Frequently Asked Questions

Why do I need Indemnity for my Establishment?
An establishment needs medical malpractice and professional indemnity cover to protect itself against the financial and legal consequences of errors, alleged negligence, or adverse outcomes arising from its services — including claims made against staff for whom the establishment is vicariously liable. These policies ensure access to expert legal defence, cover compensation costs, and safeguard the organisation’s reputation and operational stability. Without this protection, a single claim — even one arising from the actions of an employee, contractor, or agency worker — can expose the establishment to significant financial and reputational risk. 
When will my establishment face vicarious liability risks?

A legal review highlights that South African medical institutions may still face liability under certain conditions 

 

  • The practitioner acted within the scope of employment or agency.
  • The institution exercised control over the practitioner’s work.
  • The relationship was akin to employment, even if the practitioner was a contractor.

 

This aligns with UK precedent (Barclays Bank Plc v Various Claimants), which South African courts often reference. The implication is that contractual status alone does not shield institutions from liability if the practitioner’s role is integral to the institution’s operations.

 

Examples:

 

  • A hospital was held liable for a botched spinal surgery performed by its staff.
  • A hospital was found liable for cerebral palsy caused by staff negligence during childbirth.
  • The hospital was challenged on vicarious liability for a surgeon’s unauthorised removal of a patient’s ovaries. The court emphasised that nursing staff negligence could still attract institutional liability, even if the surgeon was an independent contractor 
Can you provide cover for Establishments or only individual practitioners?
Some insurers on our panel underwrite both practitioners and establishments (e.g., clinics, day hospitals, emergency units, practices, placement agencies and frail-care centres). Policy terms and limits for establishments differ, and we’ll outline the appropriate structure for your entity.
How transparent are premiums vs. cover — will a cheaper premium always save me money?
No, cheaper premiums sometimes come with cover restrictions, higher excesses, or limited defence arrangements. We produce a premium-to-coverage comparison, so you see value, not only price.
If an insurer on your panel changes its policy wording or ownership, how do you keep clients informed?
We monitor our insurer partners, notify clients of material changes, such as policy wording, and recommend action, for example, reviewing alternative cover if a provider’s terms become unsuitable.
What practical steps should I take now to reduce the chance of a malpractice claim?
Maintain accurate records, ensure your informed consent is detailed, precise, and include after-care instructions, appropriate referrals, and a practice-level incident log. These steps help in defence and claims mitigation.
If I am named in a claim, how does the notification process work through your brokerage?
Notify us immediately. We will lodge the claim with the insurer, help collate documentation, and remain involved throughout the claims process to ensure the insurer has the full context and that your defence needs are met.
What is the one question a doctor should ask you when renewing each year?
“Has anything changed in my practice, scope of procedures, or claims history that would affect my cover?”
What is Medical Malpractice Insurance, and why do I need it?

Medical malpractice insurance—also known as medical professional liability insurance—is protection for healthcare professionals against the financial fallout of being accused of a mistake. Even highly skilled practitioners can face claims, and even when they’ve done nothing wrong, defending a lawsuit is expensive. Legal fees, expert reports, and other costs can stack up quickly, and if a case is lost or settled, the financial impact can be severe. Because most of these expenses aren’t recoverable even if you win, malpractice insurance is essential for safeguarding both your reputation and your practice.

What is the difference between Claims Made, Comprehensive and occurrence-based cover?

With an occurrence-based policy, you shall be protected against any claim or event provided the incident occurred while your policy was active. Occurrence policies accommodate “long-tail” events – situations that don’t produce lawsuits or claims right away. The claims-made policy only covers incidents that occur and are reported during the policy’s term. Therefore, if a claim is reported after a policy has become inactive, the claim may be rejected or repudiated. Usually, with a claims-made policy, you can qualify for an additional 3 years to notify claims after retirement. An occurrence policy is typically more costly than a claims-made policy because there is no limit on when a claim must be reported.  A Comprehensive policy is a hybrid policy where a claims-made policy can mature to a longer reporting tail, according to the policy terms and conditions.

When should I notify the insurer of an adverse event which could result in a claim?

With the occurrence-based policy, you only need to notify your insurer if the patient or patient’s representative notifies you that they are making a claim or if you receive a request for records.

With a comprehensive policy, you need to notify the insurer as soon as practicable, but no later than 90 days of becoming aware of any incident that may lead to a claim.  

In a claims-made policy, you need to notify the insurer of each and every unfavourable incident, which may result in a claim, by no later than 30 days.

When I switch from one malpractice insurance provider to another, will my old provider still pay any claims in progress which I have notified them about?

When moving from an occurrence-based policy provider to any new Claims-made, Comprehensive or occurrence-based policy provider, your previous occurrence-based provider will always cover incidents relating to your previous period of coverage, so there would be no need to buy retroactive cover.

When moving from a Comprehensive of Claims-made provider to a new Claims-made or occurrence-based provider, your previous provider will only cover claims notified during the active period of your policy. You can request that your new provider grant retroactive cover to protect against claims that were not previously reported to the previous provider.

Why do I need to complete a no-claims declaration?

If a prolonged period has passed since your application was completed, or if backdated cover is required, the insurer needs a signed declaration confirming there have been no material changes that could affect your risk profile. 

What is the difference between Medical Malpractice, Professional Indemnity and cover extensions?
  1. PI Example (Financial Loss): A healthcare administrator incorrectly processes a patient’s insurance claim, leading to financial loss for the patient. This may fall under PI, as it pertains to financial consequences of a professional service error, not bodily injury. However, incorrect advice may also be considered under the PI section of the cover.
  2. Defamation Example (Extensions): A medical professional makes a defamatory statement about a patient’s mental health status, leading to emotional distress and other patients overhear it in the corridors of the waiting rooms. This could be covered under a Medmal extension as it qualifies as a wrongful act resulting in injury of personality (emotional distress).

  

Each claim is assessed based on its specific facts and circumstances, and both Medmal and PI may be triggered according to how the wrongful act or error occurred.

Who do you place medical malpractice cover with?
We are an independent broker and can place with a panel of specialist providers, including Genoa Underwriting Managers, EthiQal, iToo and Camargue.
Do we work with MPS?
No, we do not place business with MPS. If a doctor asks about MPS, we’ll explain the difference between the discretionary cover offered by MPS and the products offered by our insurer partners.
Which insurers on your panel specialise in medical malpractice (not general PI)?

All of our Insurers have a specialised Medical Malpractice and Professional Indemnity division, focused exclusively on medical malpractice and related liability lines, which delivers specialist underwriting and claims handling for healthcare risks.

Which providers offer medico-legal advice or in-house legal support as part of their product?
All our Insurance providers offer medico-legal support through clinicians and lawyers, which can affect how claims are managed and what support is available day-to-day.
Are there any material differences in the scope of cover between your insurers?
Yes, limits, run-off options, territorial scope, retroactive dates, and when the excess is called upon vary by product and provider. We compare those differences side-by-side so you can see which policy fits your practice, not just the premium.
How do you decide which insurer to propose for a specific practitioner?
We match the risk profile, through an in-depth Risk-Needs Analysis, including speciality, claims history and procedures performed, to the insurer’s appetite and the policy features that matter.
How does your advice differ from going directly to an insurer I’ve heard of (e.g., MPS or PPS)?
We are independent – our job is to assess multiple options on your behalf, clarify wordings and exclusions, and offer assistance during the notification/claims and renewal processes. We’ll also explain the differences between membership benefits (MPS) and pure indemnity contracts so you can choose what’s most valuable to your practice.
What’s the most critical clause doctors often miss when comparing policies?

Look for the retroactive date and how retroactive cover is handled for prior acts or continuous cover. It determines whether historic incidents are covered. Also, check the run-off/extended reporting period wording for when you stop practising.

Do you help with preparing answers to insurer questionnaires (so quotes aren’t rejected)?
Yes, we help you complete and review proposal forms to avoid misstatements or omissions that could affect premium or claims cover.
If I switch insurers, will I lose cover for past work (run-off)?
Not necessarily, but you must check whether the new policy offers retroactive cover for prior acts or whether you need a specific run-off or extended reporting period to protect past practice.