This article has been written and provided by the Medical Protection Society.
Every doctor working in the UK is legally required to have adequate indemnity before beginning practice. This is to cover legal defence fees if a patient sues for negligence, and any compensation awarded to the patient.
Doctors whose indemnity falls short of ‘adequate and appropriate’ protection can have their licence removed by the GMC [1].
For those working in the NHS, the minimum legal requirements are covered by the employer through state-backed indemnity schemes, although there is no state indemnity for GPs working in Northern Ireland and Scotland.
State-backed indemnity also has its limits.
It does not cover claims arising from private practice, for instance. Fee-paying work such as report writing, travel vaccinations, insurance forms, and private prescriptions are also not included.
The state won’t provide advice and legal representation at disciplinary hearings, support during inquests, help during a criminal investigation, or protection for Good Samaritan acts. Nor will the state always cover work commissioned privately by the NHS, such as under waiting list initiatives.
This is where private insurers and medical defence organisations (MDOs) step in.
There are a number of insurance policies and indemnity schemes that can fill the gaps left by state indemnity. Some, such as Medical Protection, also offer additional services that help doctors reduce their risk of receiving a claim or complaint, and support them through the stress of an investigation.
The benefits offered by Medical Protection include:
- Indemnity for clinical negligence claims
- Support and representation in GMC investigations
- Help in disciplinary proceedings
- Assistance with criminal investigations arising from your clinical practice
- Representation and assistance in coroner inquests
- Help responding to patient complaints
- Medicolegal advice line, available 24/7 for emergencies
- Support for managing unwanted media attention
- Protection for Good Samaritan acts worldwide
- CPD courses and online learning
- Digital publications, factsheets, and case studies
- Confidential counselling and wellbeing advice
- HR and business support for practices
Choosing the most appropriate protection can be confusing, so it is worth highlighting some of the key differences.
Insurance or indemnity: What’s the difference?
Medical malpractice insurance is usually bought as a stand-alone policy from an insurance company. It provides cover within set limits and restrictions, set out in the terms of a legally binding contract. Insurance policies are usually ‘claims-based’, meaning they only cover claims for incidents that arise, and are reported while the policy is valid.
Medical indemnity – as provided by a mutually owned, non-profit organisation known as a medical defence organisation (MDO) – is typically part of a wider package of benefits, which are discretionary. There is no contract stipulating the circumstances under which a claim will be paid. This allows MDOs the flexibility to offer as much help as is needed, especially in unforeseen situations.
It also allows them to decline assistance, although this is extremely rare. The reason for declining assistance is usually due to a member deliberately withholding or providing false information about the scale or nature of their work. Of course, this would also affect an insurance policy.
Claims-based versus occurrence-based indemnity
Claims-based indemnity only provides protection against incidents that occur and are reported during the policy or membership period. Once the policy or membership expires, so does the protection. This means that if a claim arises outside of that period of membership, you would not be able to seek assistance unless you bought ‘run off’ cover. This can be expensive and limited to a set number of years, whereas claims can arise even decades after an event. This is worth considering, given the average delay between an incident and the reporting of a claim is currently over five years [2].
Occurrence-based indemnity provides protection against incidents that happen during the membership or policy period, regardless of when the claim is made. Providing you were in membership and paying the correct subscription at the time of an incident, you are protected even if you’re retired or no longer a member. This means that you are protected for future claims arising from any year in which you were a member.
The choice is yours
The final choice of MDO membership or insurance policy will depend on the specific circumstances of the doctor, their area of practice and career priorities. For some, an off-the-peg policy may offer a sufficient safeguard in situations not covered by state-backed indemnity. Others may be looking for a more proactive and supportive solution.
At Medical Protection we have over 130 years of experience of dealing with medicolegal matters. This gives us a unique insight into why things go wrong and why complaints and claims arise.
The indemnity offered by Medical Protection is unlimited, with no financial caps on the legal fees we can incur or the compensation we can pay out. This allows us to protect and defend our members from legal, reputation, and financial consequences.
We are ready to intervene at every step of the process. By promoting best practice through our risk management resources, we help prevent problems from arising in the first place. We can nip emerging issues in the bud by helping doctors respond to patient complaints. We offer legal representation and support to members throughout legal and disciplinary hearings. And our counselling and wellbeing services provide welcome relief from the stress that an investigation brings.
For more information or to get a quote visit: Medical Protection – the world’s leading medical protection organisation
References:
[1] Domain 4 Trust and professionalism – GMC (gmc-uk.org)
[2] MPS data; based on claims reported by UK medical members between 1 Jan 2019 and 31 Dec 2024.
