Does Your Malpractice Policy Cover Telehealth?
You’re licensed in one state, the patient sits in another. You diagnose via video, prescribe through a portal. Maybe your employer says you’re covered. But when the claim comes—and it can—the first question the carrier asks is: Were you practicing within your scope and where you were authorized?
Telehealth isn’t a separate insurance product. Most individual malpractice policies now include telehealth as part of standard coverage, but only if you meet the same rules as in-person care: proper licensure, consent, and standard of care. The catch is that your employer’s policy may not cover you for telehealth at all, or may exclude care across state lines.
If you’re a nurse practitioner, therapist, or any clinician seeing patients remotely—even part-time—you need to verify that your policy explicitly covers telehealth. Carriers like CM&F Group and Berxi include it as a standard feature. Others may require a rider. Don’t assume.
What Are the Biggest Telehealth Liability Risks?
Telehealth changes the how of care, not the standard. You’re still liable for diagnosis, treatment, and follow-up. But the remote setting introduces unique exposures:
- Licensure across states: You must be licensed in the state where the patient is physically located. Most carriers require this. If you treat someone in a state where you’re not licensed, your policy may deny coverage entirely. Some states have interstate compacts (like the Nurse Licensure Compact or Psychology Interjurisdictional Compact), but many do not.
- Technology failures: If the video drops, audio cuts out, or a patient can’t connect, and that leads to a missed diagnosis or delayed treatment, you could be held responsible. Document every technical glitch and how you handled it.
- Limits of virtual exams: You can’t palpate, auscultate, or perform a hands-on assessment. Relying solely on patient self-report increases the risk of missing critical findings. The standard of care still applies—you must work within the limits of what a remote exam can reasonably achieve.
- Privacy and data security: Using unsecured platforms, texting patient info, or storing recordings improperly can violate HIPAA. Some policies include HIPAA defense coverage (e.g., Proliability offers up to $50,000 per incident), but not all.
Do I Need Coverage in Every State I Treat Patients?
Short answer: yes. Most individual malpractice policies—like those from HPSO/NSO or CPH & Associates—cover you only for care provided within states where you hold an active license. If you treat patients in multiple states, you need to be licensed in each one and ensure your policy covers those locations.
Some carriers offer “multistate” coverage, but that usually means they cover you while traveling—not for practicing in a state where you lack a license. Check the policy territory clause. For example, CM&F Group explicitly includes telemedicine and license defense, but you still must comply with state laws.
If you’re an employed clinician, your employer’s policy might cover you for telehealth only within the states where the employer is authorized. If you independently contract across state lines, you almost certainly need your own policy.
How to Choose a Telehealth-Ready Policy
Not all policies are equal. Here’s what to look for:
- Explicit telehealth coverage: The policy should state that telemedicine is included. Avoid policies that are silent on the issue.
- License defense coverage: If a state board investigates your telehealth practice, legal fees can run into thousands. HPSO/NSO includes up to $25,000 for license defense; CPH offers $35,000.
- Portability: If you change jobs or move, the policy should follow you. Occurrence forms (like those from Berxi or CPH) don’t require tail coverage, making them simpler for telehealth clinicians who switch settings often.
- Defense outside limits: Some policies pay defense costs on top of the policy limit (e.g., Berxi, HPSO/NSO). Others subtract defense from the limit. The former is stronger.
For cost reference: a therapist’s supplemental policy via Berxi runs around $363/year; a primary policy about $765. Registered nurses typically pay $100–$150/year. Nurse practitioners see $990–$2,000/year depending on employment status and limits. These are estimates—final pricing comes from the carrier at quote.
Real Claim Examples (What Can Go Wrong)
Consider this: an occupational therapist provides home exercise instructions via video. The patient misinterprets and falls. The therapist is sued. According to HPSO, the average occupational therapy malpractice lawsuit totals $60,299. That’s not a number to ignore.
Or a therapist fails to notice a patient’s suicidal ideation because the video quality was poor. The family sues for wrongful death. Without proper documentation and a clear telehealth protocol, the clinician faces an uphill battle.
Telehealth doesn’t lower the bar—it raises it in different ways. You must document the technology used, the patient’s location, consent for remote care, and any limitations of the encounter.
Bottom Line: Don’t Rely on Your Employer’s Policy
Employer policies protect the facility first. They often exclude license defense, may not cover you across state lines, and typically end when you leave the job. If you’re doing any telehealth—even one patient a month—your own policy is cheap insurance.
Compare carriers side by side at our carrier comparison hub. Look for telehealth-friendly terms, occurrence forms if you don’t want to worry about tail coverage, and solid license defense limits.
One honest caveat: every policy has exclusions. Read the fine print. If you’re unsure, call the carrier and ask: “Does this policy cover me if I treat a patient located in a state where I’m licensed but the consult happens via video?” Get the answer in writing.
Telehealth is here to stay. Make sure your liability coverage is, too.