For physicians · residents · fellows
Tail coverage: the $15K–$50K clause most physicians never read
Claims-made policy + physician-paid tail = a five-figure bill when you leave.
Tail typically costs 150–250% of your annual premium.
Who pays is decided by one clause — check yours free.
If your malpractice policy is claims-made, coverage ends when the policy does — a tail (extended reporting endorsement) covers claims filed after you leave. In one federal court record we track, a physician's quoted tail premium was $26,799–$28,370; industry rules of thumb put tail at 150–250% of the annual premium, which reaches $50K+ in high-risk specialties.
Contracts allocate this cost in patterns worth knowing from real filed agreements: physician-pays-always; employer-pays after a service cliff (a 4-year anniversary in one hospital agreement); graduated vesting (100% / 66.6% / 33.3% / 0% of the cost across the first three years in another); and triggers that flip payment on retirement age or no-cause termination. Each structure came out of a lawsuit — which tells you what happens when the clause is vague.
The negotiable middle ground is well-established: employer pays the tail if they terminate you without cause, or after 2–3 years of service, or the policy converts to occurrence-based. The decode reads your malpractice and tail clauses and tells you which pattern you have.
Tail coverage
Claims-made policy + physician-paid tail = a $15K–$50K+ bill when you leave. The single most expensive surprise we see.
Non-compete
Duration, radius, and which locations it measures from — checked against your state's law, including the states that ban physician non-competes outright.
wRVU formula
Conversion factor and threshold vs. published norms, and whether the formula is locked to a CMS fee-schedule year or free to drift.
Termination
60-day without-cause notice sounds fine until you learn credentialing takes 90–120 days — and your non-compete may still apply.
60 seconds. Free. The second opinion most attendings wish they'd gotten.
Decode my contract — freeThe $99 full report adds clause-by-clause analysis, counter-proposal language, and a ready-to-send negotiation email — a fraction of the $500–$2,000 a typical attorney review costs, and a good way to arrive prepared if you hire one.
How this comparison was built
- • joboffer.ink is built with care by children of physicians — Harvard- and MIT-trained engineers.
- • Every number traces to a named public source — 26 registered sources, 106 lineage-linked values across 20 specialties.
- • Covenant and tail-coverage norms are cross-checked against a corpus of 65 physician employment lawsuits (2021–2026) built from court records.
- • No licensed survey data is resold here: everything cited is public, with links, and the full method is documented on the methodology page.
Harvard and MIT do not endorse or have any affiliation with joboffer.ink; the reference describes the founders' training.
Full methodology & sources →Frequently asked questions
How much does physician tail coverage cost?
Typically 150–250% of your annual malpractice premium as a one-time purchase — commonly $15,000–$50,000+, higher in surgical and OB specialties. Real quoted figures in court records we track ran ~$27,000–$28,000 for a pain-management physician.
Who pays for tail coverage?
Whoever the contract says. Common structures from filed agreements: physician always pays; employer pays after a years-of-service cliff or vesting schedule; employer pays on retirement, death/disability, or no-cause termination. If the contract is silent, assume you pay — and negotiate it before signing.
Claims-made vs. occurrence — which is better for me?
Occurrence coverage needs no tail (claims are covered by whichever policy was active when care occurred), so it's simpler for you. Claims-made is cheaper for employers, which is why it dominates — if that's what's offered, the tail-payment clause is where the real money is.
Keep reading
Information and preparation, not legal advice. Benchmarks cite public sources inline; verify every number against your own documents.