A Brief Overview of Restrictions of Professional Indemnity Insurance For Healthcare Professionals

Insurance companies providing professional indemnity insurance for nurses control the potential risks involved by determining the limits of their coverage in the insurance policy. These limits set the parameters they use to find out whether an indemnity claim is applicable. The insurer is not going to cover claims that fall beyond these limitations. Careful scrutiny of this part of the insurance policy is vital in order to become aware what may be expected of an insurer in the event a claim is filed.

Most limitations are stated clearly in the contract. For instance, there are policies that indicate the amount of money that may be claimed in order to cover the liability. Because court proceedings are integral to professional indemnity, policies also include provisions regarding a legal representative during investigations, questions from professional nursing association disciplinary bodies, recognized court enquiries, and other similar situations which have bearing on the claim.

Insurance coverage limitations should be made to fit the particular nursing discipline a nurse is in. The claims that an operating room nurse may face will be very different from those that are for a nurse in pediatrics. A comprehensive policy can thus offer too much coverage in certain areas and too little coverage in others.

Some limits, however, are embedded within the definition of the stipulations being used. A good example of this is the term “prior known fact". Most policies covering professional indemnity insurance for nurses use this term in relation to covering certain claims even if the claim is made after the required period. They do so if the situation from which liability and indemnity arise is considered a prior known fact. This phrase implies that if the situation was something the insurer was officially informed of during the period of coverage, they might be able to cover claim. There are of course very certain clauses that define what would constitute as a prior known fact.

What is advertised by a business as professional indemnity insurance for nurses may appear to fit the needs of a professional when managing the risks involved in working. However, it is the wording of the insurance policy that can determine whether this is indeed the case. Before agreeing to some policy, a careful study of its wording should be carried out in order to make sure that what is advertised fits what is needed.


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