How Much Professional Indemnity Insurance Cover Does a Doctor Need?

A doctor’s career changes over time. You start with routine cases and eventually move on to specialized procedures, handle more patients, or take on more clinical work. As your needs change, your insurance requirements will change too. This is where professional indemnity insurance for doctors becomes important. But how much coverage do you need? The answer depends on several factors, such as your speciality, the services you offer, your patient volume, and other related risks. This blog post will help you understand the key factors and choose the right amount of insurance.

What factors determine how much professional indemnity insurance a doctor needs?

No single coverage amount fits all doctors. You can choose an appropriate sum insured based on your personal circumstances, including the type of activity you do, the category of patients you treat, and the associated risks. Let us consider the following criteria.

1. Your Medical Speciality

The medical speciality is one of the determining factors when choosing your sum insured. While a general physician may have a lower risk compared to a neurosurgeon or an obstetrician, the type of work determines whether there is a greater or a lower chance of getting sued.

2. The Type of Treatments and Procedures You Perform

Some doctors conduct surgical procedures, while others do not. It all comes down to the type of procedures you undertake and the possible risk involved in your procedures. The sum insured will be different depending on whether your daily procedure could cause any complications to your patient.

3. Number of Patients That Visit Your Clinic/Practice in a Week or Month

Some doctors see many more patients than others. This will definitely increase the risk of a complaint and hence should determine your sum insured.

4. Your Practice Setting 

Working alone in a clinic may differ from working in a big hospital or multi-speciality hospital. The number of your patients, your role in complex cases, etc., will differ in each case. Think about the size of your practice and the nature of your work when you choose your limit of insurance.

5. Your Claims History

If you have encountered any professional negligence claims or any legal disputes in the past, consider your insurance requirements in detail. Your claims history may also influence the premium amount that will be quoted to you. Be transparent regarding past experiences and evaluate how the policy considers such situations.

6. Legal Expenses and Compensation

In addition to the payment made to the patient, a claim may also include expenses incurred while defending yourself legally. A doctor should select a policy that provides proper coverage of legal expenses and also clarifies whether the expenses are covered inside or outside the sum insured.

7. Your Policy’s Individual Claim and Annual Limits

Don’t just focus on the cover provided by the headline figure. There may be Any One Accident (AOA) limits, which apply to each individual claim, and Any One Year (AOY) limits, which apply to all claims made in a year. They both count in evaluating whether you are adequately covered.

Should high-risk specialities consider higher coverage?

Yes, for instance, an obstetrician handles birth complications, whereas an orthopaedic surgeon performs operations that might affect a patient’s mobility. If anything goes wrong, the financial implications can be substantial. But a speciality with greater risks does not necessarily mean that each doctor should have the same insurance cover. Other factors such as experience, procedures, number of patients, and even the practice environment should also be considered. The way forward is therefore to determine your level of risk as opposed to relying on speciality for your insurance cover. Compare the various options and decide from there.

How to choose the right sum insured?

Choosing the right amount of insurance coverage is easier when you’re realistic about your practice, rather than simply choosing the most affordable option.

The following are some suggestions to help you choose.

1. Know your professional risks

Start by considering your speciality, procedures performed, patients, and cases. Evaluate what a negative outcome would cost you.

2. Compare different coverage amounts

Look at different coverage amounts like ₹25 lakhs, ₹50 lakhs, ₹1 crore, and more wherever available. This is just an example of coverages and should not be taken as universally applicable. The right amount varies from case to case.

3. Find out about the AOA and AOY coverage

For instance, if a policy has ₹50 lakhs per year coverage but only ₹25 lakhs per incident, you may end up paying for more than the AOY amount for a single adverse incident.

4. Read the policy exclusions 

Know which claims are insured and which are excluded under your policy. Learn about legal expense claims, consent-related claims, retroactive dates, and claims based on past events. Do not assume that all professional disagreements are going to be insured under your policy.

5. Compare premiums against protection 

A cheaper premium might seem like a better choice, but it should not be the only one you make. Consider how much coverage and claims support you will get for your money.

6. Have your cover reviewed by an insurance expert

If you do not know how much cover you need, have a discussion with an insurance specialist about your practice.

Can a doctor increase professional indemnity coverage later?

Yes, doctors are normally able to upgrade their professional indemnity coverage when renewing or changing their insurance policy, as long as the insurance company allows such an arrangement. This can benefit a policyholder because one may start as an independent practitioner with fewer patients but, over time, take on more responsibilities. Your existing professional cover may not cater to your new responsibilities.

However, upgrading the sum insured is not an automatic process. Sometimes, the insurance company will need new information from you or will charge you more, depending on the change you want to make. It is important to keep in mind that upgrading the sum insured might not necessarily cover your liability for all past procedures. You should check whether you will be covered for any incidents that have occurred earlier and other policy conditions like exclusions. The most effective way to deal with the situation is to review your insurance policy every year and when something changes in your professional life.

Conclusion

In conclusion, the type of medical practice you do will determine the level of professional indemnity insurance you need. Whereas some doctors might feel that a smaller level of coverage is sufficient, there might be others who require greater protection because of their speciality, number of patients, or type of procedures that they undertake. Spend some time comparing the levels of indemnity insurance cover, the exclusions, legal expense cover, and claims procedures. You should evaluate your level of protection periodically as your practice changes.

If you are looking for ideal coverage options, SafeTree provides professional indemnity insurance cover to help professionals manage the financial risks of their profession.

FAQs

1. Is ₹50 lakh professional indemnity insurance enough for a doctor? 

Although ₹50 lakh could be enough for some doctors, others might need a higher limit. Based on their speciality, number of patients, risk involved, and policy conditions, one can decide on their requirement.

2. Do surgeons need higher professional indemnity coverage?

The higher insurance limit for surgeons should be analysed with care, as surgery carries the risk of complications. The correct amount would depend upon the surgeon’s speciality, operations, risk factors, and number of patients.

3. Does the required coverage differ by medical speciality? 

Yes, coverage requirements can differ between specialities. Surgeons, as well as others, may have more requirements than some general physicians based on their operations, responsibilities, and claims.

 

Published by: A2V Insurance Brokers Pvt. Ltd. (SafeTree)

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