Updated June 2026 · 8 min read

CRNA Malpractice Insurance

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Malpractice insurance is one of those topics CRNAs rarely think about until a contract negotiation or a switch to 1099 work forces the question. The two things that trip people up most are the price — which varies far more than expected — and the difference between claims-made and occurrence policies, which can quietly cost you thousands when you change jobs. Here's the practical version.

What it costs in 2026

The spread is wide because premiums are priced to your actual exposure. If you're employed and your hospital carries you on its policy, your personal cost may be low — but the coverage is built for the employer's interests, not necessarily yours. Independent contractors who carry their own coverage across one or more facilities sit at the higher end, and higher-acuity case mixes push it higher still.

Claims-made vs. occurrence — the decision that matters

CRNA malpractice coverage generally comes in two forms, and understanding them is more important than shaving a few hundred dollars off the premium.

Occurrence coverage protects you for any incident that happens while the policy is active — forever — regardless of when the claim is actually filed. Premiums tend to stay stable over time, and there's no separate tail to buy when you leave.

Claims-made coverage only pays if the policy is active both when the incident occurred and when the claim is filed. It starts cheaper and the premium climbs gradually over the first several years as your exposure "matures." The catch: when you leave or switch carriers, you need tail coverage to stay protected against claims filed after your policy ends.

Self-employed, locums, and switching jobs

If you go independent or pick up locum tenens work, malpractice becomes your responsibility to understand even when an agency provides it. Staffing services often supply coverage for locum assignments, but you should confirm the policy type, the limits, the retroactive ("retro") date, and whether tail is included. When you change employers or facilities, the retro date and tail handling determine whether there's a gap in your protection — gaps are exactly when a late-filed claim becomes a personal-asset problem.

What drives your premium

Several factors move the number: the state you practice in (high-litigation states cost more), the facility type, your case mix (OB, hearts, and high-acuity work raise risk), your total hours and procedure volume, and your prior claims history. Two CRNAs with identical credentials can pay very different premiums simply because of where and what they practice.

Bottom line

Budget roughly $3,000–$7,000 a year for an individual CRNA policy — less if you're employed, more if you're 1099 or high-acuity. But the choice that really matters is occurrence vs. claims-made: occurrence costs more up front and travels with you cleanly, while claims-made is cheaper early but exposes you to a tail bill near 200% of your premium when you move on. Read the policy type, confirm who pays the tail, and check the retro date every time you change roles.

This article is general educational information, not legal, financial, or insurance advice. Confirm coverage details and costs with a licensed insurance broker before making decisions.