Most medical practices believe their greatest risks come from patient care. Malpractice. Clinical errors. Regulatory compliance.
But in practice, one of the most damaging claims we see has nothing to do with patients at all. It comes from inside the practice.
Employment Practices Liability Insurance, commonly known as EPLI, is one of the most overlooked coverage gaps in medical practices today. And when it is missing or underinsured, the financial and reputational impact can be severe.
Why EPLI Is So Commonly Overlooked
Medical practices are busy, complex workplaces. Physicians focus on care delivery. Administrators focus on staffing, scheduling, and compliance. Insurance often gets reviewed only when policies renew, and EPLI is frequently treated as optional or secondary.
We often hear things like:
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We are a small practice, we would never have an employment issue
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We have good people, so this is not a concern
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HR issues are handled internally
Unfortunately, EPLI claims rarely stem from bad intentions. They arise from misunderstandings, inconsistent processes, or situations that escalate unexpectedly.
What EPLI Actually Covers
EPLI is designed to protect the practice against claims brought by employees, former employees, and in many cases, job applicants.
These claims can include:
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Wrongful termination
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Discrimination
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Harassment
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Retaliation
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Failure to promote
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Wage and hour disputes
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Allegations related to hiring decisions, including failure to hire
Even when a practice believes it acted appropriately, defending against these claims can be costly. Legal fees alone can reach six figures before a case is resolved.
The Often-Missed Risk of Third-Party EPLI Coverage
Many EPLI policies also include third-party coverage, which is commonly overlooked but extremely important.
Third-party EPLI extends protection beyond employees to claims brought by non-employees, such as:
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Patients
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Vendors
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Visitors
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Job applicants
For example, allegations of harassment or discrimination made by someone outside the organization can still result in a claim against the practice. Having third-party coverage in place helps ensure those situations are not excluded simply because the claimant was not an employee.
This coverage is standard on many policies we see, but it is not always understood or reviewed intentionally. Knowing it is there, and confirming the limits are appropriate, can make a meaningful difference when a claim arises.
Why Medical Practices Are Especially Exposed
Healthcare environments create unique employment risks.
Practices often operate with:
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High stress and fast-paced workflows
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Complex hierarchies between physicians, administrators, and staff
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Frequent schedule changes, overtime, and on-call requirements
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Rapid growth or turnover
Add evolving employment laws and heightened awareness of workplace rights, and the risk increases even for well-run practices.
In Maryland specifically, employment-related claims continue to trend upward across healthcare organizations of all sizes.
Hiring activity itself can introduce risk, particularly as practices grow, add new roles, or adjust staffing quickly. Employment-related claims can begin before an employee is ever hired.
The Hidden Cost of Being Underinsured
One of the most dangerous scenarios is not having no EPLI at all, but having limits that are too low.
Practices sometimes carry minimal EPLI limits to keep premiums down, without realizing how quickly defense costs alone can exhaust those limits. Once that happens, the practice is paying out of pocket.
We have seen situations where a single claim disrupted operations, strained leadership relationships, and forced difficult financial decisions, all because coverage did not align with real-world exposure.
How to Know If You Have a Coverage Gap
Many practice leaders are surprised to learn:
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EPLI may be excluded from their policy entirely
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Coverage limits may not reflect current staff size
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Deductibles or retentions may be higher than expected
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Certain claims may be carved out or restricted
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These details are easy to miss unless EPLI is reviewed intentionally.
A Smarter Way to Approach EPLI
At Unity Insurance, we encourage practices to treat EPLI as a core component of risk management, not an add-on.
That starts with asking a few key questions:
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How many employees do we have today compared to when this policy was set
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Have our HR practices evolved as the practice has grown
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Would our current coverage realistically protect us in a worst-case scenario
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A short coverage review can uncover gaps before they become costly problems.
Final Thought
The most dangerous risks are often the ones hiding in plain sight.
EPLI may not feel urgent until a claim arises, but by then, it is too late to adjust coverage. Reviewing your EPLI now can protect your practice, your leadership team, and the culture you have worked hard to build.