Malpractice insurance was designed around a fairly simple model: a physician practices in one location, sees patients who live nearby, and the policy covers claims arising from that practice. Multi-state telehealth complicates that model, and physicians expanding into new states often discover that their existing policy raises more questions than it answers.
Does the policy actually follow the physician
Not all malpractice policies automatically extend coverage to every state where a physician becomes licensed. Some carriers require the policyholder to notify them and, in some cases, pay an additional premium before practicing in a new state. Assuming coverage extends automatically without checking is one of the more common and avoidable gaps physicians run into when expanding a telehealth practice.
Questions worth asking a carrier
Physicians expanding across state lines often ask their carrier directly whether the policy covers claims based on the patient's location, the physician's location, or both, since a malpractice claim can potentially be filed in the state where the patient received care. It is also worth asking whether the policy has any exclusions specific to telehealth modalities, and whether coverage differs for asynchronous care, such as store-and-forward consultations, compared with live video visits.
A malpractice claim can potentially follow the patient's state, the physician's state, or both — which is exactly the question a policy needs to answer before, not after, a claim is filed.
Tail coverage and compact practice
Physicians practicing under an interstate compact privilege sometimes assume their coverage automatically follows the privilege the same way it follows a full license, which is not always the case. It is also worth understanding how tail coverage works if a physician stops practicing in a particular state, since claims can sometimes be filed well after the care was provided.
State-specific requirements
Some states set minimum malpractice coverage amounts or require proof of coverage as part of the licensing or renewal process. These minimums can differ from state to state, so a policy that satisfies one state's requirement may fall short of another's, particularly for physicians who add states to their practice over time.
Malpractice insurance is a contractual and regulatory matter that depends on the specific carrier, policy, and state — always confirm current requirements directly with the relevant state board or agency before making a compliance decision.