Qualifying as a medical practitioner is a matter of great pride and honor. A doctor’s job is to diagnose the patient’s ailment and treat him to good health.
While some treatments are minor, there are complicated and riskier procedures too. A doctor treats a patient with utmost caution but during a complicated procedure, things might go wrong.
Key Takeaways
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Coverage for Inherent Risks: Medical procedures like transplants or brain surgeries have “known complications” (like organ rejection or fluid build-up). DPI insurance protects doctors when these complications are misconstrued by families as “negligence.”
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Support Staff Protection: A surgeon is only as good as their team. DPI policies typically extend coverage to both qualified and unqualified staff, ensuring the lead doctor isn’t solely liable for a mistake made by an assistant or nurse during a long procedure like a bypass.
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The “Excess” Clause: In a claim, the doctor only pays a small, pre-agreed Excess Amount, while the insurer handles the bulk of the compensation and legal fees up to the Sum Insured limit.
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Maxillo-Facial Vulnerability: Despite being perceived as less “critical” than brain surgery, Maxillo-facial and Dental surgeries actually result in higher litigation rates. DPI is essential for dentists to handle claims related to chronic pain or nerve damage.
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Legal & Compensation Backup: Whether it’s a “frivolous” lawsuit after a successful but complicated brain surgery or a genuine error during spinal correction, the policy provides the funds for a high-quality legal defense and any court-ordered settlements.
The Doctor’s Indemnity Insurance Policy provides coverage through which doctors stay insured for risky procedures.
Some of these risky procedures are as follows:
Transplant Surgery
Given the rate of organ damage nowadays, transplant surgeries have become very common. These involve the replacement of the original organ in the body with the donor’s organ. This is often accompanied by blood loss and carries a high risk of complications arising during or after the transplant. It is also common for the transplanted organ to be rejected by the new body.
Bypass Grafting
Cardiologists have been performing several bypass surgeries these days due to an increase in incidents of heart attacks and arterial congestion. These complicated operations can improve blood flow but they run for long hours. They even carry the risk of loss of life.
Brain Surgery
Brain surgery or craniectomy involves removing a part of the patient’s skull so that doctors can access the brain. This part remains separated even after the operation.
Craniectomy carries the risk of brain damage. There could be excessive fluid build-up in the brain, seizures, spinal fluid leakage, stroke, or swelling.
Spinal Osteomyelitis Surgery
This surgery is conducted to correct a spinal infection. This condition is extremely destructive and comes with a lot of risks. In case the surgery goes wrong, the patient may suffer from complete or partial paralysis or other serious infections.
Dental Surgery
Dental surgeries are also highly complicated and can cause significant pain and suffering to the patient in case something goes wrong. All the procedures like root canal surgery and apicoectomy, and several other kinds too, involve the risk of causing damage not just to the oral system, but also to internal organs by way of saliva. Maxillo-facial surgeries are the riskiest and result in litigation more often than many other procedures.
Several other surgeries and procedures also expose doctors to considerable risk.
Summary: High-Risk Procedures & Indemnity Coverage
How does Doctor’s Indemnity Cover Help Doctors?
This policy’s coverage depends on its features and the plan chosen. However, irrespective of the features, it covers compensation and legal costs. The policy provides coverage for both qualified and unqualified staff. It provides safety to doctors against unintentional errors or omissions.
The doctor’s indemnity policy will pay the sum assured up to a set limit for different incidents. The insured only has to bear the excess amount of the claim.
It is a must for doctors to remember that they should not forget to secure themselves while diligently serving and taking care of patients. This policy secures doctors against any claim that the patient or the family raises due to unintentional negligence or error.
Frequently Asked Questions (FAQs)
Q1: Does the policy cover “Organ Rejection” if the surgery was performed perfectly?
A) If a patient sues alleging the rejection was due to surgical negligence, the policy will pay for your legal defense. If the court finds that the rejection was a natural medical outcome and not due to your error, the policy covers the costs of proving your innocence.
Q2: Are “Maxillo-facial” surgeries covered under a standard dental indemnity plan?
A) Maxillo-facial procedures are high-risk and often require a higher premium or a specific specialty declaration. Because these surgeries carry a higher risk of litigation, you must ensure your insurer has classified your practice correctly to avoid claim rejection.
Q3: Does the insurance cover me if a piece of equipment fails during a bypass surgery?
A) Yes, most 2026 DPI policies cover liabilities arising from the omission or error of instruments involved in the medical activity, provided they were being used correctly by the insured or their staff.
Q4: If a brain surgery leads to a “Stroke,” is that considered negligence?
A) A stroke is a known risk of brain surgery. However, the patient’s family may allege it happened due to a “breach of duty.” The DPI policy provides the medical experts and lawyers needed to demonstrate that the standard of care was met and that the stroke was an unavoidable complication.
Q5: What is the “Excess” I have to bear in a ₹50 Lakh transplant claim?
A) The “Excess” is a small fixed amount (e.g., ₹10,000 or ₹25,000) mentioned in your policy. You pay this amount first, and the insurance company pays the remaining ₹49.75 Lakhs of the claim.
About The Author
Saloni Mishra
MBA Insurance Management
With an illustrious career in the insurance sector, Saloni is a distinguished writer specializing in articles concerning doctor professional indemnity policies for SecureNow. Leveraging 12 years of hands-on experience, she understands the intricate nuances of professional indemnity insurance tailored specifically for medical professionals. Her articles offer invaluable insights into the significance of doctor professional indemnity coverage, addressing the unique risks and challenges healthcare practitioners face. Renowned for their expertise and attention to detail, Saloni is committed to providing readers with informative and actionable content that empowers them to make informed decisions regarding their insurance needs.
