Checklist Before Buying Professional Indemnity Insurance for Medical Establishments

Why Preparation Matters Before Buying PI Insurance

Professional indemnity insurance is underwritten based on the actual risk profile of a medical establishment. Before issuing a quotation, insurers evaluate factors such as infrastructure, specialties, patient volume, procedures performed, previous claims, and the limit of indemnity requested. Most insurers collect these details through a proposal form before deciding the premium and policy terms.

Preparing these details beforehand makes the quotation process faster and helps insurers assess the risk more accurately.

Professional Indemnity Insurance Checklist

1. Define the Medical Establishment

Keep the following information ready:

• Name of the hospital or clinic
• Type of establishment (Hospital, Nursing Home, Clinic, Diagnostic Centre, IVF Centre, etc.)
• Year of establishment
• Registration certificates
• Location and branch details

These details help insurers understand the nature and scale of operations.

2. Know Your Bed Strength

Bed capacity is one of the primary rating factors.

Examples include:

A larger hospital generally has greater exposure because it treats more patients.

3. List All Medical Specialties

Prepare a complete list of departments, such as:

• General Medicine
• General Surgery
• Orthopaedics
• Gynaecology
• Paediatrics
• Cardiology
• Neurology
• Oncology
• Critical Care
• Emergency Medicine
• Anaesthesia
• Radiology

Certain specialties carry higher medico-legal exposure than others, which can influence underwriting.

4. Doctor and Staff Details

Insurers usually ask for:

• Number of full-time doctors
• Number of visiting consultants
• Resident Medical Officers (RMOs)
• Qualified nurses
• Technicians
• Paramedical staff

They may also verify whether medical professionals hold valid registrations and licences.

5. Patient Volume

Prepare annual patient statistics, including:

• Annual OPD volume
• Annual IPD admissions
• Emergency cases handled
• Average occupancy (for hospitals)

Higher patient volumes generally increase the probability of claims.

6. Procedures Performed

Mention the nature of procedures conducted.

Examples include:

• Routine consultations
• Minor surgeries
• Major surgeries
• ICU treatment
• Obstetric procedures
• Laparoscopic surgeries
• Cosmetic procedures
• Endoscopy
• Dialysis
• IVF procedures

The complexity of procedures often affects the insurer's risk assessment.

7. Annual Revenue

Many insurers request:

• Previous year's revenue
• Expected revenue for the current year

Revenue gives an indication of the establishment's size and scale of operations.

8. Previous Claims History

Keep details of:

• Number of claims
• Claim amount
• Year of occurrence
• Current claim status
• Any pending litigation

A clean claims history may support more favourable underwriting, while previous claims help insurers understand recurring exposures. Proposal forms commonly ask for claim details from previous years.

9. Decide the Required Limit of Indemnity

The limit of indemnity determines the maximum amount payable by the insurer.

Rather than selecting an arbitrary figure, consider:

• Size of the hospital
• High-risk specialties
• Expected legal exposure
• Contractual requirements
• Previous claim experience

Indicative Sum Insured Logic

*Actual limits should always be based on individual risk exposure, contractual requirements, and insurer underwriting.

10. Review Available Add-ons

A standard policy may not address every risk. Depending on the insurer, consider extensions such as:

• Legal defence costs
• Extended reporting period
• Loss of documents
• Employee dishonesty (where available)
• Retroactive cover
• Run-off cover (where applicable)

Availability varies between insurers and policy wordings.

11. Understand the Deductible

Every PI policy generally includes a deductible (also called an excess).

This is the portion of each claim that the insured bears before the insurer pays the balance.

While a higher deductible may reduce the premium, it also increases the establishment's out-of-pocket expense during a claim.

12. Check Major Exclusions

Before buying the policy, carefully review what is not covered.

Common exclusions include:

• Fraudulent or dishonest acts
• Intentional misconduct
• Criminal acts
• Known incidents before policy inception
• Claims arising before the retroactive date
• Contractual liabilities beyond professional negligence
• Fines and penalties
• War and nuclear risks

Actual exclusions depend on the insurer's policy wording.

Medical Establishment PI Insurance Quote Checklist

Questions to Ask Before Finalising the Policy

Before accepting the quotation, ask:

• Is the policy on a claims-made basis?
• What is the retroactive date?
• Are legal defence costs included?
• Does the policy cover visiting consultants?
• Is there Any One Accident (AOA) and Any One Year (AOY) limit?
• What deductible applies to each claim?
• Which exclusions should the hospital be aware of?
• Can the indemnity limit be increased during renewal?

Final Thoughts

Professional Indemnity Insurance should reflect the actual exposure of your medical establishment not just the lowest available premium. Preparing accurate operational details, selecting an appropriate indemnity limit, reviewing deductibles and exclusions, and understanding available extensions can help you secure more suitable protection.

Whether you operate a small clinic or a multi-speciality hospital, a well-prepared quotation checklist allows insurers to assess your risk accurately and recommend a policy that aligns with your healthcare practice.