Depends. Do you feel lucky? How many cases did you do? What kind? How sure (SURE!) are you that there were no bad outcomes, including delayed bad outcomes, that could lead to litigation?
That said. Once upon a time I chose not to pay for tail insurance. My circumstances were unusual though. I was working full time, on active duty in the Navy. I had my own part-time claims-made policy to cover moonlighting. The policy was relatively inexpensive, and discounted for 4 of a full time equivalent. The tail, however, was quoted at 240% of the
undiscounted full time premium. In effect, my tail was quoted at 960% of my previous year's premium. I went back and forth with them a couple times, and at one point I made some progress and the agent thought it might be possible to make an exception. I think they understood I was at about zero risk, and wanted to scratch a little extra money out of me. I think if I had pressed the issue they'd have settled for 240% of the 1/4-time policy premium.
Ultimately I didn't pay for it, for the following reasons:
- I deployed for the Navy for the better part of a year. Did zero cases moonlighting under that policy during that time.
- Got home, and because of a move and lack of desire, did about 20 cases moonlighting under that policy during the next year.
- Went away for fellowship for a year, did zero cases under the policy.
- Cancelled the policy then.
- Never did OB under that policy.
- No poor outcomes that I was aware of. (Have to admit there is risk here. You never know what delayed surgical complication will crop up, or suddenly remembered awareness under anesthesia will cause debilitating psychological trauma.)
- Importantly, for the two states I worked in, the statute of limitations for medical malpractice claims are 1 year (California) and 2 years (Virginia). It's not quite that simple - there are extensions to these times, but mainly they center around retained surgical instruments, fraud committed to conceal complications, and complications that are "discovered" later. Again, there's risk in counting on the statute of limitations to shield you. Not the least of which is that you, and not the insurance carrier, will be the one paying the lawyer to get a case thrown out.
To sum up, for the final ~2 years I had the policy in effect, I did a couple dozen low risk routine cases that would've been inside the statute of limitations. So I chose not to pay 10 years' worth of premiums to purchase a tail to cover that low risk.
That was about 3 years ago. Generally speaking, one shouldn't ever go tailless. These days when I moonlight I insist on occurrence coverage from a locums agency or the hospital I contract with directly. Just not worth the headache to carry my own claims-made policy.
There will be some who argue I was an idiot to go tailless, even under these circumstances. They may be right. So far, so good.
(Edit - fixed some dates. Time flies, feels like forever ago.)
