Locum tenens insurance primarily refers to malpractice coverage designed for physicians on temporary assignments. It protects against claims or lawsuits related to patient care provided during a locum role, covering legal defense costs and any settlements or judgments, up to the policy limits.
These policies generally mirror standard malpractice coverage, addressing allegations of negligence, errors, or omissions that result in patient harm. However, they often include specific definitions, limitations, and exclusions. Most do not cover criminal acts or services outside the scope of your assignment, so it’s important to review your policy details carefully.
In addition to malpractice coverage, locum tenens physicians—often working as independent contractors—may also need to consider health, disability, life, or travel insurance, as these benefits are not typically provided by the facility. While malpractice is the core focus, these other coverages also play an important role in a complete insurance plan for locum work.
Locum Tenens Insurance vs. Standard Malpractice Insurance
Understanding how locum tenens malpractice coverage differs from standard malpractice insurance is key for physicians considering temporary assignments.
1. Coverage Scope and Portability
- Standard malpractice insurance (typically provided by an employer or hospital) is tied to a specific job and location.
- This coverage generally does not extend to side work or temporary assignments.
- If you leave your job or moonlight elsewhere, you may not be covered.
2. Why Locum Tenens Requires Dedicated Coverage
- Locum tenens physicians often work at multiple facilities or through different agencies.
- Standard employer-provided malpractice policies typically exclude moonlighting or locum work.
- Without proper locum-specific insurance, you could be uninsured during temporary assignments.
3. Who Provides Coverage?
- In most locum tenens roles, the staffing agency or facility provides malpractice insurance.
- Reputable agencies like Wapiti Medical Staffing include coverage from A-rated carriers with tail coverage, ensuring no gaps in protection.
- In contrast, permanent employees may have to purchase their own policy or rely on an employer’s group plan.
4. Situations That Require Additional Coverage
Consider these scenarios:
- You have a full-time job with malpractice insurance but pick up weekend shifts at another hospital. That insurance likely won’t cover those shifts.
- You accept assignments through multiple locum agencies. The policy from Agency A won’t cover work done through Agency B.
- Every locum assignment must have its own malpractice policy in place.
5. Flexibility and Duration of Coverage
- Traditional malpractice policies cover one job and renew annually.
- Locum tenens coverage needs to be more flexible and portable, potentially spanning multiple states and short durations.
- Coverage may be structured on a per-assignment, per-diem, or short-term basis.
- Some locum agencies maintain master policies that extend coverage to their contractors across all assignments.
Types of Locum Tenens Insurance Coverage
Locum tenens physicians should understand the key insurance coverages that fall under “locum insurance.” Here’s a breakdown of the most important types:
1. Professional Liability (Malpractice) Insurance
This is the foundation of locum tenens insurance. It protects against claims of medical negligence and is either provided by the agency or facility per assignment or purchased independently.
Policies typically include coverage limits—commonly $1 million per claim and $3 million annually. These limits define how much the insurer will pay and should align with hospital and state requirements. Too-low limits could leave you exposed, while overly high limits may draw more attention in lawsuits.
Malpractice policies come in two forms: occurrence-based and claims-made, which we’ll break down next.
2. Claims-Made vs. Occurrence Coverage
Understanding the difference between these two policy types is essential.
- Occurrence coverage protects you for any incident that happened during the policy period, even if the claim is filed years later.
- Claims-made coverage only protects you if the claim is filed while the policy is still active.
If your policy is claims-made and ends before a claim is filed, you’re not covered unless you’ve arranged for tail coverage.
3. Tail Coverage (Extended Reporting Endorsement)
Tail coverage becomes critical when working under a claims-made policy. It extends your protection beyond the policy’s end, covering claims that arise after your assignment concludes—as long as the incident occurred during the original coverage period.
Tail coverage can be expensive, sometimes costing up to 100–200% of the base premium. That’s why it’s important to know if your agency provides this coverage. Some, like Wapiti Medical, include tail coverage as part of their group policies to ensure physicians aren’t left unprotected.
If you’re purchasing your own claims-made policy, factor in the additional cost of a tail or seek policies that include “nose coverage,” which covers prior acts and can eliminate the need for a tail.
4. Short-Term or Assignment-Based Coverage
One advantage of locum tenens work is that you can get malpractice insurance just for the length of your assignment. Many insurers offer short-term or pro-rated policies—sometimes as brief as 30 days.
While cost-effective, these are usually claims-made, which means tail coverage is still necessary if there’s a gap between assignments. Some hospitals or state regulations may require occurrence coverage for short-term work, so be sure to match your policy type to the assignment requirements.
5. Personal Health Insurance
Health insurance isn’t typically included in locum tenens assignments. As an independent contractor, you’re responsible for securing your own plan.
Whether through an individual policy or a group plan via a professional organization, having health insurance is crucial. An unexpected illness or injury without coverage can quickly become a financial burden—and could also limit your ability to work.
6. Disability and Life Insurance
Locum tenens physicians should also consider additional coverage to protect their income and families.
Disability insurance offers financial support if you’re unable to work due to injury or illness. Since locum work doesn’t come with built-in sick leave or disability benefits, this can be a vital safety net.
Life insurance is equally important if you have dependents who rely on your income. While not specific to locum work, these protections are important for anyone practicing independently.
7. Travel and Liability Insurance
Most agencies cover travel and lodging for assignments, but this does not include travel insurance. You might still want a travel policy if you’re going long distances or working in remote areas, particularly for coverage like trip cancellations or emergency medical evacuation.
If you’ve set up a locum business entity (like an LLC), a general liability policy might also be worth considering. While it won’t replace malpractice insurance, it can provide coverage for other business-related risks.
Who Provides Locum Tenens Insurance?
A common question among physicians is: Who provides the malpractice insurance when working locum tenens? The answer depends on how the assignment is arranged. Below are the typical scenarios.
1. Locum Tenens Staffing Agencies
In most cases, if you work through a staffing agency, the agency provides malpractice insurance for the duration of the assignment. This coverage is arranged and paid for by the agency—usually through a group policy or third-party insurer—and is typically free to the physician.
Agencies like Wapiti Medical Staffing include malpractice coverage as part of your assignment, often with high coverage limits and tail coverage included. This makes working through an agency a low-risk, streamlined option.
Even when insurance is provided, always confirm:
- Coverage limits
- Whether the policy is occurrence or claims-made
- Who handles tail coverage if it’s needed
2. Medical Facilities or Hospitals (Direct Contracts)
If you contract directly with a hospital or clinic—without going through an agency—malpractice coverage can vary.
Some facilities will extend their malpractice coverage to locum physicians. Others may require you to secure your own policy naming the facility as a certificate holder. In these situations, clarity is key: make sure the contract explicitly states who is providing coverage.
If the facility provides it, confirm:
- The coverage limits
- Whether it’s occurrence or claims-made
- If tail coverage is included (if needed)
If you’re responsible for your own coverage, arrange a policy before you begin practicing.
3. Third-Party Malpractice Insurers (Self-Purchased Policies)
Some physicians choose to purchase their own malpractice insurance—particularly those working independently or with multiple agencies.
Carrying your own policy gives you full control over the terms, limits, and type of coverage. For example, an annual occurrence-based policy can ensure continuous protection across all assignments, regardless of agency or location.
While this offers peace of mind, it comes with out-of-pocket costs. If you carry your own policy, notify the agency or client and provide proof of insurance. In most cases, only one policy (typically yours) will respond in the event of a claim.
4. Other Providers of Coverage
Some state-run programs or professional organizations offer malpractice coverage options tailored for part-time or locum practitioners. In certain states, you may need to enroll in a Patient Compensation Fund (PCF) or similar excess coverage program. If applicable, your agency or insurer will usually help manage those requirements.
Do Locum Tenens Physicians Need Their Own Malpractice Insurance?
Locum tenens physicians always need to be covered by malpractice insurance—there’s no exception. However, you don’t always need to purchase your own policy. Whether or not you do depends on who you’re working with and how your assignments are structured.
When You’re Covered by the Agency or Facility
If you’re working through a staffing agency that confirms in writing they provide malpractice coverage (including tail, if needed), then you usually do not need to purchase your own policy for that assignment. Most agencies prefer to funnel liability through their own coverage and include you as a named or additional insured.
What to confirm:
- Are the policy limits at least $1M/$3M (or whatever is required by the state or facility)?
- Is the policy claims-made or occurrence?
- Who provides tail coverage, if necessary?
Keep in mind: agency coverage only applies to work performed through that agency. If you take on work elsewhere, you’re not covered by that same policy.
If You Work with Multiple Agencies or Take Side Gigs
Physicians juggling multiple assignments from different agencies or contracts may be covered under different policies at different times. That’s fine—as long as each assignment is covered.
However, if you’re concerned about gaps in coverage, who handles claims, or moonlighting that’s not covered by an agency, then you may want to carry a personal malpractice policy that ensures continuity across all your work.
During Transitions or Gaps Between Assignments
If you’re between jobs or waiting for the next contract, it’s smart to consider temporary personal coverage—especially if your last assignment had a claims-made policy without tail coverage. You could purchase a tail from the previous insurer or find a policy that includes “nose” (prior acts) coverage to bridge the gap.
Even short-term gaps can become an issue if a claim arises, so it’s better to stay continuously covered.
For Peace of Mind and More Control
Some physicians choose to carry their own policy even when agency coverage is provided. This gives you:
- Control over policy terms
- Access to features like consent-to-settle clauses
- Confidence in how your professional record will be defended
Note: having both policies doesn’t double your limits. Your personal policy may act as a backup, but typically only one policy will respond in a claim.
When It’s Required by Contract
In some direct contracts—especially those with hospitals or smaller agencies—you may be required to carry your own malpractice insurance. If that’s the case, the cost should be factored into your compensation. Don’t assume coverage is included unless it’s clearly stated in writing. Always ask.
If coverage isn’t provided, it’s your responsibility to secure a policy before practicing.
Bottom line – you need malpractice insurance for every assignment. Whether that coverage comes from an agency, a facility, or your own policy depends on the arrangement.
Many physicians work exclusively with agencies like Wapiti Medical Staffing, which handle malpractice coverage—including tail—on your behalf. If that’s your situation, there may be no need to purchase your own policy. But if you’re freelancing or working independently, having your own malpractice insurance can offer added flexibility and protection.
Key Factors to Look For in a Locum Insurance Policy
Whether you’re reviewing a policy provided by an agency or purchasing your own, understanding the key elements of locum tenens malpractice coverage is critical. Here’s what to look for:
1. Coverage Type: Claims-Made vs. Occurrence
Know which type of policy you’re dealing with.
- Occurrence policies cover incidents that happen during the policy period, even if claims are filed later—no tail needed.
- Claims-made policies are more common and only cover claims filed while the policy is active. If it ends, you’ll need tail coverage unless coverage is extended or continuous.
Some agencies maintain long-standing group policies with retroactive dates that cover all past assignments, removing the need for individual tails. If that’s not the case, make sure extended reporting is provided or arrange your own tail.
2. Policy Limits
Typical physician policies offer $1M per claim / $3M per year. Some states or specialties may require more. Avoid underinsuring to save money—too-low limits can expose your personal assets in a large claim. On the other hand, excessively high limits aren’t always necessary and may make you a more attractive legal target.
If you’re on a group policy, confirm that the limits are per provider and not shared.
3. Legal Defense and Consent Clauses
Malpractice insurance should include legal defense costs—ideally paid outside the policy limits. This prevents attorney fees from reducing the funds available for settlements.
Also check:
- If the policy covers state medical board investigations
- Whether you must consent to any settlements (some policies allow insurers to settle without your approval)
- Whether there’s a “hammer clause”—which could make you financially liable if you refuse a recommended settlement
These clauses impact how your reputation and liability are handled in a claim.
4. Coverage Territory and Scope
Ensure your policy is valid in every state where you’ll work, and that it covers your full scope of practice.
- Notify your insurer if you plan to work in multiple states
- Make sure any procedures you perform are covered, especially if they’re outside your primary specialty
- Stay within the scope outlined in your contract—unauthorized work may not be covered
If an agency is handling your policy, they should coordinate state-specific compliance, but it’s still smart to double-check.
5. Insurance Carrier Quality
Stick with financially strong, reputable insurers. If a claim arises years later under a claims-made policy, you need a carrier that’s still stable and in business.
Agencies like Wapiti typically partner with A-rated carriers experienced in locum tenens coverage, which ensures reliable support and streamlined claims handling.
6. Tail Coverage or Portability
If your policy is claims-made:
- Confirm who provides tail coverage
- Understand any conditions (e.g., deadlines, non-compete clauses)
- If you’re ending your own policy, arrange tail or replacement coverage with prior acts (nose) coverage included
Occurrence policies don’t require tails, but they’re less common in locum settings due to cost.
7. Exclusions and Special Clauses
Every policy contains exclusions—such as criminal acts, undisclosed procedures, or practicing without a license. These are standard, but important to know.
Pay attention to:
- Whether multiple claims from one incident are grouped into one
- Limitations that might affect unusual or specialized procedures
- Any language that could shift liability to you in certain situations
Even if you’re not an insurance expert, reviewing these details—or asking a broker or legal professional to help—can save you trouble down the road.
Stay Protected and Focus on What Matters Most
Locum tenens work offers flexibility and freedom—but only when you’re properly covered. Locum insurance includes malpractice, health, and disability coverage, giving you peace of mind as you move between assignments. Before accepting a role, make sure you understand who provides your malpractice coverage, what it includes, and what additional protection you may need.
Working with a reputable agency like Wapiti Medical simplifies the process. Wapiti provides A-rated malpractice coverage with $1M/$3M limits and tail coverage, along with credentialing support—so you can walk into every assignment with confidence. It’s still smart to carry your own health insurance, maintain an emergency fund, and consider disability coverage for added security.
With the right protections in place, you can enjoy the benefits of locum tenens—travel, flexibility, and purpose-driven care—without unnecessary stress. New to the field? Check out our guide to locum tenens or explore current locum tenens job opportunities with Wapiti to get started.