Advanced practice providers (APPs) are entering 2026 with more professional opportunities than ever. Expanded autonomy laws, new practice models and growing demand in primary care have accelerated the shift toward APP-led care.
Having a strong partner who understands today’s medical malpractice complexities ensures APPs can take advantage of the opportunities without increasing risk. Otherwise, you face rising claim severity, escalating nuclear verdicts and emerging risks driven by cyberattacks and artificial intelligence.
For APPs, understanding these shifts is part of building a sustainable, resilient career. “APPs are entering a period of increased professional opportunity but also increased liability complexity. Those who understand how the risk landscape is evolving are most likely to thrive,” says William Sullivan, Executive Vice President of CM&F Group.”
Sullivan has his finger on the pulse of what’s happening in APP professional fields. Check out his 2026 medmal forecast for APPs, grounded in underwriting insights, multi-year market data and decades of firsthand experience serving clinicians.
Medical Malpractice Insurance Rates Are Rising for APPs in 2026
One of the most significant shifts APPs will feel in 2026 is cost. “You’re going to see the stalwarts in the market continue to need to increase their rates because the claims are just so high,” Sullivan says.
Nuclear verdicts and lawsuits aren’t showing any signs of slowing, which is driving up the cost of medical malpractice insurance. Nuclear verdicts in 2025 were as high as $950 million, including:
- A landmark $951 million verdict in a birth injury case in Utah, after nurses administered dangerously high levels of Pitocin, despite signs of fetal distress
- In Florida, a jury awarded $70.8 million to a permanently disabled patient after a nurse practitioner failed to order a CT scan or consult a neurologist.
Lawsuits like these mean many established carriers with decades of data and large portfolios are adjusting pricing to reflect the rising cost of defending and resolving claims.
At the same time, Sullivan anticipates the market will continue to see new entrants offering strikingly low prices to gain market share. “They’re coming in with no claim history and no claims being paid out, so they cut the price, thinking they can do it better than the people who’ve been doing this for years.”
Most carriers need 5 to 8 years of data before they understand how their book of business performs. In that period, newer entrants may “burn into the market” by rapidly taking on premium volume before they have to pay out their first claims.
“Over time, it starts to align,” says Sullivan.
Why Carrier Stability and Defense Strategy Matter for APP Malpractice Coverage
The risk of choosing a malpractice carrier based solely on price is that the new company may be insolvent by the time a claim arises. This is why the quality of your carrier’s balance sheet and their commitment to defending clinicians can make or break your protection.
“The whole reason we grew to be working with the AAPA is that carriers in the late 90s got hammered in the marketplace and went insolvent. And then those professionals didn’t have anywhere to go for coverage,” says Sullivan.
For APPs in 2026, history offers a warning that a cheap policy is meaningless if the carrier can’t withstand a challenging market. CM&F Group partners with MedPro Group, the nation’s largest healthcare liability carrier, with over a century of solvency. “MedPro sees trends across all professions and states. They’ve been through cycles, and they know how to sustain pricing and coverage,” says Sullivan.’’
Key takeaway: Avoid low-priced medmal insurance from newbies in the market who might not be around to defend a claim in 5-7 years.
Top Medical Malpractice Claim Risks for APPs in 2026
APPs continue to become more integral to U.S. healthcare as physician shortages plague the nation. The following are some areas where Sullivan expects to see medmal claims.
Correctional Facility Healthcare: A High-Risk Area for APP Malpractice Claims
If you’re an NP or a PA working in a correctional facility clinic, you likely already know there’s been a sharp spike in claims. “Correctional facility claims are completely off the charts,” says Sullivan.
Many carriers are withdrawing from correctional health entirely due to high frequency, questions about the quality of care and high-stakes litigation.
Key takeaway: For providers who moonlight or occasionally step into correctional settings, this exposure is significant, and your coverage must explicitly address it.
Primary Care Malpractice Risks for Nurse Practitioners and Physician Assistants
As NPs and PAs increasingly anchor the nation’s primary care infrastructure, diagnosis-related claims will follow. “We’re going to continue to see major volume coming in from a primary care standpoint,” Sullivan says.
Key takeaway: With APPs now functioning as the first point of contact for millions of patients, common claim categories, such as delayed diagnosis, missed diagnosis and communication breakdowns, remain central risk areas.
Behavioral Health and ABA: Compliance and Malpractice Risks for APPs
Behavioral health and ABA therapy remain critical growth areas, especially for pediatric mental health. But alongside the need, fraud investigations are rising and attracting national media attention. “When legitimate needs get diluted by fraud, it’s really sad. The people who suffer are the ones who genuinely need care,” says Sullivan.
Key takeaway: For APPs who own, operate or contract with behavioral health practices, regulatory, billing and supervisory frameworks must be airtight to prevent federal or payer investigations.
Cyber Liability Risks for APP Practices Are Increasing
Cyber liability is now one of the biggest financial threats to healthcare organizations and individual practices. “Healthcare is one of the top two targets, and AI is used for hacking now,” says Sullivan.
One of the largest cyber carriers in the world, Beazley Insurance, reduced its U.S. exposure because premiums aren’t keeping pace with the volume of claims.
For APPs running independent practices, this means two things:
- A stand-alone cyber policy is essential
- Basic IT setups or informal support from a friend are no longer enough
Key takeaway: “You really need fully vetted cybersecurity, and you need somebody to transfer the loss to,” says Sullivan.
How APPs Can Reduce Malpractice Risk and Build Career Resilience in 2026
The medmal environment may be complex, but having the right partner gives APPs a strategic advantage. Below are practical steps every APP should take before renewing or purchasing coverage for 2026.
- Vet carrier stability before choosing a medmal carrier
- Review policy language for exclusions and gaps
- Make sure you have cyber insurance
With the right carrier and coverage, clinicians can practice confidently, expand into new service lines and build resilient businesses in 2026.
CM&F has protected APPs for more than 75 years, through every market cycle. Get a quote in minutes or talk with our team about aligning your protection with where your career heads.
Frequently Asked Questions
- Why is medical malpractice insurance becoming more expensive for APPs in 2026?
Medical malpractice insurance rates for APPs are rising due to increasing claim severity, nuclear verdicts reaching hundreds of millions of dollars, and higher legal defense costs. Established carriers are adjusting pricing to reflect these realities, while low-cost newcomers may lack the long-term stability needed to defend claims years down the line. - How should nurse practitioners and physician assistants choose a malpractice insurance carrier?
APPs should prioritize carrier stability, financial strength, and a proven defense philosophy over price alone. A low-cost policy offers little protection if the carrier becomes insolvent when a claim arises. Working with an experienced, well-capitalized carrier ensures long-term coverage and strong legal defense. - What emerging malpractice and liability risks should APPs watch in 2026?
Key risk areas for APPs in 2026 include primary care diagnostic errors, correctional facility healthcare exposure, behavioral health compliance issues, and rapidly growing cyber liability threats. Independent practices should carry stand-alone cyber insurance and regularly review policies for exclusions related to these evolving risks.
