--- title: "HPL: What About Those Independently Contracted Mid-Level Providers???" description: Learn why independently contracted mid-level providers are not automatically extended healthcare professional liability coverage and the importance of working with true specialists in HPL placements. image: https://www.ethosinsurance.com/hubfs/AI-Generated%20Media/Images/An%20insurance%20agent%20reading%20though%20contracts%20with%20a%20magnifying%20glass-1.jpeg --- [Skip to main content](https://www.ethosinsurance.com/blog/hpl-what-about-those-independently-contracted-mid-level-providers#maincontent) [«  View All Posts](https://www.ethosinsurance.com/blog) [ Research & Analysis ](https://www.ethosinsurance.com/blog/topic/research-analysis) # HPL: What About Those Independently Contracted Mid-Level Providers??? June 13th, 2024 | 4 min. read By [David Huss](https://www.ethosinsurance.com/blog/author/david-huss) ![](https://www.ethosinsurance.com/hubfs/AI-Generated%20Media/Images/An%20insurance%20agent%20reading%20though%20contracts%20with%20a%20magnifying%20glass-1.jpeg) Over the years you have seen Ethos advocate for the use of wholesale partners that are true specialists when you need assistance with the placement of a healthcare risk. A true specialist is someone who focuses 100% of their time on their chosen area of expertise. [Why is this important when it comes to healthcare professional liability (HPL) placements?](https://www.ethosinsurance.com/blog/the-case-for-a-true-healthcare-specialist) Because HPL is perhaps the most dangerous professional liability line of coverage there is. Even small mistakes in the placement of HPL can result in big problems. ## Specialized Knowledge Required [![A mess of purple wooden blocks randomly scattered on a surface](https://www.ethosinsurance.com/hs-fs/hubfs/AI-Generated%20Media/Images/A%20mess%20of%20purple%20wooden%20blocks%20randomly%20scattered%20on%20a%20surface.jpeg?width=600&height=343&name=A%20mess%20of%20purple%20wooden%20blocks%20randomly%20scattered%20on%20a%20surface.jpeg)](https://www.ethosinsurance.com/blog/the-case-for-a-true-healthcare-specialist) Take the proper coverage of independently contracted mid-level providers for example. Nearly all HPL policies require physician providers to be scheduled for coverage to extend. On the other hand, most mid-level staff are automatically extended coverage under an HPL policy – with the typical exception of independently contracted mid-level staff. For some reason, they almost always need to be scheduled for coverage to extend. As a true specialist in HPL placements I have always been aware of this coverage peculiarity, but it was never clear to me why it existed. I decided to interview a number of HPL underwriters to gain clarity and was surprised to find that their responses varied quite a bit. The following are the 5 reasons I was given for why HPL coverage is typically not automatically extended to independently contracted mid-level staff: ### 1.  Avoiding Double Coverage The assumption is independently contracted mid-level staff are typically required to provide their own HPL insurance under the service contract with the insured. To avoid a double coverage situation the definition of “Insured” does not include this kind of staff. Rather, the underwriter relies on the applicant/insured to advise which, if any, independently contracted mid-level staff need to be added to the HPL policy. ### 2. Keeping Underwriters Informed Utilization of independently contracted mid-level staff to take advantage of significant business opportunities could allow an insured to dramatically increase HPL exposures in a relatively short period of time, and without the underwriter’s knowledge. On the other hand, ramping up operations with employed staff is much more difficult and takes time. ### 3. Contractors Are More Likely to Make Mistakes Independently contracted mid-level staff are thought to have less “skin in the game” than employed mid-level staff, and so are not as highly incented to perform at their best. ### 4. Lesser Hiring Practices & Training Because an insured likely utilizes independently contracted staff for limited periods of time, they may not vet them as thoroughly as they would an employee or provide them with the same level of training. This could negatively impact the quality of the services being provided to patients. ### 5. Higher Turnover The turnover of independently contracted mid-level staff is likely to be higher than employed staff, which could negatively impact the quality of the services being provided to patients.  ## A True Specialist’s Perspective ![A Silhouette of a hiker on top of a mountain, shading their eyes as they look at the landscape](https://www.ethosinsurance.com/hs-fs/hubfs/AI-Generated%20Media/Images/A%20Silhouette%20of%20a%20hiker%20on%20top%20of%20a%20mountain%2c%20shading%20their%20eyes%20as%20they%20look%20at%20the%20landscape.jpeg?width=600&height=343&name=A%20Silhouette%20of%20a%20hiker%20on%20top%20of%20a%20mountain%2c%20shading%20their%20eyes%20as%20they%20look%20at%20the%20landscape.jpeg) All these reasons seem plausible, but based on my numerous discussions it seems clear to me there is no one reason independently contracted mid-level staff are not typically extended HPL coverage automatically. I suspect this standard approach simply evolved over time as carriers sought to mimic the approach of their competitors. ## On The Other Hand Keep in mind there are a few HPL products out there that do automatically extend coverage to independently contracted mid-level staff because their experience is counter to some of the assumptions listed above. Specifically, their experience indicates *it is *reasonable to assume an insured will credential, vet and train contracted staff similarly to the way they would an employee. In addition, in at least one case, review of the carrier’s own experience indicated that independently contracted mid-level staff are in fact no riskier than employed mid-level staff. Finally, they believe that an automatic extension of coverage to independently contracted mid-level staff allows them to avoid time consuming and expensive wrongful claim denial allegations that may result in, among other things, distribution and product reputation issues. ## Final Thoughts The takeaway? For HPL products you place directly, be sure to determine whether or not independently contracted mid-level staff are automatically extended coverage. This is especially important for classes of business that utilize mid-level providers extensively, such as urgent care clinics and medi-spas. And if you want or need the assistance of a wholesaler for the HPL placement, make sure you are working with a true specialist. Otherwise, you could find yourself dealing with a claim denial, a very upset client, and major E&O exposure.     --- **What’s Next?**  | [![Have HPL? Chat With Us Today](https://hubspot-no-cache-na2-prod.s3.amazonaws.com/cta/default/8644502/4b052511-5480-4416-beff-820aac4cc5d4.png)](https://hubspot-cta-redirect-na2-prod.s3.amazonaws.com/cta/redirect/8644502/4b052511-5480-4416-beff-820aac4cc5d4) |  [![Learning Center Problems with Wholesalers](https://hubspot-no-cache-na2-prod.s3.amazonaws.com/cta/default/8644502/dea67bba-33f1-4c3a-815e-355bc878bd20.png)](https://hubspot-cta-redirect-na2-prod.s3.amazonaws.com/cta/redirect/8644502/dea67bba-33f1-4c3a-815e-355bc878bd20) | | --- | --- | [ David Huss ](https://www.ethosinsurance.com/blog/author/david-huss) David is Ethos’ Co-Founder and Chief Production Officer. He has decades of experience in the insurance industry during which he has played many roles, including that of a contract writer for a reinsurance brokerage firm, a management liability underwriter and, over the past 20 years, a wholesale broker focused exclusively on the healthcare professional liability (HPL) space. As a true HPL specialist David possesses a comprehensive understanding of professional liability exposures in the healthcare industry and is well-versed in the products and capabilities of Ethos’ numerous carrier partners. His role at Ethos includes supporting production support staff in their effort to efficiently solve HPL-related problems for retail customers, mentoring Ethos’ business development staff and working to develop and maintain relationships with carrier business development staff and underwriters. Personally, David enjoys building things, whether they be home projects or business ventures. He also enjoys sharing good food and good wine with friends and family. David looks forward to continuing to build Ethos and serving retail customers for years to come. Connect: [mailto:dhuss@ehtosinsurance.com](mailto:dhuss@ehtosinsurance.com) Don't forget to share this post: ## Related Articles [### The Emerging Market for Medical Psilocybin in the United States May 6th, 2026|15 min read ](https://www.ethosinsurance.com/blog/the-emerging-market-for-medical-psilocybin-in-the-united-states) [### Management Services Organizations (MSOs): What Retail Insurance Agents Need to Know and Why It Matters February 12th, 2026|15 min read ](https://www.ethosinsurance.com/blog/management-services-organizations-msos-what-retail-insurance-agents-need-to-know-and-why-it-matters) [### The New Landscape: Ketamine and TMS Treatment in the U.S. Market December 2nd, 2025|7 min read ](https://www.ethosinsurance.com/blog/ketamine-and-tms-treatment-in-the-u.s.-market) [### Long Term Care Facilities: Services, Types of Care, and Important Statistics July 21st, 2025|7 min read ](https://www.ethosinsurance.com/blog/long-term-care-facilities-services-types-of-care-and-important-statistics-2025) [### California’s New MICRA Will Negatively Impact Med-Mal Premiums June 26th, 2022|9 min read ](https://www.ethosinsurance.com/blog/californias-micra-modifications-likely-to-negatively-impact-medical-malpractice-premiums-and-availability) [### In Focus: Urgent Care January 18th, 2022|3 min read ](https://www.ethosinsurance.com/blog/in-focus-urgent-care) [### Non-Standard Physicians – A Look Back, A Look Forward June 4th, 2021|3 min read ](https://www.ethosinsurance.com/blog/non-standard-physicians) [### Healthcare Consultants – A Challenging Professional Liability Placement April 26th, 2021|3 min read ](https://www.ethosinsurance.com/blog/challenging-professional-liability) [### Actuarial Obstacle to Claims-Made Premium Reductions April 20th, 2020|4 min read ](https://www.ethosinsurance.com/blog/actuarial-obstacle-to-claims-made-premium-reductions) [### Claims-Made Step Factors 101 November 29th, 2018|4 min read ](https://www.ethosinsurance.com/blog/claims-made-step-factors-101) [### Billing E&O Insurance: 3 Healthcare Segments That Need It January 24th, 2017|3 min read ](https://www.ethosinsurance.com/blog/billing-eo-insurance-three-healthcare-segments-that-need-it) [### Regulatory & Billing E&O Exposure: Real Claim Scenarios July 21st, 2016|5 min read ](https://www.ethosinsurance.com/blog/regulatory-billing-eo-exposure-real-claim-scenarios) [### Additional (Named) Insureds: Unraveling the Confusion June 15th, 2016|5 min read ](https://www.ethosinsurance.com/blog/additional-named-insureds-unraveling-the-confusion) [### Surplus Lines Insurance: Understanding Taxes and Stamps February 23rd, 2016|3 min read ](https://www.ethosinsurance.com/blog/surplus-lines-insurance-understanding-taxes-and-stamps) [### TAIL COVERAGE FOR PHYSICIANS: Increasing Marketplace Capability January 21st, 2016|2 min read ](https://www.ethosinsurance.com/blog/tail-coverage-for-physicians-increasing-marketplace-capability) [### Peeling Back the layers: What makes a clinic a clinic? 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