Claims-made vs occurrence and what tail coverage costs
Short answer: An occurrence policy covers incidents during the policy period, whenever the claim is filed. A claims-made policy covers claims made and reported while it is active, for incidents after its retroactive date. Claims-made often costs less in the first years, but you need tail coverage when it ends to keep protection for past work.
The difference between claims-made and occurrence malpractice policies decides whether a claim filed years later is covered. It also decides whether you will owe for tail coverage when you leave a policy.
What is an occurrence policy?
- Covers incidents that happen during the policy period, no matter when the claim is filed.
- Tail coverage is not required when you cancel.
- Usually cost more upfront.
What is a claims-made policy?
- Covers claims that are both made and reported while the policy is active, for incidents after a retroactive date.
- Often cost less in the first years, with premiums rising as the policy matures.
- Require extended coverage, called tail, when the policy ends.
What is tail coverage?
Tail coverage, also called an extended reporting endorsement, lets you report claims after a claims-made policy ends for incidents that happened while it was active. Costs are often a multiple of the annual premium, so ask for a written quote and compare it with prior acts coverage from a new carrier.
What is prior acts coverage?
When you move to a new claims-made policy, you can ask for prior acts coverage that keeps your retroactive date. This can replace tail coverage.
When does each choice make sense?
- Occurrence: stable practices that want simplicity.
- Claims-made: groups that expect to change carriers or want lower early premiums, with a plan for tail or prior acts.
| Topic | Occurrence | Claims-made | Tail |
|---|---|---|---|
| What it covers | Incidents during the policy period, whenever the claim is filed | Claims made and reported while the policy is active, after the retroactive date | Lets you report claims after a claims-made policy ends for earlier incidents |
| When you leave the policy | Usually no extra purchase | You need tail or prior acts from a new carrier | Bought when the claims-made policy ends, or replaced by prior acts |
| Cost pattern | Usually higher upfront | Often lower in early years, then rises as the policy matures | Often a multiple of the annual premium; get a written quote |
What should you ask your carrier?
- What is my retroactive date?
- What will tail cost, and who pays if I retire or the group closes?
- Does the policy include free tail for death, disability or retirement?
- Are there time limits to buy tail?
Clinics adding interventional services should also read malpractice insurance for ketamine and Spravato clinics. Groups practicing across state lines can use telehealth malpractice across several states.
Frequently asked questions
Can I switch from claims-made to occurrence?
Yes, but you will need tail or prior acts coverage for earlier work.
Do group employers pay for tail?
It depends on contracts. Put it in writing.
What is a retroactive date?
The retroactive date is the earliest date of an incident a claims-made policy will cover. Keep it when you change carriers by asking the new carrier for prior acts coverage.
How Bulwark helps
Bulwark reviews coverage for telehealth groups and interventional clinics through a licensed partner agency. Request a coverage review.
Sources checked October 7, 2026. Ask your carrier for a written tail quote before you switch.