NSO Review: What Doctors and Nurses Need to Know About

No matter how experienced or dedicated they may be to their work, physicians must always carry malpractice insurance to protect themselves. There’s always the risk that a patient could file a malpractice complaint against them.

And while everyone knows that physicians need malpractice coverage, some may not realize they aren’t the only ones who need professional liability insurance protection.

The fact is that patients can file malpractice claims against anyone that provides medical care of any kind.

Like physicians and physician assistants, nurses should also be aware of the importance of having malpractice insurance. It is the single best way to protect against medical malpractice claims that could result in a loss of license or personal assets — and all nurses should have it.

NSO malpractice insurance is one of several options that nurses or the physicians that employ them can choose. They provide liability insurance specifically for nurses and offer a range of benefits, all designed with nursing professionals in mind.

Not sure if NSO is right for you?

Whether you work as a nurse or are a physician looking to provide malpractice coverage for your staff, here’s what doctors and nurses need to know about nursing liability insurance through NSO.

What Is NSO?

The Nurses Service Organization (NSO) has been in business since 1976. It is one of the leading providers of malpractice insurance and professional liability coverage for nurses in the United States.

NSO has an advisory board that helps create and provide unique services and insurance policies to nurses around the country.

Providing nurses with liability insurance is the core of what they do, but they also offer other types of insurance policies, including:

NSO policies are underwritten by CNA Financial Corporation, which includes the Continental Casualty Company, an insurance provider that has been in business since 1897. CNA has excellent ratings in terms of financial strength and holds an A rating from A.M. Best, an A2 rating with Moody’s, and an A+ rating with Standard & Poor’s.

As of 2021, NSO provides nursing malpractice insurance coverage to more than 500,000 nurses in the U.S., including student nurses, RNs, and nurse practitioners.

Why Nurses Need Malpractice Insurance

Judge's gavel

Nurses play a crucial role in every healthcare team. Like physicians, they provide critical care to patients. But they also offer the emotional support that patients often need when facing an illness, preparing for a medical procedure, or recovering.

And, like everyone that works on a medical team, nurses are human, which means that they can make mistakes. Even an unintentional error in something as routine as administering medication can be cause for a malpractice claim.

All nursing professionals, including nurse practitioners and certified registered nurse anesthetists, need malpractice insurance for the same reasons that physicians do:

To Pay for Damages

In some cases, the court awards monetary damages in favor of a patient’s malpractice claim. These damages must be paid to the patient and may be at the expense of the hospital, a particular physician, or a specific nurse.

Without malpractice coverage, you’ll have to pay those damages out of your own pocket if you’re found liable.

To Cover Defense Fees for Trial

If you’ve ever been sued before or had to defend yourself in court, you already know that attorney fees are expensive and they add up quickly.

Should you find yourself as a defendant in a malpractice suit, you’ll need a lawyer to prepare your defense before trial and speak on your behalf in court. Malpractice insurance covers legal defense fees, so you don’t have to go broke trying to prove your innocence against a patient claim.

To Protect Personal Assets

Every type of insurance policy that exists has one thing in common:

They’re all designed to protect your finances and help you to keep more money in your pocket in the long run.

Malpractice insurance is no different.

Nurses employed by hospitals or large medical groups are often covered by medical malpractice insurance policies issued through their employer. But in some cases, employer-sponsored coverage isn’t enough. Having an individual liability policy will provide you with greater benefits.


Should you be found guilty due to negligence, your employer could sue you in return for the costs they put forward for your defense fees.

The entire point of having malpractice insurance is so that you don’t go broke trying to defend yourself against a claim. After all, you don’t want to spend the rest of your life paying back damages.

To Protect Your License

When sued for malpractice, the patient isn’t the only one you’ll need to defend yourself against. You may also find yourself facing an investigation with your state’s nursing board. And if your nursing board finds you guilty of malpractice, they can revoke your license.

Malpractice insurance will also help pay for your legal defense in preparation for action taken by your licensing board. Whether or not you’re guilty of any charges, you’ll still need to defend yourself. Malpractice coverage helps you protect your license without incurring thousands of dollars in out-of-pocket costs.

Related: Why Physicians Need Malpractice Tail Coverage.

What Policies Does NSO Offer?

From nursing students still in nursing school to experienced, licensed nurse practitioners who have been in healthcare for decades, NSO provides various policies to protect nurses of all types.

NSO offers over 80 different types of policies. Depending on your license and level of certification, every nurse in every capacity can find an NSO malpractice insurance policy that efficiently covers them.

NSO provides policies for student nurses, employed nurses, and self-employed nurses. They have policies for locum tenens nurses, for CRNAs, and nurses that hold temporary licenses.

They also offer policies designed specifically for business owners, nursing school faculty members, and physicians in private practice who want to provide their nurse employees with liability coverage.

Anyone who is a nurse or has a nurse on staff can benefit from having a malpractice insurance policy with NSO.

Want to know more about working locum tenens? Read: The Pros and Cons of Physician Locum Tenens.

What Benefits Does NSO Offer?

NSO malpractice coverage comes with a variety of built-in benefits.

Some of the key benefits that you can enjoy with NSO coverage include:

Professional Liability Coverage

NSO will provide you up to $6 million in professional liability coverage. If you are obligated to pay monetary damages to a patient, NSO will pay up to $1 million per claim, up to six times in one year.

Defense Expenses

NSO offers up to $25,000 per year in defense attorney expenses. The limit is $1,000 per day, and NSO will pay these fees whether you win or lose your case.

License Protection

If you need to defend yourself against disciplinary charges brought against you by a state licensing board, your NSO policy will provide $25,000 annually for defense fees and other covered expenses.

Information Privacy

Every nurse understands the importance of HIPAA laws, yet mistakes in privacy protection happen on occasion. If you have to pay fines or penalties for a HIPAA violation, NSO will cover the costs up to $25,000 annually.

Sexual Misconduct

Should you be found guilty of sexual misconduct while on the job, NSO will pay up to $25,000 per year to cover sexual misconduct claims made against you.

Assault Coverage

If you become the victim of a violent assault in the workplace or on your way to or from work, NSO will provide up to $25,000. You can use this sum to cover medical expenses or property damage caused by the assault.

Portable Coverage

One of the best benefits of having an individual NSO malpractice policy is that you can take your coverage with you from one employer to another. You can also use this coverage to protect yourself in instances where you’re volunteering or working a second job.

Keep in mind that not all NSO policies offer all the benefits mentioned above. For example, policies for student nurses provide less benefits and offer less options than policies offered to CRNAs and NPs.

NSO Insurance for Businesses and Practice Owners

Diverse group of young doctors standing together in a hospital corridor discussing a patient's diagnosis

Hospital administrators, physicians that own their own practice, and physicians that are partners in a medical group all understand the importance of having a top-tier nursing staff.

And recruiting and retaining top-tier nurses often requires two things:

  1. Paying a competitive salary
  2. Providing a greater benefits package than what other practices or hospitals offer


NSO malpractice insurance is an excellent perk to add to a benefits package, but it can benefit your business or practice in other ways as well.

With NSO, you can add a “Business Owner Coverage Extension” to any policy you choose to offer your nursing employees. That added coverage provides malpractice protection to your business entity as well as your individual employees.

You also have the option to add a Business Owner’s Policy (BOP). The BOP includes both property and liability protection and can cover your business against a variety of unforeseen circumstances (like employee theft or cybercrimes).

Who Pays for NSO Insurance?

As a nurse with individual malpractice insurance from NSO, you will be responsible for paying the monthly premiums on your policy. If an NSO liability policy is provided to you as part of your benefits package, your employer will cover the costs.

We recommend that all nurses have their own individual policies. Regardless of whether or not they have a policy through their employer.

How Much Does NSO Insurance Cost?

The cost for a malpractice insurance policy with NSO varies from individual to individual. NSO provides malpractice insurance for student nurses for as little as $35 a year and professional nurses for as low as $106 per year. Nurses in riskier specialties should expect to pay more.

This is why:

Insurance companies rely on risk management and risk assessment principles to determine how much a policyholder will pay for coverage. And they consider many factors when determining that level of risk.

Before NSO (or any other insurer) quotes you a monthly premium, they’ll assess the type of work you do. Including your specialty and your level of experience.  The riskier your job, the more you can expect to pay.

For example, a nurse practitioner is at higher risk for a malpractice claim than a nursing student with minimal involvement in clinical work. For that reason alone, an NP will pay higher premiums than a nursing student.

Yet experience and specialty are but two of several things that will affect your premium rates.

Your Location

The state in which you’re licensed to work is also a factor. Physician malpractice insurance in New York costs more than five times the price of an equivalent policy in California, Ohio, or Tennessee.

Keep in mind that this does not necessarily correlate with states that pay high annual salaries or states with a high cost of living. The number of liability claims made in your state ー and the caps on damages that patients can receive ー makes a big difference in establishing monthly premiums.

The Amount of Coverage You Need

How much coverage you need and what additional benefits you want to add to your policy also affect your monthly premiums. Whether you’re an NP in Maine, a CRNA in Kentucky, or a student nurse in Oregon, the only way to know exactly what you’ll pay is to obtain an insurance quote.

Your History of Claims

The number of insurance claims you’ve made in the past also helps NSO to establish a monthly premium price for your policy. If you’ve been through a malpractice ordeal before, NSO may deem you a higher risk and you’ll have to pay more for coverage.

To get a quote and determine your premium rates now, consult with your insurance agent or visit www.nso.com.

You may also like: Physicians Top 10 Places to Live and Work

The Pros and Cons of NSO Liability Insurance

NSO is a viable option for nursing professionals seeking malpractice insurance. The company is financially sound, they have strong reviews, and they offer discounts for students and recent graduates.

They also have a reputation for being easy to work with whether you’re trying to get coverage or file a claim.

On the downside, the coverage is limited to $1 million per incident, and some incidents could require you to pay considerably more in damages.

For physicians offering the policy to nurse employees, it can be somewhat limiting. Because NSO only protects nurses. NSO policies do not cover any other healthcare professionals. For example, physician assistants or any other members of your staff.

Malpractice insurance is a must for nurses, even if you work in a state that doesn’t require it. It’s the best way to protect your license, defend your career, and safeguard your personal assets. Whether you opt for NSO or another malpractice insurance provider, the time to get coverage is now.

Contact Physicians Thrive today to learn more about malpractice insurance, disability insurance, or life insurance protection.

Subscribe to our email newsletter for expert tips about finances, insurance, employment contracts, and more!

About the Author