Neil Redman – Director, SEMPRIS

It is generally accepted that competition within any market is both healthy and necessary to ensure that prevailing terms and prices are challenged, that they remain competitive and that end users have a choice.

Professional indemnity is a compulsory purchase for all GMC registered doctors – there is no choice. It is almost inconceivable therefore that in this compulsory purchase environment, the UK medical indemnity market has been allowed to remain unchallenged, without competition, for the last 125 years.

It has, instead, been effectively monopolised by just two players (MDU, MPS) both now offering an outdated and increasingly discredited system of ‘discretionary indemnity’ – a system which evolved in the 19th Century which provides no guarantees and which merely entitles members to ask for assistance and indemnity when they are notified of a claim – a system of indemnity which is not allowed in other EU member states (excluding Ireland and Malta), and which was outlawed in Australia in 2003 – a system of indemnity which, in an ironic twist given their recent return to discretionary cover, the MDU themselves actually believe ‘does not provide acceptable safeguards for practitioners and patients in today’s medico-legal climate’.

It is not surprising against this extraordinary backdrop, that the emergence of ‘new players’ providing guaranteed, fully insured, ‘claims made’ indemnity was initially viewed with an element of suspicion and doubt by doctors – after all, St Pauls was hardly a positive example! The MDOs have, understandably, been quick to condemn the new players. After 125 years their tired, outdated, and mutually dominated market is under threat – their market share will be falling and they are faced with innovative and competitively priced competition.

Contrary to the opinion of the MDU, the insurance market is in robust health. New players are continuing to take market share from the big two and confidence in the belief that there is a safe world beyond the MDOs continues to grow amongst doctors. The indemnity marked has moved on dramatically since the memory and pain of St Pauls. In its refreshed and more competitive guise it will continue to evolve to reflect changes in medical services, rising claims and the disproportionate burden of claims liability and resultant subscription costs afflicting the MDOs.

As a relatively ‘new player’ SEMPRIS firmly believes doctors and patients should have the reassurance of a contractual guarantee of indemnity for clinical negligence claims and should not have to rely on a discretionary decision. From 2000 to 2013 the MDU provided insured, contractually guaranteed indemnity, stating in their 2010 Report & Accounts, “It remains your Board’s view that insurance offers the best guarantee of compensation for patients and indemnity for practitioners.”

The introduction of SEMPRIS as a specialty specific scheme whose benefits / subscriptions reflect the claims experience of individual specialties rather than ‘mutual’ or pooled claims experience was a necessary and an innovative market development – a reflection of competitive market forces seeking to match practice profile and risk with competitive, sustainable subscriptions. It is now four years since SEMPRIS was launched to provide specialist indemnity for doctors treating professional and elite sportspeople. It is an example of the response that the insurance market is able to bring to situations and circumstances that warrant specialist cover – cover that is no longer provided by the traditional MDOs.

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