Medical Indemnity in the UK: What Brokers Need to Know

Medical indemnity – or medical malpractice insurance – is one of the most complex liability classes in the UK market. For brokers, it represents both a regulatory necessity and a significant advisory opportunity.

The General Medical Council (GMC) mandates that every practising doctor in the UK has “adequate and appropriate insurance or indemnity arrangements in place covering the full scope of their medical practice.” What the GMC does not do is define what “adequate and appropriate” actually means. That responsibility falls to the practitioner and, by extension, the broker arranging cover.

With litigation costs rising, a growing “no win, no fee” claims culture, and an increasingly diverse healthcare sector (from NHS GPs to private consultants, dentists, allied health professionals, and beyond), brokers need to be clear on the indemnity options available and the risks of each.

Understanding Medical Indemnity

Medical indemnity (medical malpractice insurance) protects healthcare professionals against claims of negligence, misdiagnosis, prescription errors, surgical mistakes, or other professional failings that result in patient injury, mental anguish, or death.

Key considerations for brokers include:

• Legal costs are escalating: Even successfully defended cases leave professionals out of pocket in many jurisdictions.
• Claims environments are toughening: The prevalence of “no win, no fee” litigation increases both frequency and severity of claims.
• Policy form matters: The distinction between occurrence-based, discretionary cover and contract-certain, regulated cover is critical.

Indemnity Options: Where Brokers Add Value

There are two principal avenues for medical indemnity arrangements:

1. Medical Defence Organisations (MDOs)

• Operate on a discretionary basis – no contractual obligation to defend or indemnify.
• Cover is occurrence-based, meaning historic incidents are still eligible regardless of when a claim is made.
• Internally regulated, with no oversight by the FCA or PRA.
• Limited in scope – generally no supplementary extensions.
• Attractive for simplicity but present a real risk to clients who believe they are protected, only to find support withdrawn at the MDO’s discretion.

2. Commercial Insurance (via Brokers and Specialist MGAs)

• Policies are contract-certain – insurers are legally obliged to respond under the agreed terms.
• Typically claims-made cover, requiring run-off arrangements when a professional ceases practice.
• FCA and PRA regulated, backed by the FSCS, and bound by “treating customers fairly.”
• Brokers can access tailored extensions, including reputational harm, defamation, criminal proceedings, and more.
• Designed to respond to the evolving needs of modern healthcare providers, especially those in private practice or hybrid NHS/private settings.

Why This Matters for Brokers

The choice between discretionary and contractual indemnity is more than a technicality – it can mean the difference between a client being defended in court or left exposed to personal financial ruin.

For brokers, this is where expertise translates into value:

• Educating clients who may not understand the risks of discretionary cover.
• Structuring bespoke solutions that reflect the client’s scope of practice.
• Future-proofing arrangements through run-off planning and contract-certain policies.

Partnering with an MGA

As an MGA specialising in medical malpractice, we work exclusively through brokers. Our role is to provide market access, underwriting insight, and product flexibility so you can give your clients confidence that their cover is both compliant and fit for purpose.

If you have clients unsure of what cover they hold – or if you’d like to explore alternatives to discretionary arrangements – speak to our team. We’ll help you navigate policy structures, exclusions, and extensions so you can deliver the right advice.