Surprising Findings from the Nurse Practitioners Claim Report

In the Nurse Practitioners Claim Report, NSO and CNA review and analyze malpractice and licensing claims to help NPs understand their areas of greatest vulnerability. Included within the report are CNA’s loss control recommendations on how to avoid what can be a very stressful experience.

Over $69 million was paid for malpractice claims over a 5-year period by CNA, the underwriter of the NSO Nurse Practitioner Professional Liability Program. Another $1.4 million was paid to help defend 240 license complaints made against NPs over the same study period. 

Armed with the knowledge gained from the Report, NPs can reduce their risks of potential litigation and take steps to help improve patient outcomes.

Here are the top 10 findings from the report: 

  1. Nurse practitioner malpractice claim costs on the rise. The average cost of a NP malpractice  claim is $300,506. That’s an increase of over 5% from 2012 to 2017. 
  2. Patient death remains the most common injury (44.9%) that results in a malpractice claim. Addiction is the second most frequent injury and grew almost tenfold (1.0% to 9.5%) since the last report. 
  3. The average cost of permanent disability claims ($496,921) are double that of death claims ($232,277) due to medical and social support these patients require for the rest of their lives. 
  4. NPs specializing in adult medical/primary care and family practice account for 53.7% of malpractice claims. Adult medical/primary care experience the most frequent claims, followed by behavioral health (15.3%) and gerontology (11.9%). 
  5. 65.3% of NP malpractice claims occur at 3 locations: physician office practices (35.9%), NP office practices (16.4%) and aging service facilities (13.0%).  
  6. Allegations related to diagnosis are the most frequent (32.8%) malpractice allegation asserted against NPs, followed by allegations related to medication errors (29.4%) and improper treatment and care (22.3%). 
  7. Malpractice claims related to medication prescribing rose from 16.5% of NP claims in the 2012 study to 29.4% of claims in the current study. The increase is in part due to allegations related to the improper prescribing of opioids.  
  8. The number of license defense claims increased by 80% since the last report. 240 licensing actions were paid over a 5-year period compared to 133 in the previous 5-year study. 
  9. Average cost to hire an attorney to defend a licensure complaint rises to $5,987. This is a 34.8% increase over the last 5-year study ($4,441). 
  10. The majority of license complaints (27.1%) made against NPs involve medications. Complaints involve over-prescribing of controlled substances, as well as failure to explain potential side effects.

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Frequently Asked Questions

You have questions. We have answers. (It's why we're here.)

What kinds of activities might trigger a disciplinary action by a licensing board or regulatory agency? 

The fact is anyone can file a complaint against you with the state board for any reason—even your own employer—and it doesn’t have to be solely connected to your professional duties. All complaints need to be taken seriously, no matter how trivial or unfounded they may appear. 

How does a shared limit policy work?

A shared limit policy is issued in the name of your professional business or company. The policy provides professional liability insurance coverage for the business entity named on the certificate of insurance and any of the employees of the business entity, provided they are a ratable profession within our program. Coverage is also provided for locum tenens professionals with whom the business entity has contracted for services the locum tenens performs for the business entity.

The business, and all eligible employees and sub-contractors you regularly employ, will be considered when determining your practice’s premium calculation and share the same coverage limits you select for the business.

We have a shared limit policy. Are employees covered if they practice outside our office?

The policy covers your employees outside the office as long as they are performing covered professional services on behalf of your business.

If your employees are moonlighting, either for pay or as a volunteer, they should carry an individual professional liability insurance policy to cover those services. Otherwise, they might not be covered for claims that arise out of these activities.

There are plenty more where those came from.

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