You paid more than enough for malpractice insurance, so why would you need an additional attorney, or even several. And why would you have to pay for them? This is often a shocking question, and the answer is a poorly understood truth. Malpractice insurance offers only partial coverage of the problem, and you may well have to add to it.

How could this be true? Well there are several reasons:
1) You have a risk of exceeding the aggregate coverage of your policy.
2) The insurance company has a different purpose. They are looking at different overall goals, and you are only one part of theirs. Thus they may feel settlement is reasonable, but you don't.
3) There are multiple defendants such as hospitals, doctors, nurses and PAs. This can create tradeoffs where the decision of the insurance company is different than your interests.
4) Other issues created were not covered by the policy. The plaintiff at their attorney's recommendation reported you to the state licensing board or they complained about your billing. Defending the consequences of these is unlikely to be covered in your policy.

Thus you may need a personal attorney who has worked with physicians sued for malpractice. Plaintiff's lawyers are often best suited to be personal counsel. It is also true that a defense attorney with the right experience can be a good choice. You want the viewpoint of plaintiffs counsel in order to see your strategy from the other side.
You need someone with experience in both sides of the cases, who will look for tactics teh defense attorney is not used to.
They also may not be able to act in certain matters because they have an inherent alignment with the insurance company. It can be unethical for a defense attorney to take a position adverse to the insurance company in matters such as coverage questions.

It may be helpful to ask a prominent plaintiffs attorney about your assigned defense attorney. It is easier to switch early in the process with a call to your insurance carrier.

Your personal attorney will monitor the case to be sure that you are not at significant risk for an excess verdict. You want them to be familiar with the case and its details. This does not entail repeating the work of your defense attorney, but it may help ensure that work is complete.

In most cases, this will cost several thousand dollars. But your personal counsel should be able to give you an estimate in your case.

Your personal counsel can demand they take every action to resolve the matter within your coverage. This is almost always accepted. If it is not resolved withing your coverage and there is an excess verdict, then you can assign to the plaintiff your bad faith claims against the insurance company in exchange for being released from excess liabilty. This is a stronger case than trying to collect against you. It is not known by plaintiffs counsel during the case, and does not make the case harder to defend. If the insurance company roles the dice, they then bear the risk.

Your personal counsel also can help if there is a dispute about whether an insurance policy by your professional corporation adds another layer of coverage. This is a common battleground.

Your personal counsel should be at your cross examination at trial. That is commonly the most important contribution at jury deliberation.

Consider early if you need a personal counsel, and look carefully to make the right choice.