Claims-made, occurrence, and the gap between jobs
Medical malpractice insurance is commonly written in one of two forms. An occurrence policy responds to care given while it was in force, whenever the claim arrives, while a claims-made policy generally responds to claims first made and reported while it is active. That difference becomes very real when a clinician changes employers, retires, or a group changes carriers, because a claims-made policy may leave earlier care uncovered unless tail coverage or prior-acts coverage fills the gap. Who pays for that tail is often settled, or left unclear, in an employment agreement. Read that clause before you resign rather than after.
When something comes in
A records request from a law firm, a letter of intent, a subpoena, or a summons should usually be reported to your carrier promptly, and most policies spell out how. Late notice can give an insurer grounds to dispute coverage, so holding a letter while you decide whether it is serious is a risk rather than a precaution. Do not alter or add to the chart after the fact, and do not contact the patient about the claim. The carrier will typically appoint defense counsel, and it sometimes sends a reservation of rights letter saying that parts of the claim may not be covered. That letter is worth a separate read by someone who works for you rather than for the carrier.
Questions a policy may not answer
Coverage for a licensing board investigation, a hospital privileges dispute, or a billing audit is frequently limited or written separately, and those limits can be lower than people assume. Some policies give the insured a say before a claim is settled, while others leave that decision largely to the carrier. The difference matters because payments made on a practitioner's behalf are generally reported to the National Practitioner Data Bank, which credentialing bodies consult. When personal assets or uninsured exposure could be at stake, separate counsel can be worth considering alongside the lawyer the carrier provides. In a first conversation we read the declarations page, the policy form, and any carrier letters with you, and explain what the documents appear to cover and where the open questions sit.
