A psychiatrist in Jupiter built a busy telehealth schedule after her practice moved most medication management visits to video. Many of her patients are seasonal residents who spend half the year in Florida and the rest in New York, Ohio or North Carolina. One of them, logging in from a summer home in Asheville, later alleges that a medication change was mishandled. When the claim reaches her malpractice carrier, the first question is not what happened during the visit. It is where the patient was sitting when it took place.
That question surprises many physicians, but it sits at the center of telehealth liability. Video visits are now an ordinary part of practice in Florida, and most malpractice policies do contemplate them. The risk lies in the details: where the patient is located, whether the provider is licensed or registered there, and whether the policy is written to follow care across state lines.
Where the Patient Sits Decides a Lot
In telehealth, the place of service is generally treated as the patient’s physical location at the time of the visit, not the provider’s office. A Florida physician seeing a patient who is physically in another state may be practicing medicine in that state, which raises a licensing question first and an insurance question right behind it.
Professional liability policies typically cover professional services within the scope of the provider’s license. If a physician treats a patient in a state where the physician is not licensed or otherwise authorized to practice, a carrier may argue that the services fell outside the scope of the policy. Even when coverage ultimately applies, a dispute over it can slow the defense and add expense at the worst possible time. The safest approach is to know where your telehealth patients are when they log in and to confirm that both your licensure and your policy reach those locations.
Florida’s Registration Path for Out-of-State Providers
Florida created a telehealth registration pathway under section 456.47 of the Florida Statutes. A health care professional licensed in another state, and in good standing there, can register with the Florida Department of Health to provide telehealth services to patients located in Florida without holding a full Florida license. Registered providers must maintain professional liability coverage or financial responsibility that includes coverage for telehealth services provided to patients in Florida, and they may not open an office in Florida or provide in-person care here under that registration.
For practices that use out-of-state clinicians to see Florida patients, that requirement is worth checking directly. A policy written for another state’s practice may not automatically extend to Florida patients, and the registration depends on it.
Licensure Compacts Solve Licensing, Not Insurance
Interstate licensure compacts make it easier for physicians and some other clinicians to obtain licenses in participating states. They do not change what a malpractice policy covers. A physician who holds several state licenses through a compact still needs a policy that recognizes practice in each of those states. Some carriers write multistate coverage as a matter of course; others limit coverage to named states or require an endorsement for care delivered to patients elsewhere. The policy declarations and endorsements, not the license, determine whether a visit to a patient in another state is covered.
Questions to Ask About Your Policy
Most malpractice forms do not spell out telehealth in detail, so the questions have to be asked. Does the policy cover telehealth services at all, and does it define them? Does it cover patients located outside Florida, and if so, in which states? Are there limitations for certain services, such as prescribing controlled substances remotely, or for care delivered across international borders? If the practice uses nurse practitioners, physician assistants or therapists who see patients remotely, are they covered for the same activities and locations as the physicians?
Practices that add telehealth after a policy is written should tell their agent and carrier. A change in how and where care is delivered is a material change in exposure, and it is far easier to address at renewal than in the middle of a claim. Telehealth coverage also has to fit with the rest of the practice’s program, which our overview of medical office insurance describes.
Documentation and Technology Risks
Telehealth claims often turn on the same questions as in-person claims, such as whether a diagnosis was missed or a treatment decision met the standard of care. Remote care adds its own pressure points. A provider who cannot examine the patient physically has to document why a video visit was appropriate, what was observed and what was advised, including when the patient was told to seek in-person care. Informed consent for telehealth, identity verification and a plan for emergencies that arise during a visit all belong in the record.
Technology creates a separate exposure. Video platforms, patient portals and electronic records hold protected health information, and a breach or a ransomware event can trigger notification obligations, regulatory scrutiny and lawsuits. Malpractice policies generally do not respond to those losses. A cyber liability policy addresses breach response, regulatory proceedings, network security liability and business interruption from a system outage, and it belongs alongside the malpractice policy in any practice that relies on telehealth. Our overview of cyber liability insurance explains how that coverage is structured.
Claims-Made Coverage and Changing Platforms
Most malpractice coverage for physicians is written on a claims-made basis, which means the policy in force when a claim is made responds, subject to a retroactive date. Telehealth does not change that, but it often coincides with changes that create gaps. Physicians who leave a group to join a telehealth company, or who add a part-time telehealth role on top of an in-person practice, need to confirm that every role is covered, that retroactive dates line up and that tail coverage is arranged when a role ends. Our guide to claims-made versus occurrence malpractice insurance and tail coverage covers those transitions in detail.
Telehealth platforms that contract with independent clinicians often state in their agreements who carries the malpractice coverage. Some provide it, some require the clinician to carry it, and some do both with different limits. Reading that section of the agreement before the first visit is the only way to know which policy will respond.
Worth Confirming With Your Agent
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Whether your malpractice policy covers telehealth and how it defines those services
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Which states your policy covers when a patient logs in from outside Florida
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Whether out-of-state clinicians seeing Florida patients meet the coverage requirement for registration
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Whether remote prescribing or other specific services carry restrictions
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Whether a cyber liability policy covers your video platform, portal and records
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Who carries the coverage under any telehealth platform agreement you sign
This article is general information and is not legal or medical advice.
Talk to Prestige Insurance Group
Prestige Insurance Group works with Florida physicians, behavioral health providers and medical practices to place professional liability, cyber and practice coverage through specialty markets. If your practice sees patients by video, especially patients who travel, we can review how your current policy handles telehealth and where it may need to change.
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