Every year, more than 40,000 physicians provide locum tenens services in hospitals, clinics, and other facilities in the United States. Locums assignments are popular for the increased flexibility and earning potential they can offer, but they also bring new challenges. The temporary nature of the work, in unfamiliar environments with varying systems and processes, may affect physicians’ exposure to medical malpractice claims.
Locum tenens medical malpractice insurance helps protect physicians and practices from liability in the event a patient claims to have been harmed by a locum’s negligence. This blog post will explain locum tenens malpractice coverage so you can determine if it’s right for your medical practice.
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A Latin phrase, “Locum tenens” means “one who holds the place of another.” In healthcare, it’s used to refer to temporary work assignments. A locum tenens physician is someone who fills in for another physician in a healthcare facility.
Typically, physicians find locum tenens assignments through healthcare staffing agencies. These temporary assignments vary in length, from as short as a few shifts to as long as a year or more. The physician works as an independent contractor, rather than an employee.
Every year, 90% of U.S. healthcare facilities use locum tenens physicians to fill gaps in their workforce and ensure patients receive the care they need. There are many reasons why healthcare facilities need locums, but common reasons for staffing gaps include:
Locum tenens arrangements offer benefits for both healthcare facilities and physicians. For the facilities, filling staffing gaps with locums is a way to prevent revenue loss, ensure patients receive necessary care and take pressure off existing staff. For physicians who work locum tenens, the assignments offer supplemental income, flexible scheduling and the opportunity to gain new experience.
Of course, locum tenens arrangements are just as beneficial for patients. By filling in for absent physicians, locum tenens physicians help ensure patients have access to the care they need, when they need it.
Medical malpractice insurance is a type of professional liability insurance for physicians, physician assistants, nurse practitioners and other healthcare organizations. It helps protect your finances in the event a patient claims your actions (or inactions) caused them harm.
Medical malpractice insurance helps cover the costs of defending malpractice suits, and if you’re found liable, it also helps pay for damages, up to the policy limits. Limits are often written as two numbers, for example, $1 million/$3 million. The first number is the maximum amount the policy will pay per claim. The second number is the maximum amount the policy will pay during the policy period.
Physicians who already have medical malpractice coverage in place aren’t necessarily covered for locum tenens assignments. The policy from one job, whether it’s from an employer or purchased independently, may not apply to outside patient care. Separate locum tenens malpractice coverage may be required.
For physicians who work with healthcare staffing companies, locum tenens malpractice coverage is typically provided for the length of the assignment. Often, the staffing company also covers tail coverage. However, physicians who arrange locum assignments directly with facilities will typically be responsible for purchasing their own coverage.
Whether you buy locum tenens insurance on your own, or receive it from a healthcare staffing company, having adequate coverage in place is crucial while working as a locum tenens physician. Locum tenens malpractice insurance helps you protect:
There are two basic types of medical malpractice coverage: occurrence policies and claims-made policies. There are also policies that cater to the unique needs of various medical specialties, and reporting period extensions. Understanding the common types of policies helps physicians choose adequate coverage for their locum tenens work.
An occurrence medical malpractice policy offers coverage for alleged incidents that occur during the policy year, regardless of when the claim is filed. Even years after an occurrence policy has expired or been canceled, it continues to provide coverage for events that occurred while the policy was active.
For example, imagine a physician purchased an occurrence medical malpractice policy on Jan. 1, 2015, and ended coverage on Dec. 31, 2015. In 2025, a patient filed a medical malpractice lawsuit for an alleged incident that took place during 2015. Even though the policy is long expired, it will still respond to the 2015 incident.
Occurrence policies have several benefits for locum tenens providers. They offer long-term protection against claims, even after the policy has expired. They’re relatively simple to understand, and enable physicians to switch jobs or assignments without worrying about creating a gap in coverage.
Most medical malpractice policies are written on a claims-made basis. A claims-made policy offers coverage for claims made while the policy is in effect, so long as the claims arise from incidents after the policy’s retroactive date.
Once a claims-made policy expires, it will not respond to claims, unless you have tail coverage. Tail coverage extends the reporting period for an expired policy and protects claims that aren’t reported until after the policy ends.
For example, imagine a physician purchased a claims-made policy on Jan. 1, 2011, renewed it annually, and let it lapse on Dec. 31, 2022. In 2023, a patient files a medical malpractice lawsuit related to an incident in 2020. If the physician doesn’t have tail coverage, the policy will not respond to the claim, even though it was in effect at the time of the incident. But, if they have purchased tail coverage, the policy will respond.
Medical malpractice coverage is not one-size-fits-all. The risk of facing a medical malpractice claim varies widely across specialties. Many insurance providers offer tailored coverage based on the unique needs and risks of each specialty.
For example, locum tenens anesthesiologists, general surgeons, obstetricians/gynecologists, and those working in locum tenens emergency medicine have some of the highest rates of medical malpractice suits due to the inherent risks of their procedures. A policy tailored to their needs may offer higher limits per claim or specialized risk management programs.
Locum tenens physicians in higher-risk specialties may appreciate the more tailored protection available from specialty-specific policies.
An extended reporting period (ERP) is an optional feature of a claims-made medical malpractice insurance policy. It’s commonly known as tail coverage. An ERP or tail extends the reporting period for the policy, making it possible for locum tenens physicians to report claims that are made after their policy expires or is canceled.
Depending on the policy, physicians may have the option to purchase an ERP before their policy expires, or within a certain time frame following the policy’s expiration. ERP term lengths vary, from as short as one year to an unlimited term. Locum tenens physicians should consider the statute of limitations that applies to their assignment when choosing a term length.
Locum tenens assignments give physicians the opportunity to explore different parts of the country, but working in a new state doesn’t just mean new things to do and see — it also means different laws and regulations to follow, especially when it comes to medical malpractice insurance.
Medical malpractice insurance laws are set on the state level, so the amount physicians are required to carry for a locum tenens assignment varies. For example, physicians working locum tenens in Connecticut must have a policy with at least $500,000/$1.5 million in coverage, while in Colorado, the minimum required coverage is $1 million/$3 million.
Some states operate patient compensation funds that offer coverage over and above a physician’s primary medical malpractice policy, but physicians must maintain a certain amount of coverage to participate. For example, Nebraska’s patient compensation fund provides a malpractice cap of $2.25 million, but only if physicians have a policy with at least $500,000/$1,000,000 in coverage.
Beyond the minimum required amount of medical malpractice insurance, there are other state-specific nuances to be aware of when working locum tenens assignments. Many states have passed tort reform laws that affect the risk of litigation from patients, such as:
Consider seeking advice from a healthcare attorney to learn about state-specific medical malpractice laws and nuances that might affect your locum tenens assignment.
Risk management is the process of reducing the likelihood of a medical malpractice claim, and if a claim cannot be avoided, reducing its impact. Medical malpractice insurance is crucial on both fronts.
In the event a patient files a lawsuit, medical malpractice insurance helps reduce the impact by handling the claim. It helps pay for the costs of legal defense, and if necessary, the costs of settling the case.
Some medical malpractice providers offer physicians access to risk management advice that helps physicians prevent harm and navigate unexpected events. Some examples of risk management practices that may be recommended to locum tenens physicians include:
Locum tenens physicians work temporary assignments in healthcare facilities, and the short-term nature of this work offers unique challenges. Unfamiliar environments, processes and patient populations may affect the locum physician’s medical malpractice exposure.
When working locum tenens positions, physicians must ensure adequate medical malpractice coverage during each placement and after the assignment ends. This coverage protects against claims arising from a physician’s actions while working locum tenens.
Indigo is a new medical professional liability insurance platform. We use proprietary technology to offer real-time quoting and pricing that accurately reflects your individual risk. Our robust medical malpractice coverage includes complimentary access to a risk management helpline for all of your locum tenens-related questions.
Image by Mario Arango from iStock.
