WTW receives a number of questions regarding coverage for student interns. In particular, there is confusion over the pros and cons of the most effective solution for student intern coverage. With a variety of options including under educators legal liability, general liability or medical professional liability for such student interns, it can be challenging to determine the most cost effective and coverage rich option. It is important to carefully compare policy forms and engage in detailed discussions with underwriters before finalizing your coverage approach.
While there are many types of student interns and programs, we will use the example of nursing and other Allied Health students. Nursing and other Allied Health students are generally of majority age and are preparing to become health care professionals. Therefore, these students spend time working directly with patients and are vulnerable to malpractice or negligence lawsuits against them, and in turn, their educational institution. The goal is to protect both the students and the faculty who supervise them. Student internships or practicum programs are often at participating hospitals, facilities or clinics. Other times, students perform their intern services for the campus community (for example, nurses at a campus infirmary). One carrier describes an intern as a “student of an educational organization while serving in a supervised internship program in satisfaction of course requirements."
An important first step to clarify coverage is to determine carrier perspective. Some carriers will write the medical professional liability for instructors and students on the same form and others will not. Knowing how the carriers view students and instructors is critical.
Next, we turn to the potentially applicable coverages. Educators legal liability (ELL) covers the failure of the institution to educate. ELL is very different from medical professional liability, which covers errors and omissions in providing healthcare professional services. A third coverage that should be considered is the general liability (GL). It is important to review the potential exposures and the exact implementation of the intern program in question with the general liability or package carrier because there could be an extension under the GL form.
Realistically speaking, most host practicum sites that accept student interns will not even ask about the ELL coverage in the contract. Furthermore, most hospitals typically require the school to purchase medical professional liability for those students participating in an internship/practicum, such that the school has the obligation of maintaining coverage for those students in that capacity. This reality may influence the educational institution to seek a stand-alone MPL policy with a medical malpractice carrier.
Another key element in determining where the coverage responsibility lies for interns is found within the affiliation agreements or other contracts between the school and the practicum sites. A thorough reading of contractual language will typically reveal the party responsible for maintaining the coverage and may outline the limits of coverage required. Determining the amount of limit to carry may require further review. Even if the affiliation agreement states a minimum limit, the educational institution may want to evaluate the adequacy of the required limit. Purchasing additional limit is an option that can be considered by the school and may not need to be disclosed unless required by contract or local law. Consideration for additional limit should include an evaluation of:
There may be additional factors specific to the organization that impact the limit decision as well, such as risk tolerance.
These are a few examples of the intricacies of intern coverage. While we address some key concerns, as always, you must carefully weigh your specific needs, the programs at issue, the exposures contemplated and the policy terms and conditions.
Please reach out to our team for assistance in determining the potential need for separate medical malpractice coverage and market selection.
Willis Towers Watson hopes you found the general information provided in this publication informative and helpful. The information contained herein is not intended to constitute legal or other professional advice and should not be relied upon in lieu of consultation with your own legal advisors. In the event you would like more information regarding your insurance coverage, please do not hesitate to reach out to us. In North America, Willis Towers Watson offers insurance products through licensed entities, including Willis Towers Watson Northeast, Inc. (in the United States) and Willis Canada Inc. (in Canada).
Twane Duckworth has been a dedicated public servant with over 17 years of municipal government practice. During that time, he has served in a legal capacity as an Assistant Attorney General for the District of Columbia and Assistant General Counsel for the City of Jacksonville before transitioning into risk management. As an insurance professional, he operated as the Chief of Risk Management for the City of Jacksonville from 2012 to 2020. He continued his risk career by transitioning to the City of Garland, Texas as a Managing Director of Risk Management until 2022 before joining WTW. As a leader for WTW’s Public Sector and Education industry vertical, he participates in the national strategy to meet the risk management and insurance needs of public entities, non-profits, non-governmental organizations and educational institutions across the U.S.
