upset and worried

The Advocacy Liability Insurance Conundrum

Once in awhile a topic in the APHA Connect! Discussion Forum takes on a life of its own. The recent conversation regarding liability / professional / E&O (errors and omissions) insurance for advocates is one of them.

I’m going to share part of the conversation with you, then provide some perspective, too.

The Conversation Trigger

Recently, the company that has provided business liability insurance to the majority of professional advocates during the past few years has decided to stop covering advocacy practices. APHA’s insurance advisor* has explained that the insurer has decided instead to focus on different kinds of insurance. I suspect that if we follow the money, they just aren’t profiting enough from patient advocates. That would be because there aren’t enough of us, and not because it has cost them much of anything, IF anything. As far as I know, no advocate has ever been sued, nor has made any claim with their liability insurer.

The reaction on the part of APHA members has been, well, varied. Of course, we read the digital words and can’t help but ascribe a certain “tone of type”. While some professionals are taking this insurance company’s decision in stride, others seem to be panicking, even blaming the APHA insurance advisor as if he has any control over the insurer’s choices. (No need to shoot the messenger!)

We’ve been here before! We’ve actually been here a few times. And with each iteration of change, our professional advocacy business liability insurance situation has improved. THAT is important to note, because it’s possible that will happen again this time, too.

A Little Advocacy Insurance History

When we got started as a bona fide profession in 2009, there was no such thing as advocacy insurance! Advocates who were nurses were able to add a rider to their existing nursing insurance, but other than that – nuttin’. Nada. Non-medically-licensed advocates were flying with no insurance net.

By early 2010, we had reached out to a number of people, people who connected us to people, and eventually we found a gentleman named Bob deBlasio who helped us work with a medical malpractice company, One Beacon, to develop an actual policy. It cost advocates a “mere” $1500! WHOA! But advocates paid it, year after year, because it was the only policy available.

insurance and risk

Over the years, as more and more advocates joined APHA, we realized that the One Beacon policy didn’t fit all their circumstances:

  • They were performing different sorts of services that were not about system navigation. Some were more like accounting (client medical bills), or legal (like mediation or guardianship). Some called their services “nurse advocacy” or “physician-advocacy” – meaning they were licensed and could not fall under a non-medical advocate insurance umbrella.
  • Not all advocacy practices use the same business format. Some of you are sole practitioners. Others have created LLCs or PLLCs or even corporations.
  • Advocates are found throughout the United States and Canada, and insurance requirements and pricing changes state-to-state and province-to-province.

So APHA went in search of insurance carriers for those differing circumstances. At one point we listed as many as 15 insurers. Some have come and gone. Eventually, over time, one of the great outcomes of the shifts that have taken place is that insurance pricing has been reduced to a fraction of that original $1500 – for most advocates. (Not all. Those who are licensed physician advocates must still pay quite a bit more.)

Today APHA lists 9 different insurers. Not all of them provide insurance to all advocates or APHA members.

Now another one is going away. So, as all good, healthy organizations do, APHA is assessing the situation. Again. Because that’s what a professional membership organization does. It takes care of its members. That’s WHY you pay your dues. It’s what we have always done.

Defining Our Advocacy Profession

The suggestion has been made in the APHA Discussion Forum that in order to be insured, we need to define our profession. There are at least two responses to that:

  • A profession is defined by the services provided. We have named those services (and update them every now and again.) Find them here. Several APHA members have reported that their insurance defines them as “healthcare consultants.” That may fit for them, especially if they are working in the system navigation part of healthcare. But I’ll also point out that if I hear the term “healthcare consultant” – I think that describes a professional who consults with doctor practices, hospitals, or other medical-type businesses. And, it doesn’t work for all advocates.
  • Our profession of advocacy can’t be covered by one type of insurance policy. As described above, it’s too varied! There is nothing so simple as one-size-fits-all coverage for advocacy.

So – Where does that leave us?

While professional advocacy liability insurance may be in a bit of flux at the moment, that’s not a bad thing! Options do exist, as outlined in the pages of your membership website and your APHA team is working on more possibilities. There is no need for panic. It’s just part of our evolution, and if anything has been a certainty since 2009 – it’s that our profession continues to evolve!

One aspect of being a business owner, especially in a market segment that is so new as advocacy, is that one needs to embrace that challenges most often create positive change. Smart business owners and entrepreneurs embrace challenges for that reason.

APHA will always work on its members’ behalf to be sure that evolution and change goes in a very positive direction.

APHA’s got your back!

We know you have more questions, and we have identified experts to answer them for you.

In February (2022) we’ve scheduled an APHA Expert Call-in to help us all better understand the state of advocacy liability insurance. Don Mucci from Gallagher will join us, and you’ll have your opportunity to get the most up-to-date information.

Learn more about this call-in: Understanding insurance needs for your company and exploring future opportunities for our profession to improve access and cost.


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*It should be noted here that APHA provides the information we can find about the various companies that provide professional insurance to advocates, but does not derive any income or commissions whatsoever from providing that information, or from the sale of any policies. The information is provided as a service to our members only.

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