Can my employer refuse to defend me?

Yes. Employer-provided malpractice insurance is a contract between the insurer and the facility, not you. The insurer can deny coverage for reasons like policy exclusions, failure to meet reporting deadlines, or disputes over whether you were acting within your job duties. In the Berxi case, the NP's employer refused to defend her with no explanation.

Why would employer insurance not cover me?

Common reasons: the policy covers the facility first, not you individually; it excludes license defense; it ends when you leave the job; or the insurer decides your actions weren't covered. Employer policies often have gaps that leave clinicians exposed.

Do I need my own policy if my job insures me?

Yes, strongly recommended. Your own policy covers you when employer insurance won't—including license defense, portability between jobs, and consent to settle. For most clinicians, annual premiums are affordable ($100–$2,000 depending on role). Compare carriers at InsureMedix's carrier hub .

When Your Employer Won't Cover You: A Cautionary Claim Story

A nurse practitioner at an assisted living facility was sued after a patient's death—her employer's policy refused to defend her. Here's what happened and why you need your own coverage.

The Case That Should Make Every Clinician Rethink Employer Coverage

A nurse practitioner working at an assisted living facility got the call no clinician wants: a patient had fallen, was transferred to the hospital, and later died. The family sued. The NP had barely been involved in the patient's care—she'd only seen him once or twice. She assumed her employer's malpractice insurance would handle it. After all, the facility provided coverage as a benefit.

But when she tendered the claim, the employer's insurer refused to defend her. No explanation. No coverage. Just a letter saying they wouldn't get involved.

This real case, reported by Berxi, is a nightmare scenario—and it's not as rare as you'd think. According to the National Practitioner Data Bank, 26% of all medical malpractice payments from 2012 to 2022 were made on behalf of non-physicians. And employer policies have gaps that can leave you holding the bag.

Why Did the Employer's Insurance Refuse to Cover Her?

The employer's policy likely contained exclusions or conditions that the insurer used to deny coverage. Common reasons include:

The policy covered the facility first. Employer policies are designed to protect the organization, not you. If the insurer determines the claim doesn't meet their criteria—or if they want to avoid a payout—they can simply decline.
You weren't named as an insured. Many employer policies cover employees only while acting within their job duties, but the insurer may dispute whether your actions qualified.
No license defense included. Even if the employer covers the lawsuit, most policies don't pay for licensing board complaints. That's separate—and expensive.
You lose coverage when you leave. If you change jobs or are fired, the policy ends. A claim filed later (for an incident that happened while employed) may not be covered unless you buy tail coverage—which can cost 1.5–2 times your annual premium.

In the NP's case, the insurer simply said no. She was left to defend herself—until her own policy kicked in.

How Her Own Policy Saved Her

Fortunately, this NP had purchased a supplemental malpractice policy from Berxi. When her employer refused to defend, Berxi stepped in. They hired an attorney, covered legal fees, and ultimately resolved the claim. The cost to her? Zero, beyond her annual premium.

That's the difference between relying on someone else's insurance and owning your own. A personal policy follows you from job to job, covers license defense, and won't abandon you when you need it most.

What Employer Policies Typically Leave Out

Even if your employer's insurer does defend you, the coverage is often thin. Here's what many employer plans lack:

License protection: Board complaints can cost thousands to defend. Employer policies rarely cover them. Policies from carriers like HPSO or Proliability include up to $25,000 in license defense reimbursement.
Consent to settle: Your employer's insurer can settle a claim without your permission, even if you want to fight it. A settlement can appear on the NPDB and affect future employment.
Portability: Leave your job, and the coverage leaves with you. A personal policy—whether occurrence or claims-made with tail—stays active as long as you pay the premium.
Defense costs outside the limit: Some personal policies, like Berxi, cover legal fees on top of the policy limit, so the full amount is available for a settlement or judgment.

How Much Does Your Own Policy Cost?

For most clinicians, it's surprisingly affordable. Annual premiums (estimated ranges):

Nurse Practitioner: $990–$2,000 (Proliability ~$991 employed, Berxi ~$1,400)
Registered Nurse: $100–$150
Therapist/Counselor: $363–$765 (Berxi supplemental vs. primary)
Physical/Occupational Therapist: $100–$350
Dental Hygienist: $45–$150
Massage Therapist: $96–$235 (BBI, ABMP, AMTA)
Esthetician: ~$120/year (BBI $9.99/month)
Notary E&O: $20–$100
CRNA: $1,500–$3,000

These are ranges—your actual quote depends on state, specialty, claims history, and limits selected. But for the price of a few dinners out, you can buy protection that covers your career.

Occurrence vs. Claims-Made: What You Need to Know

Personal policies come in two types:

Occurrence: Covers any incident that happened while the policy was active, even if the claim is filed years later. No tail needed. Carriers like CPH & Associates and HPSO offer occurrence forms.
Claims-made: Only covers claims filed while the policy is active. If you cancel or switch jobs, you must buy tail coverage (often 1.5–2x annual premium) to protect past work.

For most employed clinicians, an occurrence policy is simpler. But claims-made with tail can also work—just budget for the tail if you leave.

What About the Stats?

You might think malpractice claims are rare. They're not as rare as you'd hope. HPSO reports the average malpractice lawsuit against an occupational therapist totals $60,299. And licensing board complaints happen even more often—the RN in the Berxi story was falsely accused of being intoxicated at work. Her employer filed a board complaint despite a negative drug test. Berxi assigned defense counsel immediately, and the case was resolved without license loss.

Do You Really Need Your Own Policy?

If you're asking that question, the answer is almost certainly yes. Here's a quick test:

Does your employer's policy cover license defense? (Most don't.)
Can you get a copy of the policy to read the exclusions? (Most employers won't share.)
What happens if you're sued after you leave? (Employer policy ends.)
Do you have a say in whether the insurer settles? (Usually not.)

If any of these give you pause, it's time to buy your own. For most professions, you can compare carriers at the carrier comparison hub.

A Final Honest Caveat

This article is based on real cases and publicly available data, but every situation is different. Premiums, coverage terms, and claim outcomes vary by carrier, state, and individual circumstances. Always read the policy wording and consult a licensed agent if you have questions. The stories here illustrate what can happen—not what will happen to you. But they make one thing clear: relying solely on your employer's insurance is a gamble you don't have to take.