Tail Coverage

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
D

deelo89

New Member
2+ Year Member
Joined
Sep 27, 2022
Messages
6
Reaction score
14
Without going into too much detail by doxxing myself. I'm Getting insane quotes on tail coverage for a metro area. Over 42k. I have no claims. (The group I worked for has many) Did mix of surgical and non surgical.
Considering going without it once I switch jobs because I just can't afford that number. New job refuses to provide nose coverage.
I haven't been negligent, and also figure a lawyer is also less willing to take on a case knowing collection will be difficult.
Is this crazy?
Members don't see this ad.
 
There are quite a few people on this forum who have moved on so hopefully someone will be able to advise you.

Can you describe the circumstances of your departure? Does your practice have regular turnover ie. associates coming and going with the patients just being picked up by other docs? Do you have any surgery patients who you are "maintaining" ie. their outcome wasn't perfect but you were able to keep them satisfied and now a new doctor will take them over. Was the environment collegial or are they more likely to "poison" the patients against you? Are you staying in the area or moving somewhere you could try to maintain relationships with surgery patients?

Without engaging in too much podiatry griping - having to pay tail just feels like another example of why reimbursement is insufficient. Malpractice is a price of the business of the practice. It shouldn't be born by the individual associate.
 
deelo89 said:
Without going into too much detail by doxxing myself. I'm Getting insane quotes on tail coverage for a metro area. Over 42k. I have no claims. (The group I worked for has many) Did mix of surgical and non surgical.
Considering going without it once I switch jobs because I just can't afford that number. New job refuses to provide nose coverage.
I haven't been negligent, and also figure a lawyer is also less willing to take on a case knowing collection will be difficult.
Is this crazy?
Click to expand...
How long did you work with the group? I guess it might be different for hospital tail coverage vs private practice. I was with my first job (hospital employed) for 5 years. Hospital covered a significant amount of my tail coverage due to number of years of being with the group. I only paid 10K when I left.

Others have left that same hospital and had tail coverage of up to 60K due only working 1-2 years there. So your quote is really not that insane.

I would keep shopping and see if you can get a quote any lower than the number you posted.

I would not go without tail insurance. You are playing with fire. You can literally get sued for anything. Anything. There will always be a slimy podiatrist giving expert witness testimony for fee. I promise you this.
 
Members don't see this ad :)
It's up to you. I've done it multiple times.
As you said, depends what you have.
The tail is mainly an empty threat from employers to spread out the liability for those cases.

Your net worth is almost surely negative if that was your first job, so what would any suit even be able to take?
The attorneys are almost always on contingency (percentage). If they take the case, they'd sue your former office and you also... but if you had no tail coverage, it'd be rapidly apparent that your "assets" are probably a pile of student loans and used car that's half paid off. Even if the plaintiff party had a good case, they'd be looking at the group that employed you and their 1M/3M coverage (or whatever)... and you with pocket lint. It'd be plain to see even if there was judgment or settlement, they couldn't collect from you - just the practice.

  • Should a retiring PP owner who has their house paid off or a hospital pod doing a lot of aggro stuff and with their loans paid off and decent retirement accounts go without tail? No.
  • Should a trust fund kid with big net worth and assets do it after any job? No.
  • Normal podiatry new grad with a bunch of debt who's leaving associate job with a PP group? Personal decision imo.
If you go without tail cover, you should still fully cooperate with the former employer/practice if a case were to come up. Any settlement would still be on your NPDB also, and worst case, you might have to do chapter 7 or 13 bankruptcy (which means very little if you have little/nothing except debts... basically just ruins your credit awhile, which you shouldn't be using a ton when in debt anyways).
 
Last edited:
Makes me less stressed, knowing my occurrence based policy.

Would it be possible just to keep the same insurance carrier into next job to avoid the tail?
 
podourology said:
Makes me less stressed, knowing my occurrence based policy.

Would it be possible just to keep the same insurance carrier into next job to avoid the tail?
Click to expand...

This is what I did, so thankfully didn’t have to pay anything. However I have learned that if you are switching states sometimes this is not even allowed.
 
Keep shopping. Check out doctors company. Also that was a thinly veiled shot @heybrother .
 
podourology said:
Makes me less stressed, knowing my occurrence based policy.

Would it be possible just to keep the same insurance carrier into next job to avoid the tail?
Click to expand...
Doesn't work like that.
 
Again I stress that new grads should insist upon an occurrence based policy their first few years out. Even if you have to pay the difference.
 
The practice im leaving is multi specialty. They floated partnership but it was a ploy to keep me around longer while they were in talks with private equity. Once that fell through for them it became clear their intentions were never there.
I couldn't up and leave right away (family kids) so switched to part time which means under that contract tail not covered. Didn't realize how large of an amount it would be.
I'm considering getting my own coverage with nose/ prior acts and having my new employer reimburse me for what they would have paid under their policy.
 
Members don't see this ad :)
deelo89 said:
The practice im leaving is multi specialty. They floated partnership but it was a ploy to keep me around longer while they were in talks with private equity. Once that fell through for them it became clear their intentions were never there.
I couldn't up and leave right away (family kids) so switched to part time which means under that contract tail not covered. Didn't realize how large of an amount it would be.
I'm considering getting my own coverage with nose/ prior acts and having my new employer reimburse me for what they would have paid under their policy.
Click to expand...
I don't know if I know anyone who has ever gotten nose coverage paid before.
 
deelo89 said:
I'm considering getting my own coverage with nose/ prior acts and having my new employer reimburse me for what they would have paid under their policy
Click to expand...
Please let us know if this is successful. I'm not sure how willing an employer is to having you under a separate coverage scheme (assuming they were covering your malpractice to begin with) from the rest of the group. This could potentially be complicated to practice under for the group, perhaps?

To answer your original question, the tail coverage is massive. There's no going around it. I heard it between 10-60K depending on state. Mine was 35k. You have to protect yourself and do not take unnecessary risks.
 
For perspective my tail was 2x my annual premium in a metro area. I was able to negotiate the new employer (hospital) to pay the tail policy on my behalf
 
LossToFollowUp said:
Please let us know if this is successful. I'm not sure how willing an employer is to having you under a separate coverage scheme (assuming they were covering your malpractice to begin with) from the rest of the group. This could potentially be complicated to practice under for the group, perhaps?

To answer your original question, the tail coverage is massive. There's no going around it. I heard it between 10-60K depending on state. Mine was 35k. You have to protect yourself and do not take unnecessary risks.
Click to expand...
35k is crazy also.
 
Yup....but I came from a heavy surgical practice and I did big cases. I tried other companies but they were all in the same dollar range.
 
LossToFollowUp said:
Yup....but I came from a heavy surgical practice and I did big cases. I tried other companies but they were all in the same dollar range.
Click to expand...
Love the not so subtle flex bro. Seriously.

That's like "I am telling you guys, it is seriously super hard to find XXL condoms."
 
Last edited:
LossToFollowUp said:
Yup....but I came from a heavy surgical practice and I did big cases. I tried other companies but they were all in the same dollar range.
Click to expand...

I have been one of the busiest surgeons in my practice and they quoted me close to 30-40 k as well. Most of my complex procedures are probably similar to yours, including 28285, 11750, and 28299.
 
I have about 350-400 cases over last 3-4 years. most are workman's comp and personal injury, which i would think have a lower chance of malpractice as going after the surgeon would complicate the legal process they already have going with employers / car insurance companies
 
deelo89 said:
I have about 350-400 cases over last 3-4 years. most are workman's comp and personal injury, which i would think have a lower chance of malpractice as going after the surgeon would complicate the legal process they already have going with employers / car insurance companies
Click to expand...
2 cases a week? 42k is crazy.
 
There's been the suggestion in this thread that your tail is in some way a representation of your cases / volume. However, the internet essentially says that tail is some variation of 2-3x your last year's premium. I'm currently speaking to a malpractice company about adding a "high risk" population. According to PICA - high risk is (a) Professional athletes (b) Collegiates Athletes (c) Prisoners (d) and Ballet Dancers (perhaps professional). I was told that when they perform underwriting for these populations they want to know how much you are doing ie. what percentage of your practice the population will consist of. So presumably those lead to a mark up. There's obviously distinctions also for surgical and non-surgical (and they do ask what you will be doing ie. forefoot, frames, fusions) and whether you are part time / full time.

Does anyone have any definitive knowledge / information that says tail is somehow tied to cases/case volume? Because my little old claims made policy multiplied by 2-3X would be in the neighborhood of the numbers people are saying and I'm not special or high volume.
 
Many times all things considered your current company could be the best.

The ways to get a lower premium usually involve some combination of the following

1. Use a high volume broker that deals with medical malpractice/tails to get a quote in addition to the companies you have already called directly yourself. Many companies do not price tails competitively and you really need to shop around.

2. Lower limits. Maybe your hospital required 1 million/3 million, but you can choose to go 100,000/300,000 for your tail if you feel comfortable with lower limits and contractually allowed.

3 Coverage for fewer years. Longer is better, but if you are in a state with shorter time to file claims you might be able to go shorter length of coverage and save.
 
icebreaker32 said:
Many times all things considered your current company could be the best.

The ways to get a lower premium usually involve some combination of the following

1. Use a high volume broker that deals with medical malpractice/tails to get a quote in addition to the companies you have already called directly yourself. Many companies do not price tails competitively and you really need to shop around.

2. Lower limits. Maybe your hospital required 1 million/3 million, but you can choose to go 100,000/300,000 for your tail if you feel comfortable with lower limits and contractually allowed.

3 Coverage for fewer years. Longer is better, but if you are in a state with shorter time to file claims you might be able to go shorter length of coverage and save.
Click to expand...
I did not know that $100/300K existed. Insurance contracts in my area seem to require either $200/600K or $1/3 million.
 
heybrother said:
I did not know that $100/300K existed. Insurance contracts in my area seem to require either $200/600K or $1/3 million.
Click to expand...
When you do tail and change jobs/area/facility, you can pick whatever you like (including no coverage).

The required limits to satisfy facilities/payer are for cases going forward (from the time you join the facility).

...I also agree any insurance (med mal, auto, whatever) is more area/county/zip you work (workED in if tail) than necessarily volume or complexity. They go by fraud rates, claim rates, settlements, etc for peers - or in general (home/auto).

Most insurances would have basically same rates - assuming they checked same boxes for wound care and take call and both no recent settlements and bla bla - for Dr. A doing a bunion every other week and "call" of 5th met fx a couple times per year and also for Dr. B doing Charcot and trimalls and calcs every week. The insurance just know both are DPMs and both surgical coverage and taking call and doing wounds in X county.
 
Last edited:
Resurrecting a dead thread here…

If an employer (hospital system) states they cover tail. Does that imply tail from previous position? Or they cover it if you leave that position?
 
PMG03470 said:
Resurrecting a dead thread here…

If an employer (hospital system) states they cover tail. Does that imply tail from previous position? Or they cover it if you leave that position?
Click to expand...
They cover if you leave the position. Whatever you did there during your time is covered by the hospital which is a big expense they are taking on. Some hospitals stipulate you work for a certain number of years before they would cover tail fully. I've heard of some tail coverages costing in excess of 30-40K for some podiatrists who leave a hospital gig after 1-2 years.
 
Retrograde_Nail said:
They cover if you leave the position. Whatever you did there during your time is covered by the hospital which is a big expense they are taking on. Some hospitals stipulate you work for a certain number of years before they would cover tail fully. I've heard of some tail coverages costing in excess of 30-40K for some podiatrists who leave a hospital gig after 1-2 years.
Click to expand...
Correct. Check your contract. Also some states have a fund. Some states also have very low limits. Fair to assume hospital employed has it covered. But since you should always have one eye out the door on any new job ....know your options.
 
PMG03470 said:
Resurrecting a dead thread here…

If an employer (hospital system) states they cover tail. Does that imply tail from previous position? Or they cover it if you leave that position?
Click to expand...
They cover what you did there while working for them.
 
You must log in or register to reply here.

Similar threads

Pod267
Question about tail coverage
Replies
39
Views
5K
dddunit
D
air bud
Malpractice Insurance and Tail Coverage
Replies
34
Views
9K
ldsrmdude
ldsrmdude
A
Diabetic insoles, shoes, and Medicare coverage
Replies
13
Views
4K
AttackNME
A
Top