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Frequently Asked Questions

Professional indemnity insurance for doctors is a type of liability insurance that protects against professional risks such as negligent misdiagnosis, incorrect medication dosage, surgical procedures, and the wrong course of treatment.
CoverYou is India's only insurance broker company dedicated solely to the healthcare industry. Working with India's Top Medical Associations and encouraging their members with various insurance protection needs such as tailor-made products, enrollment, and committed bolster on claims.
As seen by the facts listed below, there has been a sharp increase in hospital and doctor-related claims in recent years. India records approximately 5.2 million negligence cases a year.

  • Medical negligence has gone up by 400% in the Supreme court over the past 10 years.

  • Over 65% of Doctor’s fight medical liability lawsuits in their lifetime.

  • 2 out of 10 Doctors in India are covered under the policy.

  • Increase in awareness among people groups.

Which make it precautionary to have a professional indemnity insurance
The Hospital Indemnity covers bodily harm and/or patient deaths that are claimed to have been brought on by mistakes, omissions, or negligence in professional services provided or that should have been provided by the Insured or their qualified or unqualified assistants, nurses, or other hospital employees.
A hospital Indemnity insurance policy can be availed by Hospitals, Nursing Homes, Diagnostic Centre’s, Path Labs, and Private Clinics.
Since this insurance safeguards hospitals from professional risks and associated legal costs, especially in light of the rising number of cases filed against the hospitals.
No, we cover all kinds of hospitals (Single Speciality Hospital/Multi-speciality/Super-speciality)

  • Nursing Home

  • Diagnostic Centre’s

  • Path Laboratories

  • Private Clinics

Yes, your employees and workers who work inside the clinic/hospital such as technicians, medical caretakers, ward boys, professionals, compounders, and so on are all protected. If they have an accident while performing their professional duties and the center is notified, this will be covered by the hospital indemnity insurance.
You have the correct information. We have done the same calculation for simplicity based on approximate OPD and IPD based on market research. As a result, OPD and IPD are essentially unpredictable numbers. Things that cannot be predicted accurately and will not even have an impact on your rights.
Yes, staff and employees, including specialists, healthcare professionals, ward boys, specialists, technicians, etc., are all insured and centered in case of any accidents during the course of their work. Will receive a notice of termination, which is covered by hospital indemnity insurance.
Yes Doctor, by providing your own medical registration no, you can apply for the policy.
A retroactive date is the date in the past from which your insurer has agreed to cover you or the first day on which you have continuously had professional indemnity insurance coverage (even if you changed insurer during this period). Your insurance will not pay for any claims resulting from incidents that occurred before this date.
Fresh policy simply means when you purchase the policy for the first time.
Tenure of professional indemnity policy is 1 year.
Yes, you can port your existing policy running from any insurance company before 45 days from renewal, porting will restore the old retroactive date in the new policy.
Yes, you will be requiring an indemnity coverage to practice as an private practitioner.
Yes, you will be requiring an indemnity coverage, if you are involved in clinical training.
All sources of medical-legal notices are acceptable like,

  • Police FIR

  • District Forum

  • State Commission

  • National Commission

  • Medical Council

  • Human Right Commission

  • Email, etc.

Yes, it covers all line of specializations
Legal consultation will be arranged within 2 hours from intimation
Yes, You can choose your own choice of Lawyer, to represent your case and their fees will be paid by the insurance company.
Yes, we have a senior doctor panel for second level of consultation.
Multiple cases are covered in a particular year till the time sum insured won’t get exhausted
The amount of coverage depends on your practice risk and needs, but with increasing no. of cases, mostly doctors are opting for higher sum insureds.
List of exclusions

  • Administering euthanasia/abetting suicide

  • Criminal abortions with illegal methods/techniques

  • Deliberate malpractices like false certificates, and falsification of clinical records, Except the allegations there too.

  • Collusion or direct involvement in cold-blooded murder.

  • Divorce suits as co-defendants.

  • Staff problems/labor disputes (employer-employee relationship)

  • Administration of spurious/prohibited drugs.

  • Illegal dealings in narcotics and other drugs are declared as contraband but the appropriate authority from time to time.

  • Trade and dealings in live organs for transplant.

  • Illegal stocking or dispensing, prescription of prohibited drugs, unauthorized/illegal experimentation and procedures.

  • Practice without valid registration /certificate.

  • Contravention of Govt. Acts, Corporation / Municipal regulations in matters of practice, running establishments, licensing, display of boards, food facilities to patients.

  • Unethical and/ or illegal practice in fertility and impotence, etc.

  • Cosmetic surgery is done for/in collusion with criminals or how so over

  • Falsification/ substitution of death certificates/ cause of death/change of cadavers.

  • Collusion in substitution of babies.

No, you can increase your coverage amount at the time of renewal only.
Professional Indemnity Policy comes under a ratio of 1:1, 1:2, 1:4, etc; which is called AOA (Any one accident) & AOY (Any one year).

AOA:AOY ratio determines the maximum liability that insurance company will compensate for in case of any professional indemnity claim.

If the ratio is 1:1, it denotes the maximum liability insurance company will compensate for is equal to the amount of sum assured chosen. If the ratio is 1:1, that means the maximum liability the insurance company will compensate for in the event of claims will be equivalent to half the sum assured chosen. The other half of the sum assured will be paid for the second claim during the same policy period.

For Example, a Gynaecologist purchases professional indemnity cover for Rs. 1 Cr having AOA:AOY ratio 1:2 & court allocates compensation of Rs. 60 Lacs. In this case the insurance company will only compensate Rs. 50 Lacs (1/2 of 1Cr). The remaining Rs. 10 Lacs need to be paid by him out of his own pocket where as if the policy is 1:1 then the whole 60 Lacs will be paid by the insurance company because there is no restriction & limit of liability is up to sum insured.
No, you have to pay the premium annually.
Premium will remain the same for the coming years unless there is a change notified by IRDAI or in government taxes.
Yes, you can choose your choice of lawyer to representyour case and their fees will be paid by the insurance company.
Yes, As per the guidelines of the insurer the amount that you have to pay is 0.25% or 12500, commonly know as compulsory access.
No, only cases related to your professional medical negligence will only be covered
No, two insurers cannot represent an already running case
The case should be related to medical negligence,mishaps, or operative death.

  • The claim should be filed and intimated during the policy duration i.e., from the date of start of the policy to the end date of the policy.

  • Negligence should occur during policy duration or retroactive date.

  • Notice should have an allegation against the insured doctor.

  • If the case arises from a retroactive date, then the claim amount will be paid as per his prevailing sum assured of that year.

*Note:- If a case is registered during policy the duration and all above conditions are met, it will be fought even if the doctor decides to discontinue the policy next year.
Yes, If you wish to choose your own choice of lawyer for the case representation. Lawyer fees will be borne by the insurance company on cashless basis
Yes, we tackle 80 to 85% of cases out of court so that there is no negative impact on the image of the doctor and their profession too.

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