-3x the annual premium, in one check

If you take claims-made (most groups do), negotiate the tail up front: who pays it if you leave an employer, and whether the insurer offers free tail at retirement. When hiring associates, decide the tail question in the employment agreement, not at departure (comp models). Buy limits your state and hospitals expect (commonly

1M per claim /

3M aggregate), check for consent-to-settle language (can the insurer settle without you?), and make sure the entity is a named insured, not just the clinicians. In MSO/PC structures, the PC carries malpractice; the MSO carries its own liability policies.

The rest of the stack

Policy	Why
General liability	Slip-and-fall; landlords require it before keys
Property / BOP	Equipment and contents; a BOP bundles GL + property cheaply
Workers’ comp	Legally required with employees in nearly every state
Cyber liability	Breach response for a PHI-holding business; often required by partners
EPLI	Employment claims (wrongful termination, harassment); underrated for small practices
Business interruption + disability	Replaces income when the practice or the owner can’t work; overhead-expense disability specifically keeps the practice alive

Buy through a broker who does healthcare, revisit at every renewal, and keep certificates current in CAQH, an expired COI silently stalls credentialing.