If you’re a nurse practitioner (NP) or physician assistant (PA) expanding into a new clinical or entrepreneurial role, overlooking tailored liability insurance can make or break your career.
Instead of a “one-size-fits-all” professional liability policy that assumes you’re working in a narrow, traditional role, a tailored liability policy ensures your coverage matches exactly what you do — from the procedures you perform to the business entity where you operate.
A standard professional liability policy may leave major gaps in coverage, especially if you offer procedures, aesthetic medicine, IV therapy or telehealth. “We see different insurance carriers avoid certain risks. Once they find out you’re doing certain types of work, they can sometimes decline you or that part of your practice,” says William Sullivan, Executive Vice President of CM&F Group.
Here’s why tailored coverage might be essential for your practice — and how to avoid costly surprises.
NP & PA Liability Insurance: Why Not All Policies Cover the Same Risks
Insurance carriers don’t all view risk the same way. Some, like CM&F Group, welcome advanced practice providers in surgical or cosmetic roles, while others exclude them entirely.
Many carriers initially offered broad PA coverage nationwide. But after claims emerged, they carved out exclusions, such as:
- Surgical procedures
- Cosmetic exclusions, leaving providers uninsured for procedures like Botox or fillers
Without checking the fine print, you may think you’re covered when you’re not. “Sometimes the exclusions are buried in the cover sheet or declarations page. You think you’re covered, but the fine print says otherwise,” says Sullivan.
Liability Insurance Exclusions for NPs & PAs in Aesthetics and IV Therapy
Two rapidly growing areas –– cosmetic injectables and IV hydration –– are especially tricky when it comes to NP and PA coverage.
- Cosmetic procedures: Some carriers exclude aesthetic services entirely, or cover them only with an added rider
- IV therapy: Many insurers see IV hydration as “wellness” rather than “medical,” and simply refuse coverage
“We’ve seen nurse practitioners covered individually for years, but once they open an S-Corp for IV therapy, their insurer cancels them mid-term,” says Sullivan.
That leaves you 60 days to find new coverage, often after major carriers have blocked the practice type.
Why NPs & PAs Need Tailored Liability Insurance for Modern Practice
Tailored liability insurance anticipates the realities of modern practice:
- Cosmetic add-ons: Ensures Botox, fillers and other procedures are explicitly covered
- IV therapy: Accounts for the medical complexity of hydration therapy
- Telehealth: Clarifies whether virtual visits are included
Telehealth is a good example of why tailored insurance matters. Five years ago, many insurers required you to see a patient in person before providing telehealth care. Today, with interstate licensure compacts and rural access needs, that restriction doesn’t make sense. Yet some policies still enforce it. “You need to ask directly if telehealth is part of your policy. Otherwise, you may discover limits only after you’ve already treated patients,” says Sullivan.
For providers treating patients across multiple states, this kind of limitation could invalidate coverage. Be sure to ask specifically if there are any coverage limits.
NPs & PAs Should Ask Before Buying Liability Insurance
When evaluating liability insurance for your NP or PA practice, be sure to ask more than just the premium price. Consider asking the following:
- Are there exclusions for the specific procedures I perform?
- Does the policy cover my corporate entity as well as me individually?
- Is telehealth covered, and under what conditions?
- If I expand services, will you adjust the coverage or terminate?
- What disclosures do I need to stay compliant with your carrier?
How NPs & PAs Can Choose the Right Liability Insurance Partner
No two NPs or PAs practice identically, so neither should your insurance be the same. As you open practices, add a new service or meet patients in new ways, your liability insurance should meet the demands of how you operate.
Not all insurers move at the same pace. “The people making these decisions often have never actually experienced the services, or seen how highly professional these providers are,” says Sullivan.
That’s why tailored liability coverage with partners who understand your business isn’t just a formality. It’s protection against career-threatening gaps. By choosing the right insurance partner and asking the right questions up front, you can ensure your policy keeps up with your practice.
Frequently Asked Questions
- Why do NPs and PAs need tailored liability insurance? A one-size-fits-all malpractice policy may exclude procedures like Botox, fillers, IV therapy, or telehealth. Tailored liability insurance ensures nurse practitioners (NPs) and physician assistants (PAs) are fully covered for the services they actually provide.
- What procedures are often excluded from standard NP or PA malpractice insurance? Many carriers exclude aesthetic procedures such as cosmetic injectables, IV hydration therapy, and certain telehealth services. Without tailored liability coverage, NPs and PAs could face dangerous gaps in protection.
- What questions should NPs and PAs ask before buying liability insurance? Providers should confirm if their policy covers specific procedures, corporate entities, and telehealth. They should also ask whether coverage can expand as services grow—ensuring the insurance adapts to their practice instead of leaving costly gaps.
Click here to learn more about tailored liability insurance for your NP or PA practice.
