FAQs About Insurance

  • Do I have enough malpractice insurance?

    If you are insured through CRICO, yes.

    Physicians licensed to practice in Massachusetts are required by statute to carry professional liability insurance coverage of at least $100,000 for each claim or suit. Coverage for Harvard-affiliated physicians insured through CRICO ($5 million for each claim or suit, with an annual aggregate of $10 million) is among the highest in the country.

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  • Are CRICO physicians covered for professional services rendered outside the Harvard system?

    Yes, with some exceptions.

    Physicians, surgeons, and dentists are covered for medical malpractice for all licensed professional activities of a medical nature wherever performed. Interns, residents, and fellows are insured solely for activities performed within the scope of their formal program and approved affiliations. This specifically excludes coverage for "moonlighting." However, coverage may be extended to third and fourth-year residents and fellows for services outside the scope of their employment with the express approval of their chief of service as evidenced on the appropriate waiver form. (Most third and fourth-year residents at CRICO-insured institutions are not covered for moonlighting in non-CRICO emergency departments, for exceptions contact your risk manager.) State laws protect all physicians and nurses for "Good Samaritan" activities.

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  • Could I lose my house in a malpractice lawsuit?

    If you are insured through CRICO, it is extremely unlikely.

    If a suit is not dropped, dismissed, or settled before trial; and if a trial verdict (plus interest accrued while the case is pending) exceeds $5 million; and if a settlement negotiation of the verdict to a lower amount is unsuccessful; and if an appeal is unsuccessful; and if the verdict did not include any other physician defendants with their own policy limits to contribute; then the physician would be personally liable for the amount of the verdict above the policy limits. Thus, a CRICO-insured physician's losing his or her home is theoretically possible, but highly improbable. The risk may be higher for non-CRICO physicians with lower coverage levels.

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  • Are peer review activities by physicians (such as credentialing) covered under the CRICO policy?

    Yes.

    Services as a member of, or participant in, a formal medical accreditation or similar professional board or committee including peer review committees) of a Harvard-affiliated medical institution, other hospital, or professional society, are covered under the CRICO policy.

    Additional Resources

    1. Protecting Peer Review Information from Legal Discovery
    2. Peer Review in Practice: Carr v. Howard
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  • Are CRICO-insured physicians who self-report potential claims penalized?

    No.

    Early reporting of potential claims to the institutional risk manager and CRICO/RMF is strongly encouraged by CRICO and its insured institutions in order to mitigate or defend future claims. Individual potential claim reports are completely independent of premium rate-setting, nor are they used in any actuarial analysis for the experience rating process used to allocate the premiums among different specialties.

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  • How can I receive a copy of a CRICO insurance coverage face sheet for a physician?

    CRICO insureds, or authorized institutions can request a copy of a physician's face sheet via one of the following ways:

    • Write to:
      Underwriting Department
      CRICO/RMF
      101 Main Street
      Cambridge, MA 02142; or
    • FAX: 617.496.8671; or
    • Phone: 877.763.2742; or use
    • CRICO/RMF's Customer Service Form
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  • Does CRICO cover a staff physician's volunteer medical activities?

    Yes. CRICO-insured staff physicians are covered within the scope of their "professional responsibilities." As always, physicians should check with their sponsoring institutions, in case their institution has other policies/standards it expects its physicians to abide by.

    For more information, contact: CRICO/RMF Underwriting Department, 877.763.2742; or use CRICO/RMF's Customer Service Form.

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  • As an individual physician, can I personally apply for CRICO's medical malpractice insurance coverage?

    No.

    Coverage is not granted to individual physicians by CRICO, rather it is granted by the sponsoring institutions that participate in the Harvard Medical Malpractice Insurance Program. We suggest you review the CRICO eligibility requirements and then contact your sponsoring institution.

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  • Should CRICO-insured nurses purchase their own insurance?

    For work related to employment within their CRICO coverage, no.

    CRICO-insured institutions and entities fully cover employees, including nurses, as long as their activities are within the scope of their employment. The policy limits are the same as for CRICO-insured physicians. As with physicians, CRICO/RMF assigns attorneys to represent the interests of CRICO-covered nurses and other employees who are named as defendants in malpractice claims. For activities such as supplemental part-time employment or volunteer clinical work outside their CRICO-affiliated institution--when the outside entity does not provide insurance coverage--nurses are advised to purchase their own insurance.

    Additional Resources

    1. When A Nurse is Part of a Malpractice Claim Investigation
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  • When do conflicts with a nurse increase a physician's liability?

    Inappropriate or negligent behavior that can be tied to the responsibilities of another caregiver increase that caregiver's risk of being named in a malpractice action.

    Physicians who are actively engaged in clinical practice are always at risk for claims of malpractice based on the behavior of nurses and other employees. Nurses are rarely held legally accountable for the actions (or inactions) of their physician co-workers, but they, too, can be named in malpractice claims. Paying close attention to the following activities by other caregivers involved in your patients' care can reduce the likelihood of events leading to potential claims:

    Documentation

    • Make certain that the assessment of patient status written in the medical record matches the clinician's observations. Avoid inappropriate affixing of medical diagnostic labels to observations.
    • Review descriptions of iatrogenic injury placed in the medical record for inappropriate assignment of blame or which assign causation to iatrogenic events without supporting data such as: "burn due to electrocautery," "elevated temperature due to complications of surgery," or "low Apgar due to anoxia."
    • Seek translation of illegible medical orders which can be misinterpreted and/or misunderstood.
    • Reconcile conflicting medical orders from a variety of specialists.
    • Question apparently inappropriate medical orders.

    Communication

    • Follow up on any critical diagnostic test results which are not reported and/or noted in the medical record in a timely fashion.
    • Do not share negative, inappropriate information about a colleague with patients/staff.
    • Track patient phone calls to make certain an appropriate response is made.
    • Establish guidelines for telephone advice so that it is given with sufficient experience, protocols, and documentation.

    Supervision

    • Insist that appropriate supervision is sought by those carrying out delegated medical functions.
    • Evaluate the clinical competence of those delegated to carry out particular medical functions.

    Problems that arise in these areas which alter or disrupt patient care need to be resolved by those directly involved. Addressing interpersonal conflicts early on can avert having to face the consequences of letting them escalate into an area of potential liability.

    Additional Resources

    1. Closed Claim Abstract: Communication Among Providers
    2. Can Teamwork Enhance Patient Safety? [PDF]
    3. From Theory to Practice: An Interview with Dr. Michael Leonard [PDF]
    4. I'm a Surgeon, Not a Teammate [PDF]
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  • When do conflicts with a physician increase a nurse's liability?

    Inappropriate or negligent behavior that can be tied to the responsibilities of another caregiver increase that caregiver's risk of being named in a malpractice action.

    Physicians who are actively engaged in clinical practice are always at risk for claims of malpractice based on the behavior of nurses and other employees. Nurses are rarely held legally accountable for the actions (or inactions) of their physician co-workers, but they, too, can be named in malpractice claims. Paying close attention to the following activities by other caregivers involved in your patients' care can reduce the likelihood of events leading to potential claims:

    Documentation

    • Make certain that the assessment of patient status written in the medical record matches the clinician's observations. Avoid inappropriate affixing of medical diagnostic labels to observations.
    • Review descriptions of iatrogenic injury placed in the medical record for inappropriate assignment of blame or which assign causation to iatrogenic events without supporting data such as: "burn due to electrocautery," "elevated temperature due to complications of surgery," or "low Apgar due to anoxia."
    • Seek translation of illegible medical orders which can be misinterpreted and/or misunderstood.
    • Reconcile conflicting medical orders from a variety of specialists.
    • Question apparently inappropriate medical orders.

    Communication

    • Follow up on any critical diagnostic test results which are not reported and/or noted in the medical record in a timely fashion.
    • Do not share negative, inappropriate information about a colleague with patients/staff.
    • Track patient phone calls to make certain an appropriate response is made.
    • Establish guidelines for telephone advice so that it is given with sufficient experience, protocols, and documentation.

    Supervision

    • Insist that appropriate supervision is sought by those carrying out delegated medical functions.
    • Evaluate the clinical competence of those delegated to carry out particular medical functions.

    Problems that arise in these areas which alter or disrupt patient care need to be resolved by those directly involved. Addressing interpersonal conflicts early on can avert having to face the consequences of letting them escalate into an area of potential liability.

    Additional Resources

    1. Risk Management in the Practice of Nursing [PDF]
    2. Can Teamwork Enhance Patient Safety? [PDF]
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