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Real Story: How Berxi Supported a Licensing Board Complaint

Healthcare - Real-life Board Complaint

Imagine this …

Your years of hard work and sacrifice are finally paying off. You’ve completed your NP degree and the required clinical training to be certified in mental health.

After a few years working in a behavioral health clinic, you make a pivotal decision to strike out on your own in private practice.

The days are challenging and rewarding, and after a few years you’ve managed to build a thriving practice helping patients with a wide range of behavioral challenges. Your career is going just as you’d planned.

That is, until one day, when something unexpected happens to threaten it: You receive notice in the mail from your state licensing board. It’s informing you that one of your patients has filed a professional misconduct complaint against your nursing license.

You understand that in a challenging field like mental health, this can happen; you just never expected it would happen to you. You’re shocked and flooded with worry. Could you lose your license and the livelihood you’ve worked your whole professional life to build? How will you even defend yourself?

For one NP, this nightmare scenario wasn’t difficult to imagine at all; she lived it. The following story shares exactly how the Berxi claims team worked with that customer when faced with a licensing board incident.

The Complaint That Threatened a License (and a Career)

Board complaints can be filed for a variety of reasons. In this case, the patient alleged the NP failed to provide proper counsel, changed the patient’s medications without counseling, and refused further sessions with the patient due to the severity of her issues.

Luckily the NP had malpractice insurance through Berxi, which is part of Berkshire Hathaway Specialty Insurance (BHSI). She sent an email to the Berxi Operations Center informing them of the board complaint. Once the claim was logged, it was assigned to Jessica, a Senior Claims Examiner.

Jessica explained to the NP how the Berxi policy is available to assist for board actions: “Our malpractice policy at Berxi is unique in that in addition to providing coverage for civil complaints, there’s an additional $25,000 to help with the expense of a legal defense in board actions for professional misconduct.”

This can be a huge benefit to healthcare providers facing licensing board complaints. Disciplinary actions can be incredibly stressful and have serious consequences including fines or even suspended or revoked licenses. Having coverage for such legal fees can lessen the financial burden.

Providing Empathy, Guidance, and Trusted Legal Assistance

When Jessica handles a claim like this at Berxi/BHSI, she usually:

  • Ensures the person is a customer
  • Verifies the claim is covered by the policy (i.e., is not a criminal offense)
  • Connects with the client
  • Assigns the customer to a trusted attorney
  • Finds experts and conducts any investigation work that needs to happen
  • Makes herself available for the customer if anything comes up
  • Checks in with the attorney to get updates
  • Prepares the customer for a licensing board meeting (if necessary)
  • Attends licensing board meeting (if necessary)

Once Jessica verified coverage, she immediately reached out to the NP to offer support and guidance. “As expected, she was quite upset,” Jessica recalls. “She’d never had a complaint filed against her.”

Jessica knew exactly what to do, and in addition to Jessica’s guidance regarding the claim, she was able to offer something that the NP also needed during this difficult time: empathy.

“She was worried, but we had a nice conversation,” Jessica recalls. “I reassured her that she had legal defense coverage in her policy for such board actions. I told her I would get back to her right away with the name of an attorney to represent her.”

True to her word, Jessica connected the NP with an experienced attorney, but not before running a search to ensure the attorney did not have any conflicts and could represent the NP.

“At that point, I let our insured work directly with the attorney. I didn’t want to overwhelm her with phone calls and other communication.”

In addition to working with the NP, the attorney worked closely with investigators, incorporating their findings into a formal response to the board complaint.

A Positive Outcome

Upon reviewing the formal response from the NP’s attorney, the state licensing board found no negligence on the NP’s part, and the complaint against her was dismissed.

Jessica was thrilled to learn of the outcome – as was the NP. “She was so relieved that she was able to keep her license, and that all her legal costs for the board action were covered by Berxi.”

A Case for Malpractice Insurance Coverage – and a Strong Claims Team

As this NP’s story demonstrates, a malpractice or licensing complaint can happen to any healthcare professional at any time, which is why Jessica and her fellow Claim Professionals are so engaged and resourceful when handling these and other matters for Berxi customers.

"We're proud to say that 'claims is our product,' which means treating every one of our insured customers with care and providing them with the highest level of service. We want to make the claims process as simple and easy as possible," Jessica explains.

So what should you know if you must face a nursing disciplinary review or licensing committee? Keep in mind the following:

  • It will likely be stressful.
  • If you don’t have a lawyer (or coverage for one), you could be representing yourself.
  • Your employer’s medical malpractice insurance may not cover you.

When considering how best to defend your career (and your livelihood), having an individual malpractice insurance policy that includes coverage for board actions (such as Berxi’s policy) can help protect you from licensing complaints (and the legal costs associated with them).

But not all malpractice coverage providers are the same.

You need to ensure you choose one that’s not just experienced, but also offers a strong claims department to provide the support, communication, and, most importantly, empathy to help you through it all.

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Last updated on Feb 26, 2024.

Originally published on Jul 13, 2023.

The views expressed in this article are those of the author and do not necessarily reflect those of Berxi™ or Berkshire Hathaway Specialty Insurance Company. This article (subject to change without notice) is for informational purposes only, and does not constitute professional advice.

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