As a clinician with a heavy caseload; one of the last things on your mind would typically be indemnity – that is until you are in the position of receiving a clinical negligence claim, says Lola Mitchell, junior policy specialist at THEMIS Clinical Defence.

It is always a surprise to realise how many clinicians are not fully aware of the indemnity that they have in place, which is something I tackle day after day.

Shouldn’t your knowledge of your protections in place begin before the occurrence of an incident?

The nature of your policy – Indemnity vs Insurance

Many clinicians are under the impression that any indemnity that they hold for their practice can be considered insurance, which is incorrect. Not all indemnity can be considered insurance. To be considered insurance, a financial contract is required. Some indemnity providers do not actually provide clinicians with an insurance contract, these clinicians could be left liable for their own claim.

Contractual indemnity is backed by:

  • Set indemnity limits – you know the exact amount of financial protection you have in place, should a claim arise.
  • Legally binding insurance contracts – cover will not be withheld from you at your providers discretion, something we have seen before when clinicians have been supported by discretionary indemnity providers.
  • Regulated cover – all contractual providers will be regulated by the Financial Conduct Authority, creating an additional level of reassurance to all policyholders.

Understanding your requirements – Clinical negligence scheme for trusts

Those working in the National Health Service would typically be covered by the Clinical Negligence Scheme for Trusts (CNST) which is implemented by NHS Resolution. A common misunderstanding when regarding CNST is that this would also cover clinicians for personal regulatory representation, medico-legal support and advice – the CNST would typically not cover clinicians for this. To tackle this gap in cover, many providers offer additional indemnity to NHS clinicians.

As an NHS clinician, I would encourage you to ask yourself the question – does the CNST cover me for everything that I could be exposed to?

Provisions in your indemnity policy

Part of my role as a junior policy specialist at THEMIS Clinical Defence is to ensure clinicians are receiving the correct indemnity that is appropriate to their scope of practice. Something that I do is to provide my clinicians with a policy comparison; sifting through the legal jargon to identify any provisions in place, or lack thereof.

Upon comparing the policy wording of many indemnity providers, something that has become apparent to me is the Prospect of Success/Burden of Proof clause. This clause outlines that an insurer may only defend the insured at the point of a claim; should there be realistic prospect of success.

This risk highlights the importance of thoroughly reviewing your policy wording.

Lola Mitchell, junior policy specialist at THEMIS Clinical Defence.
Lola Mitchell, junior policy specialist at THEMIS Clinical Defence.

How can we mitigate these struggles?

The General Medical Council suggests you should review your indemnity arrangements regularly; this might look like:

  • Revisiting your Statement of Fact upon renewal – Something you cannot do with Auto-Renewal!
  • Thoroughly reading through your policy wording – I am always on hand to support you in understanding key terms.
  • Checking indemnity requirements with employer – Most clinicians are always shocked by the lack of an agreed indemnity limit which doesn’t meet the £10 million limit most private hospitals set.

At THEMIS, we see our clinicians’ careers as though they are our own, not risks. This is reflected through our consultative approach as brokers. By taking the time to understand each and every one of our clinician’s specific indemnity requirements; this allows us to provide bespoke, tailor-made indemnity that is built for clinicians, by clinicians.