What Nurse Practitioners Should Know About Tail Coverage

What Is Tail Coverage?

Tail coverage, also known as an extended reporting endorsement, protects you after your claims-made policy ends. It allows you to report and be covered for claims that arise from incidents that happened while your policy was active, even if the lawsuit is filed later.

Here’s a simple way to think about it:

If your malpractice insurance was active from 2021–2024 and a patient files a claim in 2025 for care you provided in 2023, you’d need tail coverage to stay protected.

Without it, that claim could leave you completely uncovered.

Claims-Made vs. Occurrence-Based Coverage

To understand tail coverage, you first need to know which type of policy you have.

• Claims-Made: Covers claims only if the incident and the lawsuit happen while the policy is active.
  • Do you need tail coverage? Yes, when you cancel or change policies.
• Occurrence-Based: Covers incidents that happen during the policy period, regardless of when the claim is filed.
  • Do you need tail coverage? No, tail coverage isn’t needed.

Most nurse practitioners have claims-made policies because they’re typically more affordable, but that means you’ll need tail coverage if you change employers, switch insurers, retire, or go out on your own.

Why Tail Coverage Matters for Nurse Practitioners

As an NP, you make critical clinical decisions every day. Even years later, a patient could claim injury or negligence from an encounter long past.

Tail coverage ensures:

• Continuous protection even after your policy ends
• Legal defense and settlement coverage for post-policy claims
• Peace of mind when switching jobs, insurers, or practice types

Without tail coverage, any future claims tied to your past work could become your personal financial responsibility.

When You May Need Tail Coverage

You should consider purchasing tail coverage if you:

• Change employers or move to a new practice
• Switch insurance carriers (unless your new carrier provides “prior acts” coverage)
• Retire or take a career break
• Start your own practice or begin consulting independently
• End a claims-made policy for any reason

Pro Tip: Always confirm with your employer whether they provide tail coverage when you leave. Many group policies require you to buy it yourself.

How Much Does Tail Coverage Cost?

The cost of tail coverage varies, but it typically ranges from 150%–250% of your annual premium. For example, if your annual malpractice premium is $1,000, your tail coverage could cost $1,500–$2,500.

Factors affecting cost include:

• How long you’ve been insured under the current policy
• Your specialty and claims history
• The policy limits and the carrier’s pricing model

Good News: Tail coverage is usually a one-time purchase that lasts indefinitely. Once you buy it, it stays in effect for that coverage period permanently.

How to Secure Tail Coverage

Here’s what to do if you’re changing jobs or policies:

1. Check your current policy type. Confirm if it’s claims-made or occurrence-based.
2. Ask your employer who’s responsible for tail coverage. Some employers include it in contracts; others expect the nurse practitioner to buy it.
3. Get quotes early. Don’t wait until your last week on the job. Carriers may require notice to issue a tail endorsement.
4. Ask about “prior acts” coverage. If your new insurer can backdate your coverage, you may not need a tail.
5. Work with a broker who understands healthcare. They can compare options and ensure you don’t overpay for redundant protection.

Example Scenario

Case: Sarah, a Family Nurse Practitioner, had a claims-made policy through her clinic. She left to open her own telehealth practice.

Risk: Six months later, a patient from her old clinic filed a malpractice claim.

Outcome: Because Sarah purchased tail coverage, her previous insurer handled the claim, avoiding thousands in out-of-pocket defense costs.

How Leavitt Select Insurance Can Help

At Leavitt Select Insurance, we specialize in helping nurse practitioners and advanced practice clinicians understand every part of their malpractice protection, including tail coverage.

We’ll review your existing policy, explain your options, and make sure you stay covered through every career transition.

Ready to Review Your Coverage?

Get a personalized NP insurance quote or learn more about professional liability coverage for healthcare providers.