The professional indemnity insurance a.k.a malpractice insurance or error and omissions insurance has become imperative and a burgeoning need for medical professionals in today’s times. Cover you, India’s insurance broker provides professional indemnity insurance specially for healthcare professionals. Their insurance covers doctors, surgeons and pathologists against professional negligence owing to unforeseen circumstances. Deepanker Mahajan, Co-Founder and CEO, CoverYou, reveals more

By Sonali Patranabish

Professional liability insurance for healthcare professionals is being increasingly availed and insurance companies have been seeing a boost in demand. What factors have brought about this wary
mindset amongst healthcare professionals to increasingly adopt liability insurance coverage?

There has been a tremendous increase in medical malpractice claims against doctors lately in India, with cases under the Consumer Protection Act growing 110 per cent since 2015. Defending such cases may be very expensive, costing between Rs 2 to Rs 10 lakhs. The new Consumer Protection Act of 2019 has made it easier for patients to claim medical negligence, with tougher penalties and better redress systems. More patients are aware of their rights now—over 60 per cent, according to a 2022 survey by the Indian Medical Association (IMA). Expectations have also risen by 40 per cent from 2015 to 2020, according to a National Law School of India University study. Peer influence plays a big role too; in a 2021 IMA survey, 75 per cent of doctors said they got liability insurance because their colleagues recommended it.

Can you outline the lucrative benefits of professional indemnity insurance coverage for doctors and HCPs?

Doctors’ Professional Indemnity Insurance in India covers an extensive range of risks, encompassing both compensation and defense costs thereby providing financial protection. Legal support services are also included in these policies which usually allocate legal representation within one or two days upon receipt of notification from the insured party. Also included are risk management tools such as regular provision of legal advice as well as risk assessments and training sessions that aim at minimising potential claims. Given the high-risk nature of the medical field, doctors in India face a relatively high claims frequency, averaging around 5-10 per cent per year.

Are there different brackets/segments for coverage depending on the risk associated or the type of HCP i.e. a different coverage for a consultant, surgeon, practitioner, and health coach?

Healthcare professionals (HCPs) are given a tailor-made professional indemnity insurance (PII) based on their profession and the risks involved in their practice. Consultants pay premiums that differ per specialty and threat level, with higher charges being imposed on high-risk areas like cardiology and oncology as they have several frequent and expensive claims. The risks associated with surgery make surgeons’ premiums higher, those of general practitioners or family doctors moderate reflecting average risk; whereas health coaches incur the lowest costs because of lower risk. Specialty carries significantly more weight when it comes to premium amounts, for instance high-risk practices such as surgery attract higher rates than low risk fields like psychology.

Geographic location also affects the amount charged due to varying trends in local medical practices settings and litigation levels. Experience also counts; highly experienced professionals may be offered PII at a relatively cheaper rate while recently qualified or less experienced ones may have to pay more premiums. For example, neurosurgeons pay between Rs 50,000 – Rs 100, 000 annually; Cardiologists pay between Rs 30,000 – Rs 60,000 per annum; family physicians pay between Rs 10,000 – Rs 25,000 for protection every year while Health Coaches usually offer less than Rs 5,000 per year.

What is your competitive advantage amidst multiple players in the market offering this sort of malpractice insurance for HCPs?

Leading in the line of a variety of products is professional indemnity insurance for healthcare rofessionals
(HCPs). CoverYou is an IRDAI-approved broker. We provide immediate and focussed legal assistance available nationwide through an extensive legal network of over 10,000 medico-legal lawyers. The policies provide comprehensive medico-legal coverage even against FIRs, E-notices & even threat calls. Policyholders can choose their own lawyers, thus enhancing personalised legal representation. Besides expert advice on case defenses and risk management, second-level consultation is available from a panel of over 500 senior doctors. Unlike the industry norm which has 0.25 per cent - 1 per cent compulsory excesses, CoverYou provides ZERO compulsory excess.

What sort of trends and advancements do you foresee shaping this niche segment of the insurance sector in the future?

Professional liability insurance is expected to change considerably due to several important trends. In India, personal insurance is classified as non- life insurance and this is in contrast to the global experience. The global ratio of life to non-life insurance sits at 45:55 pointing at a bias towards non-life insurance. However, contrary to this trend, life insurance holds 75 per cent of the Indian market while non-life takes
just 25 per cent.

What sort of restraints and challenges does the medical professional liability insurance market face in
India?

India’s literacy and education levels have risen by 77 per cent, consequently empowering patients. The legal profession has also seen growth with about 1.7 million lawyers being registered as of 2021, According to the Bar Council of India. However, the healthcare system is overwhelmed with an approximate doctor-to-patient ratio of 1:834. This extra burden usually results in mistakes
such as surgical accidents and wrong diagnosis, whose incidence has recently increased by between 7-10
per cent. Consumer Protection Act now makes it easier for individuals to seek redress against medical
negligence thereby simplifying the process that was once prolonged before one could complain against
healthcare providers. In fact, even minor occurrences like misdiagnosis and adverse drug reactions fall under this lawsuit in Indian law now which formerly only dealt with severe cases.

What is the market size of the medical Professional liability insurance sector in India? Do you expect to see further developments in terms of value and revenue added to the market in the future?

Increasing awareness and demand for risk management solutions among healthcare providers are driving
significant growth in India’s medical professional liability insurance. As per the latest report, the allied market research projects a rise of about $ 16.6 billion by 2021 with an expected $25.7 billion by 2031 at a CAGR of 4.5 per cent. India has seen a dynamic shift within its wider insurance industry, changing the face of financial services in niche markets like medical professional liability insurance.

Factors such as increased foreign direct investment (FDI), regulatory support, use of advanced technology, and claims management, provide a positive outlook for this sector. Medical professionals are at the receiving end when in the majority of the cases medical negligence tag is being used against them, sometimes facing mob violence.

What role is Cover You playing when it comes to the safety of doctors, nurses, etc?
CoverYou embodies the safety measures for doctors by providing a range of Professional Indemnity Insurance policies that include coverage for legal expenses incurred in defending and resolving medical malpractice claims. They have an in-house team of claim experts who provide handheld support to doctors to go through the medico-legal process worry free. In addition,

CoverYou works with over 75 different medical societies, in order to make sure insurance plans are tailored for cost effectiveness and customised offerings They also consider mob attacks as a risk thus covering these incidents such as physical assault and property damage among other things. Besides, organising seminars for healthcare providers to enlighten them about their rights and methods of handling medico-legal problems giving them the knowledge and instruments needed to shield
against false allegations and violence.

A majority of the patients face hurdles when it comes to getting the health insurance facility despite paying high premiums. How accessible is it when it comes to providing insurance for doctors?

Our website allows us to easily compare robust plans from over 20 top insurers, ensuring you find the best fit for your needs. We’ve significantly streamlined our process, cutting the policy issuance time down from 24 hours to an impressive 5-7 minutes, allowing you to get covered swiftly.

Moreover, our in-house claim settlement team is available 24/7 to provide you with unparalleled support whenever you need it. We also understand the importance of continuity in coverage; that’s why we provide coverage from the first day in cases of portability, ensuring there are no gaps in your protection.

How many doctors, nurses, etc are under the purview of CoverYou?
At CoverYou, we are dedicated to serving the medical community with excellence. Annually, we consult 518,400 doctors, making an impressive 1,800 calls daily over 24 working days each month. Our commitment ensures that each doctor receives personalized attention and support. With our extensive reach and consistent communication, we strive to address the unique needs and concerns of doctors, helping them secure their professional and personal futures with confidence and ease.