Picture an ordinary year for one Acadiana family. A checkup with the family doctor off Kaliste Saloom. A Saturday trip to urgent care in Youngsville after a fall in the backyard. A few weeks of home health visits after a parent's hip surgery, and later, hospice care at home in Broussard.
The patient is the same in every setting. The insurance isn't. Each of those providers carries a different mix of risk, and coverage built for one setting leaves gaps in the next. Here's how it changes, and where the gaps tend to show up.
A few things apply to almost every practice, clinic, and agency in south Louisiana before the differences start.
The Patient's Compensation Fund. Under Louisiana's Medical Malpractice Act, qualified health care providers who enroll in the Fund carry a defined private layer of malpractice coverage, and the Fund covers damages above it up to the statutory cap. Enrollment status changes what the private policy has to do. That's why a quote from a carrier that prices Louisiana like any other state usually isn't measuring the same thing.
Patient data. Louisiana's Database Security Breach Notification Law and federal health privacy rules both apply to patient records. Malpractice coverage doesn't respond to a breach. Cyber coverage does.
Storms. A provider that can't operate after a storm still owes payroll, rent, equipment payments, and premiums. Business interruption coverage should be sized to actual monthly overhead, not a round number picked at binding.
Clinical staff injuries. Needlesticks, patient lifting, and transfers make clinical workers comp different from office workers comp, and classification affects what you pay.
For a physician practice, PCF enrollment is the starting point, and practice structure decides most of the rest. A solo physician leasing space needs something different from a three-provider group that owns its building.
The assumption we run into most often is that malpractice covers the practice. It covers claims arising from patient care. Falls in the waiting room, equipment losses, a breach of patient records, and an office closed for two weeks after a storm all need their own coverage. So do the decisions practices tend to make once and never revisit: whether associates and mid-levels are covered under the entity policy, and who pays for tail coverage when a physician leaves.
More on how we approach this: Insurance for Medical Practices in Lafayette, LA.
An urgent care center runs like a clinic, a retail storefront, and often an occupational health provider, all under one roof. That changes the coverage in a few specific ways.
Rotating providers. Centers rely heavily on nurse practitioners, physician assistants, and per diem or locum physicians. Gaps open when providers change and nobody updates the schedule of insureds.
Employer work. Many Acadiana centers handle drug screens, DOT physicals, and injury care for local employers. An error in one of those services can bring a claim from the employee, the employer, or both, so those services need to be listed on the policy.
Power without damage. Standard business interruption coverage usually requires physical damage at your location. A center with an intact building and no power can lose days of revenue without triggering it. Utility service interruption and equipment breakdown coverage close that gap.
Front desk payments. Card payments, patient portals, and billing vendors add payment card exposure on top of health records.
More on urgent care coverage: Insurance for Urgent Care Centers in Lafayette, LA.
Home health and hospice care happens in living rooms, on parish roads, and at the bedside. Most of the exposure sits outside the agency's office.
The drive. Nurses, aides, and chaplains driving their own cars between visits create auto exposure that can come back to the agency. The employee's personal auto policy usually responds first, but larger claims often look to the employer. Hired and non-owned auto coverage protects the agency in that situation.
Care in a setting you don't control. Falls during transfers, medication errors, pressure injuries, and missed visits drive home health claims. Ask whether your policy includes abuse and molestation coverage. Many policies exclude it, and in-home care is one of the settings where those allegations come up.
Hospice is different again. Hospice claims rarely turn on whether a patient recovered. They tend to center on pain management, communication with the family, and whether documented wishes were followed, and they often come from family members rather than the patient.
Volunteers and medical directors. Hospice volunteers generally aren't employees, so workers comp may not respond if one is hurt during a visit. Volunteer accident coverage fills that gap. Contracted medical directors may or may not be covered under the agency's policy, so that's worth confirming in writing.
Audits. Home health and hospice draw heavy audit attention around eligibility and documentation. Standard professional liability usually doesn't pay to defend those proceedings, though some carriers offer regulatory or billing errors coverage that does.
More on home health and hospice coverage: Insurance for Home Health and Hospice Services in Lafayette, LA.
Whatever setting you work in, these three questions catch most of the gaps we see:
Kastner Insurance Group is an independent agency on Ridgeway Drive in Lafayette. We work with physician practices, urgent care centers, and home health and hospice agencies across Acadiana, from Carencro to Broussard and out to the rest of south Louisiana.
We'd rather review coverage before a renewal than after a claim. If your practice, center, or agency has grown since the last real look, get a second opinion on your insurance. Call 337-291-0018 or click the button below.
Founded in 2017, Kastner Insurance Group is a full-service, independent insurance broker based in Lafayette, LA. Our insurance agents specialize in offering a variety of insurance products tailored to individual and commercial needs, making sure clients receive personalized and comprehensive coverage options from a variety of insurance companies/insurance carriers.
With over 43 years of combined experience, the team at Kastner Insurance Group is dedicated to providing expert advice and exceptional service. They proudly serve professional offices and businesses across Lafayette city/parish, Youngsville, Broussard, Baton Rouge, New Orleans, Alexandria, Acadiana, and statewide in Louisiana.