Medical malpractice insurance

A straightforward guide to protection for clinical risk

Medical malpractice insurance covers the cost of claims if a patient alleges negligence, error, or omission in your professional healthcare services. In the UK, most NHS staff are indemnified for NHS work, but private work typically needs separate cover. With private healthcare activity growing and employer-funded private medical insurance reaching a 30-year high, more clinicians are working in settings where dedicated malpractice insurance is essential.

Recent UK data shows why this matters. NHS Resolution recorded 16,395 new clinical negligence claims in 2024-25 while total expenditure on settled claims exceeded £3.1 billion. Obstetrics drives much of the overall claim value and high-severity cases can exceed £1 million. The NHS’s estimated liability for current and future clinical negligence claims was £59.99 billion in 2024-25. Although the Personal Injury Discount Rate moved to +0.5% in England and Wales in January 2025 - reducing some future-loss awards - the overall environment remains high-stakes for providers and patients alike.

Insurance can offer real financial protection, but only when you understand what is covered - and where the gaps are.

This guide explains in plain English how malpractice insurance works, what it typically includes and excludes, and how claims are handled. We will keep expectations realistic, point out common pitfalls, and help you assess whether this cover fits your practice. No jargon, no push - just clear guidance so you can make confident decisions.

What is covered and how claims are handled

A medical malpractice policy is designed to meet the legal costs and compensation that may be payable when a patient alleges negligent treatment, failure to diagnose, medication errors, consent issues, or poor aftercare. Cover can extend to vicarious liability for practice owners, good Samaritan acts, and inquests. Policies usually pay for solicitors, experts, court fees, and approved settlements within the policy limit.

Claims are commonly written on a claims-made basis. That means the policy that responds is the one in force when the claim is first made and notified, not the one in force when the treatment occurred. If you change insurer or retire, you may need run-off cover to protect against late-arising claims. Some policies are occurrence-based, which respond to incidents during the policy period regardless of when the claim is made, but these are less common and typically pricier.

There are important exclusions. Criminal acts, reckless or deliberate harm, practising outside scope, and work without the required licence are not covered. Contractual penalties, fines, or data protection penalties are typically excluded, though defence costs for certain investigations may be included. Claims arising where consent was not obtained or records are missing may be defensible but can be complex, especially as NHS England has highlighted information governance and patient safety risks that affect liability.

In practice, an error in an A&E setting or a surgical complication might trigger a notification. The insurer investigates, appoints specialists, and may attempt resolution without court. In 2024-25, over 11,000 clinical claims were resolved without proceedings, which reduces distress and legal cost for everyone involved.

Who needs this cover - and who may not

This insurance is particularly relevant to professionals delivering private clinical services: doctors, surgeons, dentists, allied health professionals, nurses undertaking private clinics, and aesthetic practitioners. Practice owners or companies employing clinicians often need vicarious liability cover. Locums who mix NHS and private work benefit from clear, separate protection for their private sessions.

If you only provide NHS services covered by Crown or NHS indemnity and have no private work, standalone malpractice insurance may not be necessary for those NHS activities. However, training, telemedicine, second opinions, voluntary work, and cosmetic treatments can blur lines. If in doubt, check whether your activity is fully indemnified. The growth of private pathways and employer-funded schemes means more clinicians are working in mixed settings where personal cover fills gaps safely and transparently.

Choosing a level of protection

1. Entry level

   • Typical limit: £1m - £2m each claim
   • Best for: Low-risk procedures, supervised roles, and early-career clinicians with limited private hours
   • Usual features: Claims-made cover, defence costs, inquest representation, basic medico-legal helpline
   • Trade-offs: Lower limits, narrower extensions, higher risk of hitting caps in severe claims

2. Standard level

   • Typical limit: £5m each claim or aggregate
   • Best for: GPs, dentists, physiotherapists, sonographers, and aesthetic practitioners performing moderate-risk treatments
   • Usual features: Broader definitions, vicarious liability for small teams, extended reporting periods, cover for ADR and complaints handling
   • Trade-offs: Higher premium than entry level, sub-limits for certain procedures and data-related incidents

3. Enhanced level

   • Typical limit: £10m+ with higher aggregates
   • Best for: Surgeons, obstetrics and gynaecology, orthopaedics, emergency medicine, and multi-site private practices
   • Usual features: Wider jurisdiction, more generous run-off, regulatory and disciplinary defence, reputational support
   • Trade-offs: Costlier, underwriting scrutiny is detailed, conditions on risk management and credentialing

4. Optional add-ons

   • Run-off or extended reporting for retirement or career breaks
   • Public liability and products liability for premises and devices
   • Cyber liability for data breaches and system outages affecting patient care
   • Locum cover and loss of income following suspension investigations
   • Contractual vicarious liability for incorporated practices and agencies

What it might cost

These figures are indicative, not guarantees. Global trends show rising severity of large claims, which can pressure pricing even when local reforms help. Market growth in UK malpractice to around £1.8 billion reflects expanding private care and wider insured pools.

Can you apply? Key eligibility points

Most UK-registered healthcare professionals with valid licences and appropriate qualifications can apply. Insurers usually request your registration number, CV or credentialing summary, evidence of CPD, and a breakdown of procedures and hours. Incorporated practices must disclose staff roles, supervision arrangements, and clinical governance. You will be asked about previous claims, complaints, disciplinary actions, and any practice restrictions.

Applications can be declined where there are unresolved sanctions, work outside scope of practice, inadequate supervision for high-risk procedures, or poor record-keeping systems. Some policies will not cover specific interventions without evidence of training or minimum case volumes. If you work across England, Wales, Scotland, and Northern Ireland, confirm territorial limits and jurisdiction so the policy matches where you practise.

From quote to claim - a simple path

1. Gather registration, qualifications, procedures, and private practice hours.
2. Request quotes with your specialty, turnover, and desired limit.
3. Compare scope, exclusions, excesses, and run-off provisions carefully.
4. Confirm claims-made or occurrence basis before you purchase.
5. Bind cover, receive documents, and set up incident notification steps.
6. Record consent and clinical notes consistently to reduce disputes.
7. Notify incidents early, follow your insurer’s panel solicitor guidance.
8. Review cover annually as procedures, hours, or staff change.

Benefits and drawbacks at a glance

Key checks before you commit

Before you buy, read the policy schedule and wording in full. Focus on the limit of indemnity, whether it applies per claim or in the aggregate, and any sub-limits. Check the excess and whether it applies to defence costs. Confirm the basis of cover - claims-made or occurrence - and understand how run-off works if you retire, relocate, or pause practice. Look for exclusions affecting your specific procedures, especially sedation, obstetrics, aesthetics, or telemedicine. Review consent, chaperone, and record-keeping requirements. Understand renewal pricing, notification deadlines, cooperation duties, and incident reporting protocols. Keep copies of training certificates, clinic protocols, and equipment maintenance logs, as these often influence both underwriting and claims outcomes.

Alternatives you might consider

1. NHS indemnity schemes - Suitable for NHS work only. Does not typically cover private practice or services provided outside NHS contracts.
2. Professional indemnity via medical defence organisations - May include discretionary assistance and wider advisory services for professional issues.
3. Public liability insurance - Covers third-party injury or property damage at your premises, not negligence in treatment.
4. Cyber insurance - For data breaches and system failures that affect patient information and service continuity.
5. Management liability - Protects directors and officers of clinics against management-related claims.

Frequently asked questions

Q: Is malpractice insurance required by law in the UK? A: UK healthcare regulators require appropriate indemnity. NHS indemnity usually covers NHS work, but private practice generally needs separate insurance. Professional bodies expect adequate, ongoing cover for your scope.

Q: How does the new Personal Injury Discount Rate affect claims? A: The move to +0.5% in England and Wales reduces some lump sum awards for future losses, which can stabilise claim costs. It does not remove the need for appropriate limits in higher-risk specialties.

Q: What limit should I choose? A: It depends on your specialty, procedures, and potential severity. Higher-risk fields like obstetrics and surgery often require higher limits. Consider per-claim and aggregate needs and seek professional guidance if unsure.

Q: Will my policy cover historic work? A: A claims-made policy usually only covers incidents if the claim is made and notified during the policy period and after the retroactive date. Run-off or extended reporting may be needed when you stop practising.

Q: Are legal expenses always included? A: Defence costs are typically included within or in addition to the limit. Check whether costs are inside the limit, which can erode the amount left for damages.

Q: How are claims usually resolved? A: Many cases settle through negotiation or alternative dispute resolution, avoiding court. Early notification, strong records, and cooperation with panel experts improve outcomes and reduce stress.

What to do next

Take stock of your procedures, hours, and practice locations. Compare policy limits, exclusions, and the basis of cover from several insurers. If you split NHS and private work, confirm exactly what each arrangement covers. When you are ready, request quotes and review the documents side by side so you can choose cover that genuinely fits your risks and budget.

Important information

This guide provides general information, not personal financial advice. Policy terms, limits, and exclusions vary by insurer and your individual circumstances. Always read your policy documents carefully and seek professional guidance if you are unsure about suitability or coverage details.