Professional Liability Insurance – Chapter 10 – Flashcards
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certificate of insurance
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a document that alerts the nurse to specifics about the institution's policy and assists the nurse in knowing what type of coverage he or she needs to secure in an individual policy
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claims-made policies
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provide coverage only if the claim for an injury that has occurred is filed with the courts and is reported to the insurance company during the active policy period or during an uninterrupted extension of that policy period
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coverage agreements
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outline the types of claims that will be covered by a given policy
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coverage conditions
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outline the insured nurse's duties to the insurance carrier in the event a claim or lawsuit is filed, provisions for cancellation of the policy, prohibition of assignment of the policy, and subrogation of rights
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coverage extensions
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outline additional protections that a policy afford the policyholder, such as license protection, including representation before a board of nursing during a disciplinary hearing or proceeding or legal representation at a deposition hearing
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covered injuries
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outlines the types of injuries and provisions that the insurance company will honor
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declarations
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First part of the policy which includes: policyholder's name, address, covered professional occupation (e.g., general staff nurse, advanced family nurse practitioner, or emergency center staff nurse), and the covered time period
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deductibles
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any amounts that the insurance carrier deducts from the total amount available to pay for plaintiff damages
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defense costs
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include all reasonable and necessary costs incurred in the investigation, defense, and negotiation of any covered claim or suit
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employer-sponsored coverage
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obtained by institutions, it is perhaps the narrowest of coverage for individual nurses because they must first show that they are practicing within the scope of their employment and within the scope of professional nursing practice
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exclusions
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items not covered in the insurance policy
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indemnity
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claims that are brought by the employer for monetary contributions form the nurse or nurses whose actions or failure to act caused the original patient injury
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insurance policy (insuring agreement)
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a formal contract between the insurance carrier and an individual or corporation
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licensure protection
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coverage which gives nurses a choice to have nurse attorneys represent them should a case come before the board of nursing
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limits of liability
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describe the limits to what the insuring agency will pay for a single claim and for the length of the policy period (e.g., $500,000 each claim, $1,000,000 aggregate)
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occurrence-based policies
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cover the nurse for any injuries arising out of incidents that occurred during the time the policy was in effect
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policy period
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dates for which the policy was in effect
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policyholder
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the insured party who pays the monthly premium
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professional liability insurance
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protects nurses against lawsuits that arise from real or alleged errors or omissions, including negligence, in the course of delivering nursing care in clinical settings
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reservation of rights
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section of the policy which states that the insurer reserves the right to deny coverage when an exclusion is discovered
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supplementary payments
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include provisions for additional payments to the insured party
