MEDEFEND

What is the MEDEFEND Medical Indemnity?

MEDEFEND Medical Indemnity is a coverage specifically to protect medical practitioners for any claims/potential claims of actual or alleged acts of negligence relating to and/or arising out of their medical professional services. The primary objective is to pay for any loss or damages and defence costs from the medical negligence claims/potential claims (subject to Policy/Certificate terms and conditions).

Apart from the compulsory legal requirement, medical indemnity coverage should be a part of any medical practitioners’ overall risk management approach. Medical indemnity coverage is meant to be the last line of defence to protect the practitioner in the event of an adverse medical incident.

The Insurer for MEDEFEND is Pacific & Orient Insurance Co. Berhad (P&O). The Takaful Operator for MEDEFEND Takaful is Etiqa General Takaful Berhad (EGTB).

The rates and coverage are the same for both MEDEFEND and MEDEFEND Takaful. The only difference is that MEDEFEND Takaful is Shariah-compliant and underwritten by EGTB. The same MEDEFEND team and Claims Management will handle both MEDEFEND and MEDEFEND Takaful.

Why do I need MEDEFEND?

You need MEDEFEND because it is a compulsory requirement for all Registered Medical Practitioners (“RMP”s) to have Medical Indemnity and 20 CPD points for their Annual Practicing Certificate (“APC”) application. The Malaysian Medical Council (MMC) stated that the compulsory requirement for a medical indemnity coverage for APC application only applies to:

• Full-time Private RMPs
• Government RMPs who do locum work in private practice

Please refer to the 2012 Amendments to the Medical Act 1971 (“the Act”):

Amendment of Section 20

Section 20 of the Act is amended –

(a) by substituting for subsection (1) the following subsection:

 “(1) Any fully registered person who desires to practise as a medical practitioner after the thirty-first day of December of any year and who produces evidence of having satisfied any requirements or restrictions stipulated by the Council shall, not later than the first day of December of that year, make an application in the prescribed form, produce evidence of professional indemnity cover and pay the prescribed fee for a certificate to practise as a medical practitioner during the ensuing year.”

Marsh Specialty consists of the brokers managing the MEDEFEND Indemnity Scheme and is responsible for handling new applications and renewals, general inquiries, negotiating the terms and conditions of the policy, and most importantly the claims management.

Marsh Specialty, with vast experience in managing professional indemnity schemes, will strive to ensure that the members’ interest will be the utmost priority under the scheme. A dedicated claims team, consisting of former practising lawyers, will ensure the medico-legal claims and notifications from members will be handled competently and professionally. Marsh will bring the members a fresh, value-added approach to insurance whilst maintaining competitive but stable premiums.

Who needs MEDEFEND?

In relation to the answer for “Why do I need MEDEFEND?”, MEDEFEND is compulsory for you if you are a:

Government doctor doing locum at a private hospital/ clinic.
You must have MEDEFEND cover as it is compulsory under the Medical Act as you do locum work.

Lecturer in a public university with a practice in the private wing.
It is compulsory for you to obtain a medical indemnity coverage as per the Medical Act.

Lecturer in a private medical university with a practice in university’s medical centre.
You will need to apply for MEDEFEND coverage to fulfil the compulsory requirement for your APC application.

It is advisable to apply for MEDEFEND if you are a:

Lecturer in a public university.
Please check with your University and/or MMC if you are indemnified by the Government. This also relates to the compulsory requirement for the APC application.

Lecturer in a private medical university.
If your work is purely as an academician, you may wish to apply for MEDEFEND under the ‘Non-Clinical Doctor’ category. This is to fulfil the compulsory requirement for your APC application. It is advisable for you to check with your university if they have a separate Educators Liability cover.

Practicing doctor under MOH Hospital/Clinic.
You are strongly advised to have MEDEFEND. It provides you with a legal representation/lawyer, and the costs will be paid by the Insurer/Takaful Operator in the event of any regulatory investigation claims and/or MMC Inquiry. MOH will not provide you with any lawyer should there be any regulatory investigation hearings and/or MMC Inquiry filed against you.

If, besides your service at MOH, you are actively involved in voluntary medical service outside your regular work, you are advised to apply MEDEFEND to protect your voluntary work.

Retiree from medical practice who wishes to retain your APC.
You can apply MEDEFEND under the ‘Non-Clinical Doctor’ category (RM380 annually) for you to satisfy the compulsory requirement for APC application. Please be mindful that under this category, there is no coverage for claims arising from your past medical practice.

What is the sufficient Limit to purchase?

There is no direct “one-size-fits-all rule” answer in determining an appropriate Limit of Indemnity coverage. It depends on the Specialty and the categories under MEDEFEND. Our recommendation would be:

• General Practitioners (GP) and Low Risk (between RM1 million to RM3 million)
• Medium Risk (between RM3 million to RM5 million)
• High Risk (between RM5 million to RM30 million)

It also depends on the size of the practice and the doctor’s risk profile. Kindly contact us to discuss if you are unsure.

Our online application has a payment gateway where you can make payment by credit card, debit card or online transfer.

In what other situations am I covered/not covered under MEDEFEND?

You are covered by MEDEFEND if:

You helped someone involved in an accident on your off day and a claim arises from such an emergency medical situation.
MEDEFEND provides coverage under the Good Samaritan act. It means that coverage is extended for a doctor who is a bystander providing emergency medical situation. This includes medical crisis, disaster or catastrophe, as long as there is no formal Doctor-Patient Relationship, without any monetary benefits. This cover is worldwide excluding Iran and any countries sanctioned by the United Nations, European Union, United Kingdom, Canada, Australia, Japan and United States of America.

Your nurse/locum doctor makes a mistake.
You are covered under MEDEFEND for any allegation against your nurse/locum doctor. Please ensure that your nurse is covered under Clinic Liability and the locum doctor has their own MEDEFEND coverage.

You are not covered by MEDEFEND if:

You are the Person In Charge (“PIC”) in a private hospital.
MEDEFEND is an individual medical indemnity for doctors and exclude coverage as a PIC. If you are the PIC in your hospital, please get confirmation that the hospital has a Medical Liability cover. This will protect your position as the PIC.

You own a medical practice and several doctors and nurses work for you.
If you own a medical practice, you must have a separate Clinic/Entity Medical Liability cover. Such policy provides cover for your clinic and/or employees (including nurses) in the event of a medical negligence claim against them separately or collectively. It is not included in the MEDEFEND indemnity cover. For the doctors, they will need to subscribe MEDEFEND individually (this relates to the answer for “Why do I need MEDEFEND?”).

I have been with another indemnity policy for the past 20 years. If I change to MEDEFEND, will you cover me for a new claim for my past practice when I was with the previous policy? Do I have to pay additional premium to cover my past practice?

MEDEFEND is a Claims-made policy that provides Full Retroactive Cover with no additional premium. This means you get full backdate cover for all your past medical treatments PROVIDED the new claim/potential claim arises AFTER you signed up with MEDEFEND (refer to Scenario A below).

However, if you are from an Occurrence-based provider, your retroactive/backdate cover starts from the policy date when you first join MEDEFEND (refer to Scenario B below).

Scenario A: Change from Claims-made policy to MEDEFEND:

• 2018: Treated Patient A (with a previous indemnity policy)
• 2021 January: Sign up with MEDEFEND
• 2021 December: You receive a complaint letter (new awareness) from Patient A arising from the treatment in 2018. You notify Marsh of the potential claim; it is covered under MEDEFEND (subject to policy terms & conditions)

Scenario B: Change from Occurrence-based provider to MEDEFEND:

• 2018: Treated patient A (with Occurrence-based cover provider)
• 2021 January: Sign up with MEDEFEND
• 2021 December: You receive a complaint letter (new awareness) from patient A arising from the treatment in 2018. You notify Marsh of the potential claim; it is covered under the Occurrence-based and we will advise you to notify your previous provider (with Occurrence-based cover provider)

I don’t understand what Claims-made and Occurrence-based. Can you explain?

MEDEFEND is a Claims-made policy. It means if there is a new claim/ potential claim (Circumstance) being made against you, MEDEFEND will provide coverage as long as you have an active MEDEFEND policy.

Example: 3 March 2021 you receive a claim and you notify MEDEFEND. Your active MEDEFEND policy is from 1 January 2021 to 31 December 2021.

Under the Claims-made policy, it is important for you to notify MEDEFEND immediately once you are aware of a claim/ circumstance.

A Claim includes:

• A letter of demand
• A writ from court

A Circumstance includes:

• Lawyer/Patient requesting for medical records/report relating to a complaint
• Verbal or written complaint from a patient
• Grievance meeting
• Investigation from MOH/MMC/MDC

An Occurrence-based indemnity gives you cover for claims/circumstance arising from a medical incident within the period when you were with the indemnity provider regardless of when you notify the claim/ circumstance (when you are made aware of it).

Scenario:

• 2018: Treated patient A (you were with Occurrence-based provider)
• 2021 January : Switched to MEDEFEND and policy is from 1 January 2021 to 31 December 2021
• 2021 December: You receive a claim against you by Patient A and you notify MEDEFEND.

There is no coverage under MEDEFEND as the claim arises from a treatment that you gave in 2018 while you were with the Occurrence-based provider. We will advise you notify the said provider.

I already have an ongoing court case with my current indemnity provider but I would like to change to MEDEFEND next year, who will handle the ongoing court case?

If you have an existing court case with your current indemnity provider, they will continue to defend you even after you have changed to MEDEFEND. Under a Claims-made policy, you notify MEDEFEND for any new awareness of a claim or circumstance. If you have an existing notification with an indemnity provider, they must continue handling the claim for you even if you have changed to MEDEFEND.

If you have an existing circumstance (potential claim) with an indemnity provider, the same rule applies. If the circumstance developed into a suit in the future, you need to inform that indemnity provider so they can appoint a lawyer to defend you in court. This is because the first notification (awareness) was made with them.

What is Malaysian Medical Association (MMA)?

For more information on Malaysian Medical Association (MMA), please go to https://mma.org.my.