Most base malpractice policies exclude coverage for State Board licensing actions, audits, sexual misconduct claims, and criminal prosecution. No malpractice carrier can cover you for criminal actions or criminal prosecutions because coverage of such actions is prohibited by law.

But many malpractice companies will add other types of coverage for conduct by a specific endorsement and that can cover you for your defense costs. It will not cover you for any money that may need to be paid to the other side to resolve the claim.

Usually, these endorsements also have a sub-limit. Thus, instead of having coverage up to the full limits of your policy, you will only have coverage for somewhere between $5,000.00 and $30,000.00, depending upon your malpractice insurance company.

Coverage for Manipulation Under Anesthesia Most malpractice carriers will cover a chiropractic doctor for this at no additional charge. This tends to be more of an underwriting issue than a coverage issue. Most malpractice carriers are primarily concerned with the level of training of a chiropractic doctor and where the manipulation under anesthesia ("MUA") is performed. Most malpractice carriers will want the facility in which the MUA is performed to be accredited by either the Joint Commission on Accreditation of Healthcare Organizations, the American Association for Accreditation of Ambulatory Surgery Facilities or the Accreditation Association for Ambulatory Healthcare.

As to training, most malpractice carriers will want proof of training either from an accredited chiropractic college or for the National Academy of MUA Physicians. When MUA coverage is granted, there typically is no lower sub-limit. Most malpractice carriers will want an Informed Consent form, and require that you (a) obtain second opinions before performing MUA; (b) use a physician anesthesiologist or a Certified Registered Nurse Anesthetist for anesthesia.

Issues to Consider When Switching Malpractice Carriers

The obvious thing that everyone looks at when switching malpractice carriers is the cost of the insurance and the policy features. The policy features are discussed above and tend to be fairly similar. One thing that is not always as obvious is that if you have claims made coverage and either do not have or do not qualify for convertible claims made protection, you will need to get a tail when leaving one carrier and going to another carrier. These can sometimes be quite pricey. One thing to keep in mind is that the carrier that you are leaving may charge quite a bit of money for your tail, and the malpractice insurer that you want to go with may be willing to provide it at less cost or at no cost in order to get your business.

In many respects, retiring is the same issue as switching carriers. If you have occurrence coverage or a convertible claims made coverage for five years, you simply can let your policy elapse. If you have claims made coverage with no convertible claims made option, make sure that you purchase tail coverage before you retire so that claims that come in after you have retired will still be covered.

Cost comparison is never precise, but a bit of shopping, armed with this information, should save you money and get you the peace of mind that quality insurance is supposed to offer.