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Many Professional Indemnity/Medical Indemnity Insurance policies for Doctors or Dentists are structured to work on what is known as a “Claims Made“ policy.

With this type of cover, the insured is generally covered for claims first made against them AND notified in writing to the Insurer during the policy period.

The Insured Doctor or Dentist will need a Current insurance policy to protect them against claims made by patients and other third parties at the time the claim is made, rather than when the incident leading to the claim occurred.

If your coverage with an Insurer has ended, and a claim is then first brought against you, for work done prior to the date the policy ended (ie whilst the policy was in force), then the insurance policy from your insurer at that time, will not respond.

This information is general in nature. Policy wordings differ from insurer to insurer and need to be read before considering taking out or replacing insurance.

This article (click to read) discusses an interesting legal case study where an insured Doctor failed to notify his Medical Indemnity Insurer (Avant) of facts and circumstances that may give rise to a claim within the requisite policy period. At trial, the plaintiff was granted leave to join the insurer to the proceedings. The insurer was successful on appeal.

For medical practitioners, this case highlights the importance of early notification to insurers of any claims or potential claims. For insurers, this case clarifies that an insured’s failure to notify facts and circumstances that may give rise to a claim does not constitute an omission to which section 54 of the Act will apply.