When compared to other medical specialties, podiatry is often underestimated as a liability risk. Podiatrists perform both elective and non-elective surgeries, and the stakes are high: over 75% of foot and ankle surgery malpractice lawsuits involve podiatrists, rather than orthopedic surgeons.
If you have the wrong medical malpractice coverage—or worse, no coverage at all—a single lawsuit could end your practice. The right insurance gives you the financial protection and support you need in the event of a claim, so you can focus on providing quality care. In this guide, we'll break down malpractice insurance options for podiatrists, including policy types, costs, and how to choose a provider.
Podiatrists offer a wide scope of services. On the same day, a podiatrist could help one patient with routine nail care and perform a complex joint reconstruction on another.
Podiatry patients often require ongoing care, which could include gait analysis, multi-stage surgery, orthotic support, and physical therapy. Many of these procedures are elective, which creates unique risks for podiatrists. 94.5% of malpractice lawsuits in this field involve elective procedures, which means that the patient chose to have surgery in advance and didn't get the outcome they wanted, rather than having emergency surgery.
When performing these surgeries, getting informed consent can protect you in the event of a malpractice claim. Research has found that patients have poor recall of the risks explained to them pre-surgery. However, signed consent forms can protect you, as they show that the patient was informed of and accepted the risks of the procedure.
Because podiatrists perform such a wide range of procedures, there are a variety of malpractice allegations they could face. One study assessed malpractice claims associated with foot surgery between 2004 and 2017. This study found that the most common complaints from plaintiffs in these cases were persistent pain, accounting for 41.8% of cases, and deformation, accounting for 27.3% of cases.
Anatomically, forefoot surgery accounts for the largest share of malpractice claims in this specialty. Post-surgical infection is the most common complication. Podiatrists also increasingly treat conditions tied to diabetes and cardiovascular disease, which can make malpractice claims more complex. Research has also found that the rate of complications is slightly higher in podiatric surgery than in general surgery, which could affect your coverage. The odds of experiencing a complication when operated on by a podiatrist are 84.1% higher than when operated on by a physician, although the causes of these complications are very complex.
Systemic illnesses can increase liability exposure when podiatrists manage infections, which reinforces the need for specialized coverage. If an infection isn’t managed properly, it could spread and require amputation, which is one of the most potentially litigable outcomes in podiatry.
Communication breakdowns are one of several contributing factors in malpractice claims across all specialties, and podiatry is no exception. Research has found that approximately one-third of these cases involve some sort of communication failure.
Medical malpractice insurance is essential for podiatrists, and podiatrist malpractice insurance should be tailored to your procedures, legal risks, and state requirements. Every policy is different, but here are some components you can expect to find in standard coverage.
There are some types of coverage that are not included in malpractice policies. These include:
These types of coverage require separate insurance policies.
When choosing a malpractice policy, you'll need to decide between claims-made vs. occurrence policies. This decision affects when and how your coverage applies if a patient files a claim. The right choice for you will depend on factors like your business model, career stage, and carrier availability.
Claims-made policies cover claims that are reported while the policy period is active, regardless of when the incident actually happened. This means that you need tail coverage to extend the policy if you retire, change careers, or switch to a different provider. Many patients don’t file malpractice claims until years after the initial injury happened, as the extent of the damages aren’t always clear right away.
The benefit of claims-made policies is that they have much lower upfront costs than occurrence policies. Many carriers offer new to practice credits, with discounts of 25 to 75% for DPMs just starting their careers. Residents who moonlight may also be able to obtain affordable moonlighting coverage. However, these premium costs will increase over time.
Tail coverage can cost 1.5 to 2 times the annual premium cost of an active policy. However, some providers offer tail coverage at no extra expense for providers after they’ve been with the provider for 5 years, or when they retire. Eligibility may also require a mature claims made policy with a qualifying retroactive date and continuous prior coverage.
Although tail coverage can be expensive, you shouldn’t skip it. Say you treat a patient in the first year of a new insurance policy. The patient gets injured during the procedure, but doesn’t report it right away. You switch carriers after three years, but don’t buy tail coverage for your original malpractice insurance. If the patient were to file a claim the next year, you wouldn’t be covered at all and would need to pay for everything out of pocket.
To help you avoid this scenario, many claims-made policies include prior acts coverage. This means your coverage starts from a retroactive date, rather than the date you purchased it. Always check the coverage start date before switching policies to avoid unexpected liability.
Occurrence malpractice policies cover any incident that happened during the policy period, regardless of when the claim is filed. This means that you don't need to buy tail coverage when your policy ends.
These policies have a much higher upfront cost than claims-made policies. However, premiums may stay flat over time, and you don't need to buy tail coverage. Many insurance carriers don't offer occurrence policies for podiatrists and other specialists, so your options will be limited, even if you are willing to pay the higher initial costs.
The cost of malpractice insurance varies by specialty, and podiatry often falls in the middle of the spectrum. As a podiatrist, you likely won’t pay as much as high-risk specialists like neurosurgeons or OB/GYNs, but your costs will be higher than family doctors or other generalists.
When discussing podiatrist insurance cost, premiums for malpractice coverage and other insurance for podiatrists can also vary significantly based on the scope of your practice. DPMs who perform complex surgeries will pay more than those who only offer conservative treatments.
Many malpractice insurance providers use three rating tiers to determine premium costs for podiatrists. The higher the tier, the more you’ll pay for coverage:
Your geographic location and state regulations will also affect premium costs. In lower-risk states where malpractice litigation is less common, such as Idaho, Minnesota, and North Dakota, podiatrists may pay toward the lower end of the typical range. Such annual premiums would likely start around $3,000 to $5,000 for non-surgical coverage.
However, in high-litigation states like Florida or New York, premiums for surgical coverage can climb significantly higher. Most podiatrists with surgical scope pay between $10,000 and $15,000 annually for malpractice insurance, though practicing in a high-litigation state or major metropolitan area can push costs even higher.
The healthcare liability market is also seeing higher claim severity, which has pushed malpractice premiums upward. There are several other factors that can affect your monthly premium costs. These include:
Practicing safely can help you save money on your insurance premiums. Many insurance providers will offer annual premium discounts for podiatric physicians with no claims history. Some insurers also offer discounts for healthcare professionals who complete risk management courses.
Many insurers also offer new-to-practice credits, which can save DPMs up to 75% on their premiums for their first year in practice. New insurers entering the market can also increase competition and lead to lower premiums or additional discounts. However, these credits will expire and monthly premiums will go up once your practice is more established.
In addition to malpractice insurance, you’ll also need general liability insurance for your facility. This can cost anywhere from $1,000 to $5,000 per year and is separate from your coverage.
Standard limits for malpractice insurance are typically structured as $1 million per individual claim and $3 million aggregate per policy year. In many states, hospitals and healthcare networks require proof of malpractice insurance before granting clinical privileges to podiatrists. Be sure to review your contract before choosing your own limits.
Some DPMs choose to invest in higher policy limits for more protection. While this comes with a higher monthly premium, it also provides peace of mind if you perform complex surgeries, work with higher risk patients, or practice in an area with high litigation rates.
There are a few other factors to consider when choosing your policy limits. The first is whether your policy covers the cost of defense inside or outside limits. If defense costs are covered inside the limits, they will erode your total policy value, reducing coverage for settlements and other legal expenses.
However, if your defense costs are covered outside limits, your insurer will pay them in addition to your total indemnity coverage. This means you can focus on building the best defense team possible without worrying about costs.
You’ll also need to consider the size of your practice and how that affects your limits. If you run a high-volume practice, it’s possible to have multiple claims in a single year, which could quickly exhaust your aggregate limits. If you’re in this situation, it may be worth investing in a policy with higher aggregate limits.
Podiatrists operate differently than other healthcare professionals, and that can affect the type of malpractice coverage you need. Here are some podiatry-specific factors to consider when choosing malpractice insurance.
Every US state has its own laws about the types of surgery podiatrists are allowed to perform. Carriers also look closely at riskier procedures and other state-authorized surgical work when underwriting coverage. For example, podiatrists in Mississippi, Alabama, and Massachusetts are only permitted to treat the foot. However, podiatrists in other states can treat both the foot and ankle.
Your podiatry insurance must cover the procedures you are licensed to perform under state laws. This is especially important for podiatrists performing surgery in hospitals or ambulatory surgery centers. However, if you perform a procedure outside of your state’s authorized scope and it leads to a malpractice claim, your insurer may not cover it.
Diabetic podiatry patients come with a higher risk of treatment complications. This is because diabetic patients often experience poor circulation and even a loss of sensation in their feet. Podiatrists also increasingly manage foot issues tied to diabetes and cardiovascular disease, which can lead to more complex malpractice claims.
Because of this, diabetic patients often don’t catch foot injuries until they’ve become very serious. If the patient develops a need for wound care related to a diabetic ulcer or has a surgical incision, the risk of infection is high, can even lead to amputation, and may result in claims involving patient injuries.
If you work with diabetic patients, some malpractice insurance carriers may charge higher rates to offset the additional risk. Proper patient selection and careful documentation matter especially when complex symptoms from systemic illnesses elevate liability exposure and may require more specialized coverage.
Many podiatrists now offer remote consultations. While this makes care more accessible, it also creates new digital risk that isn’t present with in-person care. While they cannot physically treat conditions or take X-rays remotely, virtual visits are highly effective for initial consultations, postoperative follow-ups, reviewing home-care options, and monitoring ongoing issues.
If you offer telemedicine as part of your practice, check to make sure your malpractice policy explicitly covers claims related to these services. You may also want to add cyber liability protection to your policy. Cyber liability coverage helps protect you financially if you experience a data breach or cyber attack, which is increasingly important in an increasingly digital world.
Many DPMs perform joint reconstruction, joint fusion, and other procedures that require implants. Insurance providers treat implant-related cases as a distinct claims category, so make sure your policy covers these if you offer these procedures.
If you're licensed and practicing in more than one state, your malpractice insurance policy should reflect that. Check to make sure your policy explicitly covers claims made in both states.
Some podiatrists are employed by hospitals or large healthcare systems, while others run their own independent practices, which can affect the kind of podiatry insurance you need. If you run your own practice, you’re in charge of selecting and maintaining your own malpractice insurance.
However, employed podiatrists are often covered by their employer’s malpractice policy. In this situation, you don’t need to purchase your own policy—but you may still want to. The scope, policy limits, and clauses of your employer’s insurance may not be right for you, especially if you work with high-risk patients. Independent owners may also need business coverages such as commercial auto insurance for practice-owned vehicles and workers’ compensation for employee injuries, medical bills, and lost wages.
Choosing the right medical malpractice insurance coverage for your practice can be tricky, especially with so many options on the market, so it’s important to compare carriers carefully to find the coverage you need. Here’s what to look for when choosing an insurance carrier:
Work with a broker who understands podiatric practice, state regulations, and carrier differences, since many states require malpractice coverage for licensure and practice.
Proactive risk management is essential to avoiding claims. Here's what your podiatry practice can do to lower your risk.
Every podiatrist must carry insurance, but your coverage options will look different depending on where you are in your career. Here's what to expect and consider at each stage:
As a DPM, a standard malpractice policy isn't always enough. You need a policy that's built for the unique risks of your specialty.
At Indigo, we offer coverage built for the realities of private practice. We have policy options available for a wide range of specialties, with tailored pricing based on your unique risk profile.
Get a quote today to learn more.
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