Where should I get private GP indemnity?

Your options

Route	How it works	Points to check
Medical defence organisation (MDO)	Mutual, not-for-profit membership. You can ask for help with claims, GMC investigations, inquests and complaints. Help with claims is discretionary.	Which private services are included, the extra cost for private work, and whether cover is occurrence-based
Commercial insurance	A contract with an insurer, often arranged through a specialist broker. It pays within set limits on the policy terms.	Limits per claim and per year, claims-made terms and run-off, whether regulatory and inquest support is included
Cover from a clinic or online provider	Some organisations hold cover for claims against the organisation, and a few extend it to the clinicians they engage.	Whether it covers you personally, and what happens when you leave
Cover for your own company	Organisation-level cover for claims against your practice company, alongside individual cover for each clinician.	Whether it is claims-made, and who it covers

The law allows either route. Section 44C of the Medical Act 1983 says an indemnity arrangement can be an insurance policy, an arrangement for indemnifying you, or a combination of the two, as long as it gives appropriate cover for the risks of your practice.

Start with your current provider

If you already have GP membership with an MDO, ask it first. It knows your practice history, and adding private work avoids gaps between providers.

• Medical Protection offers GPs in England and Wales “Professional Protection” for advice, GMC, inquest and disciplinary support. For work outside an NHS primary medical services contract, such as private clinics, private prescriptions and paid reports, it says you should add “Claims Protection”, because this is not added automatically.
• The MDU says fee-paying work for patients registered at your practice, such as insurance reports, is typically included in membership. It lists the provision of private GP services, including online and telemedicine services, as likely to need an additional subscription, along with procedures, aesthetics, weight-loss and travel clinics.
• MDDUS also provides GP indemnity across the UK and describes its membership as occurrence-based. For GPs in England and Wales, it says membership includes some fee-paying work outside NHS indemnity as standard, and that it can extend membership to other work, including private GP work. Ask it how your private work is handled and priced.

Then get at least one comparable quote elsewhere. See what drives the cost.

Discretionary membership or insurance

MDO help with claims is discretionary. Medical Protection and the MDU both state that they are not insurance companies, and that the organisation decides whether to help under the organisation’s articles of association. In return, MDO membership has no fixed limits and tends to include a wide package of support.

An insurance policy is a legally binding contract. It pays what the terms say within its limits, and insurers are regulated. The Department of Health and Social Care has noted that most indemnity outside the state schemes is discretionary and not subject to prudential or financial conduct regulation. It consulted on requiring regulated cover and, in December 2022, said it preferred that option. At the time of review we found no legislation making that change, so discretionary MDO cover remains lawful. Check the current position before you rely on it.

Neither route is automatically better. Choose knowingly, and read the terms.

Questions to ask every provider

1. Exactly which of my services are covered, including online, video and telephone consultations, prescribing and any procedures?
2. Is the cover occurrence-based or claims-made? If claims-made, what is the retroactive date and what will run-off cost? See claims-made and occurrence-based cover.
3. Are there limits per claim or per year?
4. Does it include support with GMC investigations, inquests, complaints and disciplinary matters?
5. Is there a 24-hour medico-legal advice line, and who staffs it?
6. Does it cover patients who are outside the UK, or UK patients while I am abroad?
7. How is the price worked out, and what makes it change at renewal?
8. Can you cover my company and any staff, or do they need their own cover?
9. What must I tell you during the year, and what happens if I don’t?

Ask colleagues already in private practice about their experience of claims and advice with each provider. Service when something goes wrong matters more than a small difference in price.

Switching without a gap

• Arrange the new cover to start the day the old one ends.
• Tell your current provider about any incident or complaint you know of before you leave.
• If your old cover was claims-made, buy run-off or confirm that the new provider covers earlier incidents.
• Keep every certificate and membership document. You may need them years later.

Across the UK

In England and Wales, the state schemes (CNSGP and GMPI) cover claims from NHS GP work only. In Scotland and Northern Ireland there is no equivalent scheme for GP contractors, so your MDO membership already covers NHS claims and private work is added to it. The MDU moved its Northern Ireland GP members to claims-made membership from August 2021, so GPs there should check run-off terms closely. See whether you need different indemnity for private work.

Before your first private patient

Get written confirmation of the services covered and the start date, and keep it with your CQC evidence. If you are setting up an online service in England, the CQC asks for a medical indemnity quote or policy that covers online services with your application. See other insurance your practice needs.