What is tail coverage and when do I need it?

Tail coverage — formally an Extended Reporting Period endorsement — applies to claims-made policies. It extends the window during which a claim arising from past patient care can be reported to the carrier after the policy ends. You need it when you change employers (and your employer's group policy ends), retire, switch to a different malpractice carrier that won't honor your retroactive date, leave a hospital for a solo practice (or vice versa), or shut down a practice. Tail is typically 100%–300% of your final annual premium; many carriers offer free tail at full retirement, on death, or on permanent disability after a vesting period (often 5+ years with the carrier). Tail negotiation should happen at the front end of any placement and before an employment change — leaving it to the last day creates leverage for the new employer or current carrier.