Medical Indemnity Insurance UK

What is medical indemnity insurance UK and why is it needed? If you’re new to the world of running your own business, or it’s the first time you’ve been tasked with sorting out your yearly insurance cover, you’ll surely have lots of questions.

You will probably be asking yourself, what types of cover do I need? One type of cover we are often asked about is medical indemnity insurance and what medical indemnity insurance actually is.

So let’s take a look at which businesses need medical indemnity insurance, what it covers, and everything else you need to know about this insurance.

To begin with, it’s worth pointing out that medical indemnity insurance is also known and referred to as medical malpractice insurance or cover.

If you see medical malpractice mentioned anywhere, we’re talking about medical indemnity insurance. This should prevent any confusion later down the line.

Overview of Medical Indemnity Insurance UK

In a nutshell, medical indemnity insurance covers you against a breach of your professional duties. If someone believes that there has been a breach of duty of care or omissions, or professional negligence whilst you and your business are carrying out medical work, there is a possibility that the person will make a claim against you.

This work usually involves providing care to your patients and medical indemnity insurance will cover you against legal costs and claims for damages associated with the perceived negligence.

What types of businesses need medical indemnity insurance?

Medical indemnity insurance is a cover relevant to all healthcare providers, including Hospitals, Individual practitioners, mental health clinics, Medical staff suppliers, Obstetric scanning, Aesthetic cosmetic practices, and complementary medical practices.

Medical indemnity insurance is an essential cover that can cover you against legal costs and claims for damages.

Is medical indemnity compulsory?

Medical indemnity insurance for doctors and other registered medical practitioners is a statutory requirement.

Insurance and indemnity is a complex area, which is why it is important to use an insurance broker that has specialist expertise in this field to ensure that you have the right level of protection in place and avoid any gaps in cover, which could lead to serious consequences.

What types of incidents does medical indemnity cover you for?

Whilst you’re working sometimes things don’t go according to plan, even in a healthcare setting. If an incident happens and one of your service users believes you have breached your duty of care, medical indemnity insurance can step in.

Here are some of the common claims* that medical indemnity insurance can cover you for: Misdiagnosis, Failure to diagnose, Surgical errors, Incorrect treatment, Prescription errors, Failure to provide a clean environment, and failure to adequately train doctors and other staff.

Professional Medical Indemnity for Doctors in the UK

Even if you are a safe doctor, indemnity is your extra coverage to protect you as a doctor in the UK in case of clinical negligence claims.

Yes, your NHS Trust will have provided you with coverage, but this coverage is more about keeping the hospital happy and safe than it is about ensuring your well-being.

That being said, this coverage also only takes into account claims from contracted NHS duties. So let’s first list out what IS NOT covered by your NHS professional indemnity:

Defense of medical staff in GMC disciplinary proceedings for stopping at a roadside accident, and other Good Samaritan acts not listed in your contract.
Clinical trials not covered under legislation.
Work for any outside agency on a contractual basis.
Work for voluntary or charitable bodies.
Work overseas

So at the end of the day, it’s better to be safe than sorry, and by keeping an extra coverage over your work, you are ensuring your security.

What is medical indemnity coverage for doctors in the UK?

We all know that doctors work hard to take care of their patient and they are trained to provide the best possible safe care. But things go wrong.

Medical Indemnity coverage protects a doctor against claims that arise out of professional negligence and breach of duty from the professional services, such as treatment and care that a doctor have provided to patients.

GMC’s Good medical practice requires doctors to have insurance or indemnity in place where necessary. GMC has regulatory powers to check whether doctors have adequate and appropriate insurance or indemnity.

They can:

Check that any doctor practicing in the UK has adequate and appropriate insurance or indemnity cover.
Remove a doctor’s license to stop them from practicing altogether, if they learn that they don’t have adequate and appropriate insurance or indemnity or if they fail to give us the information asked for.
Refuse to grant a license to a doctor if they can’t assure them that they’ll have adequate and appropriate insurance or indemnity in place by the time they start practicing in the UK.

A doctor must have adequate and appropriate insurance or indemnity in place when they start to practice medicine in the UK.

Under the law, a doctor must have cover against liabilities that may be incurred in practicing medicine having regard to the nature and extent of the risks.

The type and level of insurance or indemnity a doctor requires depends on factors including where a doctor works, whether they are employed (and, if so by whom and for what services) or self-employed, and the nature of work they do.

Does NHS provide professional indemnity to doctors in the UK?

NHS bodies and organizations are financially responsible for the clinical negligence of their employees.

All NHS Trusts/ Health Boards in England, Scotland and Wales are members of the state-backed NHS medical schemes.

In England, indemnity is provided through the Clinical Negligence Scheme for Trusts (CNST), which is administered by the NHS Resolution.

In Wales, indemnity is provided through the Clinical Negligence Scheme for Trusts and Health Board by Welsh Risk Pool Services.

In Scotland, indemnity is provided by the Clinical Negligence and Other Risks Indemnity Scheme (CNORIS).

NHS National Services Scotland is the Scheme Manager, with the Central Legal Office providing legal advice and guidance to Health Boards.

In Northern Ireland, each health and social care trust provides its own indemnity, funded by the Department of Health, Social Security and Public Safety.

The legal and professional requirement that all individual doctors hold adequate and appropriate clinical negligence indemnity cover is fulfilled through their Trust/Health Board, either through their membership of an NHS scheme or arranged directly.

But as mentioned earlier, it is still a better option to have additional indemnity coverage to cover all your work scopes.

Is Insurance different to Indemnity?

Indemnity works on the basis that the claim is covered as long as the cover was in place when the incident occurred, rather than when the claim is made.

Insurance is like your car insurance – you are only covered whilst the policy is in place and/or for a defined period after, called “run off”.

Any insurance arrangement needs to ensure cover is provided for any incidents, no matter how long after the incident the claim arises.

The run off period is insufficient in most insurance policies. There can often be a delay in a claim arising particularly in some cases involving children where it can be 10-20 years. The three major Medical Defense Organizations (MDOs) provide indemnity cover and not insurance. Insurance companies may limit the level of cover or have certain exclusions.

The three key questions to ask about insurance apart from ensuring the cover is adequate are:

Will it cover me for criminal investigations?
Will it cover me for GMC investigations?
How long is the run off period?

So, it’s better to sign up for indemnity, not insurance.

What should be covered by indemnity?

Medical Negligence Claims.
Criminal and GMC investigations.

BMA (British Medical association) is a trade union and it does not cover medical indemnity for professional negligence claims for doctor in the UK but its function is to protect you in other ways.

From Rota discrepancy, contract checking, dealing with maternity pay to salary related issues to lobbying with related stakeholders regarding the overall well being of doctors in the UK is looked after by BMA.

How to apply for Indemnity coverage?

Firstly, you must decide who to apply with. The organizations most of us tend to go for are as follows:

Medical and Dental Defense Union of Scotland (MDDUS).
Medical Defense Union (MDU).
Medical Protection Society (MPS).

It’s best to obtain quotes from each, and see which company provides you with the coverage you need for the fee you’re willing to pay.

Ensure you complete the applications keeping in mind what your role in the hospital is and your title as well, so that you can get the most accurate quote.

So the steps on how to obtain indemnity coverage are as follows:

Decide on an indemnity organization
Contact several organizations, through their website in order to obtain a quote. Please only choose ONE to go with. Too many cooks spoil the broth.
Provide accurate information in the application
Make sure you give your correct role in the hospital, as well as provide the correct information for all of the questions asked.
Apply: Select an organization that works best for you, be it on cost, or the level of coverage you hope to receive. In general, all tend to work in the same way, but personal preferences and first-hand reviews should always take precedence to cost.
Setting up payment
Submit your application and set up a payment system. Direct debit tends to be the easiest.
Update as needed: Make sure to update your insurance coverage and profile information as your career progresses and your job changes.

When should I review my indemnity arrangements?

You should do this at regular intervals and whenever your scope of practice, private practice income or employment or contractual arrangements, change.

The terms of your insurance or the scope of your indemnity protection may require you to tell your provider if certain things happen, such as sanctions being imposed on your registration, or if you join the Specialist Register.

In all, you should also know how to be safe doctor in the NHS as this can be a completely new healthcare system for you.

So remember that indemnity is for your safety as well as the safety of your patients. It is something you will want to have but hopefully never use!

How it applies if you are medical personnel in Whales

If you are working as a locum General Practitioner in Wales, you will need to join the All Wales Locum Register and meet the requirements for the use of the All Wales Locum Register.

The Employment Services Division of NWSSP can advise on the application process. The Welsh government has published a statement explaining this.

You will need to maintain membership with an MDO or other indemnity provider or insurer to retain cover in respect of activities and services not covered by CNSGP or GMPI – including non-NHS or private work, inquests, regulatory and disciplinary proceedings, employment and contractual disputes, and non-clinical liabilities.

You must also have appropriate arrangements to cover you for liabilities that arise from your practice as a doctor whenever a claim is brought (such as ‘run off’ cover).

It is important that you assure yourself that you have appropriate arrangements in place for all aspects of your clinical practice.

If you are unsure about your current indemnity arrangements then you should contact your existing indemnity provider or insurer to check and potentially retain or arrange additional cover if necessary.

Insurance and indemnity when you’re working as a GP in Scotland or Northern Ireland

The 2018 General Medical Services Contract in Scotland sets out how the Scottish Government will work with partners, including medical defense organizations, to deliver the best solution for indemnity in Scotland.

Consideration is being given to the indemnity needs of partners, locums and seasonal GPs in the NHS.

However, unless similar schemes are introduced in Scotland, or Northern Ireland, if you are working as a GP in these countries you must arrange adequate and appropriate insurance or indemnity as you will not be covered by the CNSGP.

Working as a private or independent GP

If you carry out any private or independent GP practice in any part of the UK, this work will not be covered by the CNSGP. You must arrange adequate and appropriate insurance or indemnity.

I’m a locum

As a locum you should check any contract or arrangement that you enter into to make sure you have adequate and appropriate insurance or indemnity in place.

If you’re working as a locum for an NHS or HSC body, indemnity for the organization will be provided by a clinical negligence scheme.

Furthermore, If you’re working as a locum GP in England you will be covered by the CNSGP for claims arising from incidents which took place on or after 1 April 2019.

If you are working as a locum GP in Wales, you will need to join the All Wales Locum Register. The Employment Services Division of NWSSP can advise on the application process.

Insurance and indemnity for medico-legal work

If you do medico-legal work (like providing advice, writing medical reports, or giving evidence in connection with a legal action, tribunal or hearing) and this work requires you to hold a license to practice, you must take out adequate and appropriate insurance or indemnity.

What do you mean by adequate and appropriate?

The law says appropriate cover is cover against liabilities that may be incurred in practicing as a doctor having regard to the nature and extent of the risks of practicing as such.

What constitutes adequate and appropriate is a complex area and you need insurance or indemnity that covers the full scope of your practice.

Medical defense organizations and other organizations in the commercial insurance market can advise you about what level of insurance or indemnity is adequate and appropriate for your practice.

To get the best possible advice, you must give them accurate and up to date information about the scope and nature of your practice.