Switching Malpractice Insurance Carriers for Physician Assistants (Retro Dates, Prior Acts, and Tail Coverage)

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At a glance: switching malpractice insurance carriers for physician assistants

When switching malpractice insurance carriers for physician assistants, the goal is simple: protect prior acts and avoid gaps. If you are on a claims-made policy, you have two main paths:

1. Your new insurer carries your retroactive date (prior acts coverage) → no tail needed, or

2. Your new insurer won’t carry your retro date → buy tail coverage from the old carrier.

Occurrence policies are simpler (no tail), but are less common for PAs and often cost more per year.

Why timing, retro dates, and tail coverage matter

Most PA policies are claims-made. They respond to claims filed while the policy is active, for acts that occurred on or after the retroactive date. When you switch:

• If the new policy lists the same retro date, your past work stays protected (no tail).

• If it does not, your past work is unprotected after cancellation unless you buy a tail (Extended Reporting Period) from the old carrier.

Even short gaps between cancellation and new effective date can cause issues for claims-

made. Plan your dates precisely—down to the day.

The switching malpractice insurance carriers for physician assistants checklist

Use this step-by-step sequence to avoid surprises:

1. Map your change (start date at the new employer, last day at the old employer, coverage requirements, any moonlighting or telemedicine).

2. Pull documents (current Dec page with retro date, endorsements, loss runs, any employment agreement language about tail).

3. Request quotes (include current retro date; ask up front whether the new insurer will carry prior acts).

4. Decide structure (stay claims-made with prior acts vs occurrence). Occurrence</a> article if changing structures.

5. Get it in writing (new carrier’s written confirmation of the retro date appearing on the Declarations page).

6. Align effective dates (no lapses; same-day cancel/bind if possible).

7. Secure tail if needed (from the old carrier, within the allowed purchase window).

8. Confirm board defense, telemedicine, and multi-state endorsements on the new policy.

9. Update your files (keep both Dec pages, tail endorsement if purchased, and loss runs).

The three scenarios and what to do in each

Scenario A: New carrier carries your retro date (best)

• Outcome: Prior acts protected; no tail needed.

• What to do: Confirm the exact retro date on the new Declarations page before canceling the old policy. Line up effective dates with zero lapse.

Scenario B: New carrier refuses to carry your retro date (tail required)

• Outcome: You must buy tail from the old carrier to protect your prior acts.

• What to do: Ask the old carrier for tail options (term-limited vs unlimited). Align tail start with cancellation of the old policy.

Tip: Tail is often a one-time premium (commonly referenced in many markets at ~150–200% of the expiring annual premium). It can be more or less depending on tenure, rules, and carrier. Some insurers offer discounted retirement tail (age + years insured thresholds).

Scenario C: You are switching employers on an occurrence policy

• Outcome: Tail is not required for prior acts, because occurrence covers incidents that happened during the policy period even if reported later.

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• What to do: Keep proof of your occurrence policy terms and dates. Ensure the new policy (occurrence or claims-made) starts on time, and confirm state and credentialing requirements.

Switching malpractice insurance carriers for physician assistants: timelines that work

Use this sample timetable and shift the dates to your reality.

• T-45 to T-30 days: Request quotes, deliver loss runs, share current retro date, ask whether the new carrier will carry prior acts.

• T-21 to T-14 days: Choose structure and carrier. If tail will be needed, request tail quotes now from the old carrier.

• T-7 to T-3 days: Receive written retro date confirmation (or tail quotes), review endorsements (board defense, HIPAA, telemedicine, multi-state).

• T-1 to T-0 days: Bind the new policy and cancel the old policy with aligned effective dates.

• T+1 to T+7 days: File the new Dec page and, if applicable, the tail endorsement in your records.

Common switching pitfalls and how to avoid them

• Assuming prior acts will be carried without written confirmation. Always verify the retro date on the new Dec page.

• Letting the employer handle everything. Their policy is designed for the employer’s risk. You need clarity on your own exposure, especially if you moonlight or do telemedicine.

• Gaps in dates. A weekend lapse can matter for claims-made. Align dates precisely.

• Forgetting board defense and telemedicine. When you switch, make sure the new policy includes the endorsements you rely on.

• No plan for tail. If prior acts won’t be carried, tail has a binding window. Miss it and coverage may be unavailable later.

What to compare in quotes beyond price

When switching malpractice insurance carriers for physician assistants, the structure is only part of the decision. Compare:

• Consent to settle (pure consent vs hammer clause)

• Defense costs (outside vs inside limits)

• Board/licensure defense (sub-limits, triggers, panel counsel)

• Telemedicine and multi-state coverage (are all states scheduled)

• HIPAA/privacy defense and subpoena assistance

• Definition of professional services (are your procedures and tasks clearly within scope)

• Limits (common benchmarks: $1,000,000/$3,000,000 or $2,000,000/$4,000,000; confirm payer/hospital requirements)

Illustrative math: prior acts vs buying tail

Example A (carry prior acts):

• New claims-made policy at $1M/$3M: $2,050/yr (illustrative)

• Old policy canceled with no tail because the new carrier carries retro date

• Total year-one outlay: ~$2,050

Example B (buy tail):

• New claims-made policy: $2,050/yr

• Tail from old carrier: 175% of expiring premium ($2,000 expiring) → $3,500 one-time

• Total year-one outlay: ~$5,550

Your real numbers will vary by state, specialty, procedures, tenure, and carrier. See directional ranges in the PA Cost by State (2025) data

Employer changes, moonlighting, and telemedicine

If you are adding moonlighting or telemedicine while switching, check both the employer’s policy and your new individual policy:

• Are non-employer locations and virtual visits covered

• Do you need to schedule specific states for telehealth

• Are there sub-limits or exclusions for telemedicine platforms or asynchronous care

FAQs: switching malpractice insurance carriers for physician assistants

If I keep my policy active until the new one starts, do I still need tail? Only if your new policy does not carry the retro date. Active to active helps, but prior acts protection comes from the retro date or tail, not just overlap.

Can I buy tail later if I change my mind? Tail usually must be purchased immediately after cancellation (or within a short window). If you miss it, tail may be unavailable.

Do I need my own policy if my employer provides coverage during the switch? Employer coverage is centered on the employer’s risk and may not include moonlighting, telemedicine, or board defense tailored to you. A personal policy keeps continuity on your terms.

What limits should I carry after switching? Most hospitals and payers expect $1,000,000/$3,000,000 or $2,000,000/$4,000,000. Check your credentialing requirements and match them on your individual policy.