Does our practice policy cover a locum tenens physician?

It depends on how your form defines who is an insured. Some policies include temporary or locum providers automatically for a stated period, some include them only when scheduled and reported for additional premium, and some exclude care rendered by providers not named on the declarations. A fourth and often preferable structure covers the practice for vicarious liability arising from that physician's care without insuring the physician individually. Confirm which one you have before the next locum starts.

If the locum physician has their own malpractice insurance, are we protected?

Partially. Their policy covers them, and if a patient sues only the physician it may be enough. But patients routinely sue the practice as well, on apparent agency, negligent credentialing, or corporate negligence theories. Those claims are against the practice, and the physician's policy generally will not defend the practice. Your own coverage for vicarious exposure, plus a credentialing file that documents what you verified, is what answers that half of the claim.

What is tail coverage and why should we require it from contractors?

Most malpractice policies are claims made, meaning they respond to claims reported while the policy is in force. When that policy ends, later reported claims are uncovered unless an extended reporting period, or tail, was purchased. Because malpractice claims often surface years after the care, a contractor who let coverage lapse without a tail has no insurance behind your indemnity clause. Requiring evidence of a tail, or of occurrence form coverage, closes that gap.

What should the independent contractor agreement require?

Specifics rather than generalities. State the required per claim and aggregate limits, state whether occurrence or claims made coverage is acceptable and require a tail if claims made, require certificates at engagement and at each renewal, require notice of cancellation or non renewal, and keep the indemnity obligation aligned with coverage that will actually exist. An indemnity promise wider than the contractor's insurance is a promise without funding behind it.

Does any of this change for telehealth providers?

The vicarious liability analysis is similar, but licensure adds a layer. A provider delivering care to a patient located in another state generally needs to be licensed, or otherwise authorized, in the patient's state, and a policy may exclude care rendered without proper licensure. So for contracted telehealth providers, the credentialing file needs to track licensure by state alongside the usual verifications, and the policy needs to be read for any territory or licensure condition.

Locum Tenens and Contracted Physicians: Who Covers the Claim?

How Vicarious Liability Reaches the Practice

A practice can be liable for the acts of a non employee physician on several theories. Apparent agency applies when the patient reasonably believed the physician was acting for the practice, which is usually the case when the patient booked through the practice and was seen in the practice's office. Negligent credentialing applies when the practice failed to adequately verify training, licensure, or claims history. Corporate negligence applies when the practice's own systems, scheduling, supervision, or coverage protocols contributed to the injury. None of those theories require the contracted physician to be an employee. They require only that the practice did something, or failed to do something, that connects it to the harm. That is why an independent contractor agreement with a strong indemnity clause is useful but not sufficient. Indemnity is only as good as the indemnitor's assets and insurance, and if the locum physician's carrier denies or the limits are exhausted, the practice is paying. The practical conclusion is that a practice using contracted physicians needs its own coverage to respond to claims arising from their care, not just a promise from them that it will not be necessary.

Apparent agency, negligent credentialing, and corporate negligence all reach the practice directly
None of them require the contracted physician to be an employee
Contractual indemnity is useful but depends on the contractor's assets and insurance
The practice needs coverage of its own for claims arising from contracted care

Where the Policy Language Lives

Medical professional liability policies define who is an insured, and that definition is where the locum question gets answered. Some forms include leased, temporary, or locum tenens providers as insureds automatically for a stated period. Some include them only if scheduled and reported with additional premium. Some exclude care rendered by any provider not named on the declarations. And some cover the entity for vicarious liability arising from a non insured provider's acts while not covering the provider individually, which is often exactly what a practice wants. That last structure is worth understanding, because it is the cleanest answer to the problem. The locum physician carries their own professional liability, usually arranged through the staffing agency. The practice's policy does not insure the physician, but does cover the practice's own vicarious exposure for that physician's care. Both parties are protected without anyone paying twice for the same risk. The failure mode is a form that excludes care rendered by non insured providers. Under that language, the practice has no coverage for the vicarious claim at all, and is relying entirely on the locum's policy and the indemnity clause. That is a structural gap, and it is invisible until the claim arrives.

The definition of insured, not the contract, decides whether the practice is covered
Some forms add locum providers automatically, some only when scheduled, some not at all
The best structure often covers the entity's vicarious exposure without insuring the individual
A form excluding care by non insured providers leaves the practice relying solely on indemnity

Claims Made Dates and the Departing Contractor

Most medical professional liability is written claims made, which means the policy responds to claims reported during the policy period for incidents occurring after the retroactive date. That structure creates two timing problems with contracted physicians. The first is the retroactive date. A locum physician who worked at the practice two years ago and whose patient files a claim today is a claim reported now for care delivered then. Whether the practice's current policy responds depends on its retroactive date and on whether that care was covered when rendered. Practices that change carriers without carrying prior acts coverage forward can lose coverage for a period they already lived through. The second is tail coverage on the contractor's side. When a locum physician's own claims made policy ends, claims reported afterward are not covered unless an extended reporting period, commonly called a tail, was purchased. If the practice's indemnity protection depends on that physician's insurance, and the physician let coverage lapse without a tail, the indemnity is worth whatever the physician personally has. Requiring evidence of tail coverage, or of an occurrence form, in the contractor agreement is one of the few genuinely effective contractual controls here.

Claims made coverage depends on the retroactive date, not just the current term
Carrying prior acts forward at every carrier change protects care already delivered
A contractor's claims made policy needs a tail, or claims reported later are uncovered
Require evidence of tail coverage or occurrence form coverage in the contractor agreement

Building the Contract and the Credentialing File

Insurance and contracting work together here, and the credentialing file is the bridge. Negligent credentialing claims are defended with documentation, so the file needs to show what was verified, when, and by whom: licensure, DEA where applicable, board certification, training, claims and disciplinary history, references, and current evidence of professional liability coverage with limits and form type. On the contract side, the provisions that actually do work are specific rather than general. Name the required limits and whether they are per claim and aggregate. Specify occurrence form or claims made with a tail requirement. Require the practice to be given notice of cancellation or non renewal. Require certificates at engagement and at every renewal during the term. And align the indemnity language with what the physician's policy will actually cover, because an indemnity obligation broader than the available insurance is an uninsured promise. Then, separately, confirm with your own carrier how the policy treats these providers. That conversation takes fifteen minutes and is the only way to know whether you are buying coverage for your vicarious exposure or assuming it.

Document credentialing verification thoroughly, since it is the defense to negligent credentialing
Specify required limits, form type, and tail requirements rather than requiring adequate insurance
Require certificates at engagement and at each renewal, and notice of cancellation
Confirm directly with your carrier how your form treats locum and contracted providers

Frequently Asked Questions

Related Resources

This article is for general information and is not a substitute for policy language or professional advice.

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