Insurance for Nurses and Nurse Practitioners
Your hospital’s policy was bought to protect the hospital. We look for professional liability insurance for nurses that stays with you, the license holder, for California RNs, LVNs and nurse practitioners, and the insurer decides once it has reviewed your license, your specialty and where you work.
RN malpractice insurance when an employer already covers you
California’s Labor Code section 2802 requires an employer to indemnify an employee for losses incurred in direct consequence of the discharge of the employee’s duties. That is the main reason a staff nurse is generally backed by the hospital or clinic for what happens during a shift. The protection follows the job, though, and it stops where the job stops: a volunteer clinic, a weekend shift somewhere else or care given outside your employer’s walls sits beyond it.
Berxi, a Berkshire Hathaway Specialty carrier, lists four things its individual nurse policy adds on top of employer coverage: protection for work outside your employment such as volunteering or moonlighting, limits beyond your employer’s limits, licensing board actions that employer policies often don’t cover, and a say in whether to accept your employer’s decision to settle. Those are one carrier’s selling points, but they make a useful checklist for any RN malpractice insurance quote you compare.
License defense before the Board of Registered Nursing
The Board of Registered Nursing (BRN) licenses registered nurses and certifies nurse practitioners. Licensed vocational nurses answer to a separate agency, the Board of Vocational Nursing and Psychiatric Technicians. Either board can open a complaint with no lawsuit in sight, and the cost of answering it lands on the nurse. In the NSO and CNA Nurse Professional Liability Claim Report (2025 dataset), license defense averaged $6,304 per matter, up 18.3%, and professional conduct complaints were the largest category of license matters.
Money paid on a claim also reaches your board file. Business and Professions Code section 800 has both boards keep a central file on every licensee, recording any judgment or settlement over $3,000 for injury or death caused by the licensee’s negligence. The insurer reports a settlement or arbitration award over $3,000 to the board within 30 days, and a nurse with no professional liability insurance for that claim must report it personally. Ask for a stated license defense limit on any policy you consider, and take questions about a pending complaint to the board and a licensing attorney.
Nurse practitioner malpractice insurance for 103 and 104 NPs
AB 890 (2020), amended by SB 1451 in 2024, created two categories of nurse practitioner who practice within a defined scope without standardized procedures. A 103 NP, under Business and Professions Code section 2837.103, works in a group setting with at least one physician and surgeon. A 104 NP, under section 2837.104, may work independently within the population focus of their national certification after at least three years as a 103 NP in good standing, not counting the transition to practice. Both sections apply beginning January 1, 2023.
The insurance requirement is written into both sections. A 103 NP “shall have professional liability insurance appropriate for the practice setting,” and a 104 NP “shall maintain” the same coverage. Neither section names a dollar limit, so the limit you carry comes from your practice setting, the contracts you sign and what the insurer will write. The BRN’s AB 890 page explains the current certification steps.
A 104 NP practice carries its own liability
Section 2837.104 says a 104 NP “shall be solely responsible for the services they provide,” and that consulting a physician doesn’t create a physician-patient relationship. The 104 NP also keeps a referral plan and consults a physician when a condition is emergent, a problem isn’t resolving, findings are inconsistent or the patient asks. With no supervising physician on the chart, your own policy is the one that answers a claim. The NSO and CNA Nurse Practitioner Claim Report (5th edition, 2022 dataset) put the average total incurred on NP claims at $332,137.
An independent practice is a business as well as a license. The practice entity needs its own malpractice cover, and the office needs general liability or a business owner’s policy. Patient records bring the Confidentiality of Medical Information Act: a patient whose medical information is negligently released can recover $1,000 in nominal damages without proving actual damages, and negligent disclosure carries a fine or civil penalty of up to $2,500 per violation, which is the case for cyber insurance. Labor Code section 3700 makes workers’ compensation mandatory from your first employee.
Travel, per-diem and agency nurses
Staffing agencies and facilities take different approaches to insuring the nurses they place, so ask the agency in writing what its policy covers, whose name is on it and whether it follows you to each facility. The indemnity in Labor Code section 2802 runs from an employer to an employee, so a nurse working on a 1099 should plan on a policy of their own.
Contract status is its own question. Labor Code section 2783(b) does not list nurses among the professions exempt from the ABC test, so per-diem and contract RNs and NPs paid as independent contractors are measured against it. Our guide to employees vs independent contractors in California walks through the three prongs; the Labor Commissioner’s office answers questions about a specific arrangement.
What nursing claims look like and when they arrive
The 2025 NSO and CNA nurse report, built from CNA-insured claims nationwide, put the average total incurred at $236,749, up 12.5% from $210,513, with claims above $750,000 rising to 7.9%. Home health nurses were the largest specialty share at 21.7%, averaging $301,031; obstetrics had the highest severity at $543,305; emergency and urgent care averaged $298,115; and aesthetics claims doubled in share, averaging $131,148. Treatment and care was the top allegation at 56.2%, and LPN/LVN claims averaged 36.2% more than RN claims. Agencies that send nurses into patients’ homes can read our page on home health care agency insurance.
In California, a patient must give at least 90 days’ notice before suing a health care provider for professional negligence (Code of Civil Procedure section 364), and that letter is often a nurse’s first sign of a claim. Most claims-made policies require you to report it. The suit itself must be filed within three years of the injury or one year after the patient discovers it, whichever comes first (section 340.5). Noneconomic damages are capped under Civil Code section 3333.2; Milliman’s table puts the cap for claims resolved in 2026 at $470,000 for injury and $650,000 for wrongful death, and the caps rise each January 1.
What nurse liability insurance costs
Two published sources give a starting point, and neither is a Mithril1 quote. Berxi publishes its own annual prices (updated March 27, 2026, national): $81.38 a year for an RN, CNA or LPN/LVN occurrence policy when an employer also covers the nurse, and $296.57 when it is the nurse’s only policy. Insureon reports a national median of $56 a month for nurses’ professional liability, drawn from policies its customers bought; most of those customers have fewer than five employees and five years or less in business. These are prices for individual nurses and very small practices at standard limits; larger practices pay well above them.
Berxi prices NPs by policy trigger and by whether an employer also covers them: occurrence runs $1,570.08 with employer coverage and $1,963.23 as the only policy, and claims-made runs $502.43 and $628.23. Berxi offers occurrence only to RNs, CNAs and LPN/LVNs, while NPs can choose; our guide to occurrence vs claims-made policies compares the two. As a worked example, a 104 NP opening a practice with one employee who buys that $628.23 claims-made policy and adds Insureon’s nurse medians for general liability ($381 a year) and workers’ comp ($47 a month, or $564 a year) spends about $1,573 a year before cyber ($52 a month) or a business owner’s policy ($64 a month).
Expect a higher premium for an NP license rather than an RN license, a policy with no employer coverage beneath it, an occurrence policy for an NP, independent 104 practice, higher limits and past claims or board complaints. Expect a lower one for a staff nurse whose employer also covers them, a claims-made form for an NP and a clean claims and board history. The insurer’s quote sets the actual price.
A few useful answers
Common questions
Do I need professional liability insurance for nurses if my hospital already covers me?
Your employer generally backs you for work done on the job, but that protection ends where the job ends. An individual policy can add coverage for volunteering and moonlighting, limits on top of the employer’s, license defense and a voice in settlement decisions. Compare those four points against what your employer’s coverage actually provides.
Does my employer's policy pay for a Board of Registered Nursing complaint?
Often it does not. Berxi notes that employer policies often don’t cover licensing board actions, and the 2025 NSO and CNA report put the average license defense matter at $6,304. Look for a license defense limit stated on your own policy.
Are 103 and 104 nurse practitioners required to carry malpractice insurance?
Yes. Sections 2837.103 and 2837.104 of the Business and Professions Code require professional liability insurance appropriate for the practice setting. The statute sets no dollar amount, so the limit comes from your setting, your contracts and the insurer.
Who is liable for a 104 NP's patients?
The NP is. Section 2837.104 says a 104 NP is solely responsible for the services they provide, and consulting a physician doesn’t create a physician-patient relationship. That is why an independent NP’s own policy and practice coverage matter so much.
Can I get RN malpractice insurance through Mithril1 as a travel or per-diem nurse?
You can, when an insurer accepts the application after reviewing your license, specialty and the facilities you work in. We request quotes for individual nurse coverage and show you how each one treats agency and per-diem shifts.