Professional Indemnity: What to look out for when renewing your policy

This advisory covers what a practitioner requires from a Professional Indemnity (PI) arrangement. It sets out what individual practitioners need, how that requirement shifts across different specialties, and the specific gaps an institution or practitioner should check for before relying on an existing policy. It is intended as a practical reference for credentialing committees, clinical governance leads, and individual practitioners reviewing their own cover.

1.  The Baseline: What Every Practitioner Needs

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Regardless of specialty, every practitioner licensed by KMPDC must hold current professional indemnity cover under Section 15A of the Medical Practitioners and Dentists Act. This is a personal obligation, entirely separate from any institutional liability cover. At minimum, that cover should provide:

• Continuous, unbroken cover. Most Kenyan PI policies are written on a claims-made basis, meaning the policy in force when a claim is reported responds, rather than the one in force when the incident occurred. A lapse at any point, including between employers, can leave a practitioner exposed for past work.

• A sum insured matched to actual risk, not a default minimum. The right limit depends on specialty, procedure mix, and patient volume, rather than a one-size schedule.

• Clarity on defence costs. Confirm whether legal defence costs are paid in addition to the indemnity limit or erode it. This difference materially changes what is actually available to settle a claim.

• A vicarious liability extension where relevant, particularly for consultants who supervise registrars, interns, or clinical officers.

2.  What Changes by Specialty

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Risk is not uniform across specialties, and cover should reflect that. The table below groups specialties by broad exposure tier. It is useful both for credentialing review and for practitioners benchmarking their own sum insured.

Risk Tier	Specialties & Why	What to Insist On
High	Obstetrics and Gynaecology: high-severity claims including birth injury and stillbirth, with long claim latency. Surgical specialties: General, Orthopaedic, Neurosurgery, Cardiothoracic, and Plastic/Reconstructive Surgery. Anaesthesiology: frequently named as co-defendant in surgical claims. Emergency Medicine: high acuity and high volume of time-pressured judgment calls.	Highest available sum insured tier. Explicit retroactive date confirmation. Named-procedure endorsement, not a generic specialty description. Cover that functions independently of a co-defendant's separate policy.
Moderate	Internal Medicine subspecialties with procedures: interventional cardiology, endoscopy, and nephrology dialysis access. Paediatrics and Neonatology: extended limitation periods tied to the child's majority. Interventional Radiology. Oncology: chemotherapy and radiotherapy delivery.	Confirm procedural work is covered, not just consultative or cognitive practice. Specific endorsement for radiotherapy and chemotherapy where applicable. Sum insured reviewed against actual case mix, not specialty label alone.
Lower	Psychiatry: risk-assessment and duty-to-warn exposure rather than procedural risk. Dermatology (non-procedural). General and Family Practice: lower severity but higher claim frequency from missed or delayed diagnosis. Public Health and Occupational Medicine: advisory and certification liability.	Do not assume low risk means minimum cover is sufficient; frequency still drives cost. Confirm certification and advisory work is explicitly within scope.

Special Categories Requiring Separate Attention

The following categories are frequently overlooked in standard policy reviews and deserve explicit confirmation:

Category	What to Confirm
Cosmetic & Aesthetic Procedures	Commonly excluded from standard policies unless specifically endorsed, even for dermatologists and plastic surgeons who are already covered for reconstructive work. Confirm explicit inclusion.
Locums & Visiting Consultants	Frequently missed at renewal. Cover should be actively added and removed as practitioners arrive and depart, not assumed to carry over from a previous period.
Employed versus Private Practice	An institution's liability cover protects the institution's own vicarious exposure; it does not automatically substitute for a practitioner's personal cover. Confirm in writing which gaps remain.
Telemedicine & Cross-border Consultations	Increasingly common and frequently silent in older policy wordings. Worth confirming explicitly rather than assuming inclusion.
Supervisory liability	A consultant supervising trainees carries exposure for that supervision specifically. It should be named in the policy rather than inferred from the general specialty description.

3.  Red Flags: What to Watch for in an Existing Policy

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These are the points most often missed when a policy is renewed on autopilot rather than actively reviewed.

4.  Action Checklist

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For Doctors

• Confirm cover is active for the full period of practice, with no gaps at transition points such as a change of employer, return from leave, or change of practice setting.

• Match the sum insured to your actual procedure and risk profile, not a generic minimum.

• Get written confirmation of whether an employer's institutional cover extends personal protection, or whether it only covers the institution's own exposure.

• Request explicit retroactive date confirmation whenever switching insurers.

• Budget for run-off cover in advance before retiring, resigning, or relocating out of practice.

About LGM Health Advisory

LGM Health Advisory advises hospitals, specialist groups, and individual practitioners on medicolegal risk, clinical governance, and compliance architecture across Kenya's regulatory and healthcare environment. For a structured professional indemnity audit of your institution or practice, contact us at lgmhealthadvisory@gmail.com or visit lgmhealthadvisory.org.

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