Medical indemnity insurance is essential for consultants in private practice, providing financial protection and legal support in the event of a claim arising from the provision of medical services. While it does not prevent claims from occurring, it ensures that consultants have the necessary legal expertise and financial backing to respond effectively. 

The General Medical Council (GMC) states that doctors must make sure they “…have adequate and appropriate insurance or indemnity arrangements in place covering the full scope of your medical practice in the UK.” The level of cover required depends on individual circumstances and must be in place before a doctor begins practising. 

Government-backed schemes, such as the Clinical Negligence Scheme for Trusts (CNST), cover NHS-employed doctors, but these only apply to NHS-related work. 

If you undertake private practice, you must arrange separate indemnity insurance. Not only does CNST not extend to private clinical negligence claims, but it also does not provide cover for essential areas such as: 

• Regulatory investigations – including GMC fitness to practise proceedings. 
• Disciplinary hearings – both internal (e.g. Trust-led) and external. 

A comprehensive private indemnity policy ensures you are protected for clinical negligence claims in private practice, as well as including additional covers such as regulatory or disciplinary cover, support for coroners’ inquests and Good Samaritan Acts. 

Policies are available with either claims made or occurrence based cover. To ensure you have the right coverage, it’s essential to assess your individual needs and consult with providers to determine the most suitable option. 

Beyond regulatory requirements, having the right indemnity insurance safeguards a consultant’s career, reputation, and financial security, ensuring peace of mind should an issue arise. 

When selecting medical indemnity, it’s crucial to understand the distinction between contractual insurance, which PMP provides, and discretionary membership, as this choice significantly impacts the reliability and enforceability of your coverage.

Contractual insurance 

Contractual insurance involves a legally binding agreement, subject to the specific terms and conditions outlined in the policy documentation. This contract explicitly defines the scope of coverage, and as long as a claim falls within these terms and conditions, the insurer is legally obligated to provide assistance. 

Providers of contractual insurance are authorised and regulated by the Financial Conduct Authority (FCA), the UK’s financial regulatory body. FCA regulation ensures that these insurers adhere to strict standards of conduct, financial stability, and consumer protection. One of the key benefits of FCA regulation is that policyholders have access to the Financial Ombudsman Service (FOS), an independent body established by Parliament to resolve disputes between consumers and financial services firms. If a policyholder believes their claim has been unfairly denied, they can escalate the issue to the FOS for a fair and impartial review. 

Discretionary membership 

Discretionary membership, often offered by Medical Defence Organisations (MDOs), operates differently. Instead of a contractual obligation, assistance is provided at the discretion of the organisation. This means that even if a member pays their subscriptions regularly, the MDO is not legally bound to assist with every claim. Decisions are made on a case-by-case basis, and there is no guarantee that support will be provided when needed.

Benefits of FCA regulation 

Choosing a provider authorised and regulated by the FCA offers several advantages: 

• Consumer protection: The FCA enforces rules to ensure that insurers treat customers fairly, manage conflicts of interest, and maintain adequate financial resources. 
• Access to dispute resolution: Policyholders can refer complaints to the FOS, which provides a free, independent service for resolving disputes. 
• Regulatory oversight: FCA-regulated insurers are subject to ongoing supervision, ensuring they comply with conduct standards and are financially sound. 
• The Financial Services Compensation Scheme (FSCS): We are covered by the FSCS. You may be entitled to compensation from the scheme if we cannot meet our obligations. This will depend on the type of business and the circumstances of the claim. 

In summary, opting for contractual insurance provides a legally enforceable agreement with defined terms and conditions, backed by regulatory safeguards and access to independent dispute resolution. In contrast, discretionary membership lacks these assurances, as support is not guaranteed and is subject to the organisation’s discretion. 

At Premium Medical Protection (PMP), we understand that every medical professional’s circumstances are unique. That’s why we offer a choice between claims made and occurrence based indemnity policies, allowing you to select the coverage that fits your specific requirements. 

Understanding claims made and occurrence based policies 

• Claims made policies: These policies provide coverage for claims made and reported during the active policy period, regardless of when the incident occurred, as long as it is after the policy’s retroactive date (subject to policy terms and conditions). If a claim or potential claim is reported after the policy has lapsed, it won’t be covered unless you have an Extended Reporting Period (ERP), commonly known as ‘Run-Off Cover’. This extension allows you to report claims even after the policy has expired, offering continued protection. 
• Occurrence based policies: These policies cover incidents that occur during the policy period, irrespective of when the claim is reported. Even if a claim arises years after the policy has ended, as long as the incident happened while the policy was active, it will be covered (subject to policy terms and conditions). This provides seamless protection without the need for additional ERP purchases. 

Factors to consider when choosing between claims made and occurrence based policies 

• Career trajectory: Consider whether you anticipate changes in your practice, such as relocation, which might influence the type of coverage that best suits your long-term needs. 
• Financial planning: Evaluate the premium structures of both policy types. Claims made policies often start with lower premiums that increase over time, while occurrence based policies typically have higher initial premiums but do not require ERP (Run-Off). 

At PMP, our dedicated team is committed to helping you navigate these options to find the right coverage for your unique situation. We pride ourselves on offering competitive solutions, clear policy wording, and a customer focused approach to ensure you have peace of mind throughout your career. 

Yes, your PMP policy will protect you into retirement, whether you have a claims made or occurrence based policy. The way your cover responds will depend on the type of policy you have. 

• Occurrence based policies – If you hold an occurrence based policy, you do not need to take any additional steps when you retire. Since this type of policy covers claims for incidents that occurred while the policy was active, regardless of when the claim is reported, you remain protected into retirement without needing to purchase additional coverage. 
• Claims made policies – If you have a claims made policy, PMP provides free, indefinite extended reporting period (ERP) cover when you permanently retire, ensuring you remain protected against future claims arising from work carried out during your insured period. This means that even if a claim is made years after you have stopped practising, as long as the incident occurred after your retroactive date and before your permanent cessation of work, you are covered at no additional cost, subject to policy terms and conditions.
  
  This indefinite ERP is also provided in the event of the insured’s death, or disablement, offering peace of mind that both you and your estate are protected against any future claims.

Choosing the right indemnity cover for retirement is a crucial decision, and PMP ensures consultants have long-term protection without the uncertainty or financial burden that may be associated with ERP cover under other policies. 

At PMP, we prioritise your peace of mind by partnering with financially robust underwriters. Our policies are backed by Berkshire Hathaway International Insurance Limited (BHIIL), trading as MedPro, which holds an AA+ financial strength rating from Standard & Poor’s (S&P)—the highest rating of any underwriter in the UK healthcare indemnity insurance market. This exceptional rating reflects MedPro’s financial stability and ensures that, should you need to rely on your indemnity cover, it is supported by a trusted and resilient insurer. 

You can apply here, contact your local Area Sales Manager, or call 0345 163 0063

Switching to PMP from another commercial insurance provider or Medical Defence Organisation (MDO) is a straightforward process, and our team is here to ensure a smooth transition. However, we understand that every consultant’s situation is unique, and there may be factors to consider depending on your existing cover. 

If you are moving from a claims made (CM) policy to PMP’s claims made policy, we will work with you to ensure continuous cover, including aligning your retroactive date so that past work remains protected. 

If you are switching from an occurrence based policy to a claims made policy, there are no retroactive cover concerns, as your occurrence based policy will continue to cover any incidents that took place during its term, regardless of when a claim is made. The key consideration is ensuring there is no gap in cover by aligning the expiry date of your occurrence based policy with the start date of your new claims made policy. Our team will guide you through this process to ensure a seamless transition. 

We recognise that changing indemnity providers is an important decision, and we are here to help answer any questions, clarify complexities, and make the process as seamless as possible. To discuss your specific situation, contact us, and we will guide you through the transition. 

PMP partners with a carefully selected panel of elite legal experts from the most highly regarded specialist healthcare law firms in the UK. These firms are consistently recognised for their excellence in medical defence, demonstrating a deep understanding of the complexities of healthcare litigation and regulatory matters. 

Additionally, PMP offers a 24/7 medicolegal helpline, providing access to advice and assistance from legally qualified healthcare specialists. 

As MedPro deal exclusively with medical malpractice, our claims team is highly specialised. This expertise ensures that PMP clients receive the highest calibre of legal support, strategic guidance, and robust defence when they need it most. Our approach guarantees that every case is handled by industry-leading professionals with a proven track record of success in protecting the interests of healthcare professionals. 

We understand that financial circumstances can change unexpectedly. If you are facing financial difficulties during your policy period, please contact us as soon as possible. We are committed to supporting our policyholders. To discuss your options, please reach out to us via: 

Telephone: 0345 163 0053, Option 3. 

Email: admin@premiummedicalprotection.com 

Post: Unit 25, Athena Court, Athena Drive, Tachbrook Park, Warwick, CV34 6RT