You think your employer has your back. Then a lawsuit lands on your desk.
If you're a nurse practitioner, especially one who prescribes or works in a high-acuity setting like cardiology, you've probably wondered: What happens if I get sued? Most NPs assume the hospital or clinic will cover them. That assumption can be devastatingly wrong.
Ask the cardiac NP whose story is documented by Berxi, a Berkshire Hathaway insurer. He was an experienced, self-employed NP contracted to work at a hospital. One day, he found out the hospital and several employed colleagues were being sued for wrongful death. Then a server handed him a summons. He was named too.
The hospital told him flatly: it would represent the employees, but not him. As a contract worker, he was on his own.
Fortunately, he had made one critical business decision years earlier: he bought his own nurse practitioner malpractice insurance through Berxi. That decision turned a potential career-ending crisis into a manageable — though still stressful — legal process.
What happened in the cardiac NP lawsuit?
According to Berxi's account (published March 2026), the patient was a 58-year-old man who came to the hospital one evening with shortness of breath. He had a history of congestive heart failure and pulmonary artery disease. The NP was working intake and admitted the patient under a supervising physician.
More than a year later, the patient died. The family sued the hospital and several clinicians, including the NP. The hospital refused to defend the NP because he was a contractor, not an employee.
Berxi stepped in. They provided legal representation, covered defense costs outside the policy limits (a key feature of Berxi's policy), and ultimately reached a settlement. The NP's career and finances were protected because he had his own coverage.
Are nurse practitioners sued often?
Yes — and the numbers are growing. According to the National Practitioner Data Bank (NPDB), 26% of all medical malpractice payments from 2012 to 2022 were made on behalf of non-physicians. That includes NPs, PAs, nurses, and other advanced practice clinicians.
NPs who prescribe, work in high-acuity specialties (cardiology, emergency, ICU), or see patients independently face the highest risk. Even a routine admission can turn into a lawsuit years later, as this case shows.
Does your collaborating physician's policy cover you?
Almost never. A collaborating physician's malpractice policy covers their liability, not yours. If you're named in a suit, the plaintiff's attorney will go after everyone involved — including you. You need your own defense, your own coverage, and your own limits.
Many NPs also assume the hospital's policy protects them. But as this case demonstrates, if you're a contractor, locum tenens, or even an employee in some states, the hospital may exclude you from its coverage. Employer policies typically protect the facility first, not you. They often lack license defense coverage (which can cost $25,000 or more per incident) and usually end the moment you change jobs.
Why do prescribers need their own coverage?
Because prescribing is high-risk. A single medication error, missed diagnosis, or adverse reaction can trigger a lawsuit. And even if you're not at fault, defending yourself costs thousands. Without your own policy, you pay that out of pocket.
Here's what employer policies often don't do:
- Defend you if the employer decides you're not covered (e.g., contractor status)
- Cover license board complaints or investigations
- Give you control over settlement decisions (the insurer can settle without your consent)
- Follow you if you change jobs or retire (claims-made policies require tail coverage)
Your own policy — especially an occurrence policy — avoids these traps. Occurrence coverage means any incident that happened while the policy was active is covered, even if the claim is filed years later. No tail needed. Claims-made policies are cheaper upfront but require you to buy tail coverage (often 1.5–2x the annual premium) if you leave or cancel.
Carriers like Berxi, HPSO, Proliability, CM&F Group, and CPH & Associates offer NP-specific policies. Compare them here.
What does NP malpractice insurance cost?
For a nurse practitioner, annual premiums typically range from roughly $990 to $2,000, depending on specialty, location, claims history, and coverage limits. Proliability lists about $991 for employed NPs and $1,190 for self-employed. Berxi's typical $1M/$3M policy runs around $1,400. These are estimates — your exact quote comes from the carrier.
Compare that to the cost of a single lawsuit. Even if you're not liable, defense costs can easily exceed $50,000. License defense coverage (often included or available as an add-on) can pay for an attorney to represent you before the state board — something employer policies almost never provide.
What if you're a nurse, therapist, or other clinician?
Rates vary by profession:
- Registered nurse: ~$100–$150 per year
- Therapist / counselor: Berxi supplemental ~$363/yr, primary ~$765/yr; CPH occurrence often lower
- Physical / occupational therapist: ~$100–$350/yr (APTA members get 10% off via HPSO)
- Dental hygienist: ~$45–$150/yr
- Pharmacist: varies by setting
- Massage therapist: BBI from $96/yr; ABMP $199/yr (occurrence $2M/$6M); AMTA $235/yr
- Notary public E&O: ~$20–$100/yr
For profession-specific guides, see nurse practitioner, registered nurse, therapist, psychologist, social worker, physical therapist, occupational therapist, dental hygienist, pharmacist, massage therapist, and notary public.
The bottom line
One decision — buying your own malpractice insurance — can be the difference between a defended career and a financial disaster. The cardiac NP in Berxi's story made that decision before he needed it. You should too.
Don't rely on your employer's policy. It's not designed to protect you. Get your own occurrence-based policy from a reputable carrier. The cost is small compared to the risk.
Caveat: All premium figures are approximate ranges based on publicly available data from carriers as of early 2026. Your actual premium depends on your specialty, state, claims history, and coverage choices. Always get a personalized quote before purchasing.