Even Failed Claims Against Nurses Cost Insurers $20K, Liability Study Shows

By | September 28, 2020

The report is based on an analysis of professional liability claims to CNA involving registered and licensed nurses and nursing students that were closed from 2015 through 2019. The data set includes 455 claims where more than $10,000 indemnity was paid and an unspecified number of claims where no indemnity was paid.

Paid expenses for those no-indemnity claims climbed from about $6,000 in 2010 to about $13,000 in 2015, and to about $21,000 through the end of 2019, according to a graphic included in the report. That amounts to an average annual increase of 14.6% over the past five years. By comparison, expenses for those claims increased at a 2.8% rate from 2011 to 2015.

“Even when excellent nursing care is provided, patient co-morbidities or system failures can result in an inadequate patient outcome. Understanding the conditions that lead to a claim can help nurses develop techniques to mitigate risk and minimize the potential for litigation.”

“The reasons for the increased costs vary, including the escalating costs of defense counsel, as well as the need for skilled experts knowledgable in the science and regulations relating to the practice of nursing,” the report says. “These expense costs are integral to an aggressive defense of an insured nurse against non-meritorious claims.”

The 2020 report was the fourth issued by CNA and NSO and includes data from the last report in 2015 up until the end of 2019. Reports were also issued in 2008 and 2011.

The latest report shows the cost of claims where at least $10,000 in indemnity was paid increased much less rapidly than the no-indemnity claims, averaging an annual rate of less than 1%. The report shows the average cost of claims with an indemnity payment was $204,594 in the 2011 report, dropped to $201,670 in 2015 and climbed to $210,513 in the 2020 report.

The vast majority of those 455 claims — 86.8% — involved registered nurses, with the remaining 12.8% involving licensed vocational and licensed practical nurses. CNA said 89% of insured nurses are registered nurses and 11% are licensed.

Home Health Nurses

The report says home-health care nurses are becoming a more frequent target of lawsuits. Nurses involving in palliative and hospice care in patients’ homes were involved in 20.7% of CNA closed claims involving nurses. That is up from 12.4% in 2015 and 8.9% in 2011.

In the meantime, the share of claims involving adult medical/surgical nurses dropped from 40.1% in 2011 to 36.1% in 2011 and 18.5% in 2019. Nurses in senior care facilities were involved in 18% of claims in 2011, 16.4% in 2015 and 10.5% in 2020.

The report says that allegations involving treatment and care made up 56% of paid indemnity claims. Many of the claims reflect a failure to fulfill core nursing responsibilities, such as negligent performance in the use of peripheral intravenous catheters, nasogastric tubes or urinary catheters.

Allegations involving patient rights, abuse or professional conduct made up 14.3% of claims, medication administration 10.1%, monitoring 7.6%, assessment 5.1% and scope of practice 3.3%.

The report also includes an an analysis of costs in claims involving license protection, such as an inquiry by a state nursing board in response a patient’s complaint. The average cost of those claims was $5,330, an increase of 33.7% compared the 2015 report and 58.9% since 2011.

The report says defense payments are increasing because of the escalating costs of defense counsel, inflation and the “individual nature” of investigations that make take years to resolve.

“Even when excellent nursing care is provided, patient co-morbidities or system failures can result in an inadequate patient outcome. Understanding the conditions that lead to a claim can help nurses develop techniques to mitigate risk and minimize the potential for litigation,” stated Michael Scott, assistant vice president for healthcare underwriting at CNA. “Through this report, we are giving nurses the tools they need to help create a safer environment for their patients as well as themselves.”

(AP Photo/John Minchillo, File)

About Jim Sams

Sams is editor of ClaimsJournal.com, the online resource and daily newsletter for property/casualty insurance claims professionals. ClaimsJournal is a member of the Wells Media Group. Sams can be reached at jsams@wellsmedia.com More from Jim Sams

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