Our Personal Indemnity

Provide outstanding patient care without the distraction of litigation

Specialist contractual indemnity – 100% guaranteed cover and peace of mind. No more discretionary refusal when you need legal support the most.

“The litigation risks facing clinicians and hospitals in the modern age of medicine are higher than ever before, presenting a real threat to the advancement of medicine and provision of patient care.”
Miss Lorna Phelan, Consultant Obstetrician at Imperial College Healthcare NHS Trust.
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Forward-thinking indemnity for medical professionals

Negligence claims reported to NHS England are on the rise, with the most common claims typically arising from misdiagnosis, negligent surgery and incorrect treatment. If a claim were made against you or your practice, are you certain you have the right protection in place? If a claim is incorrectly settled, it can ruin your reputation and increase future indemnity premiums.

At THEMIS, we pride ourselves on offering medical indemnity tailored to the needs of each medical profession. Whether you’re a gynaecologist, general practitioner, oncologist or cardiologist, we take the stress out of searching for the right indemnity. We offer complete defence solutions, coupled with exceptional customer service, so you can focus on providing great patient care without the worry and distraction of litigation risks.


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No discretionary refusal

We provide specialist contractual indemnity with no discretionary refusal. Our indemnity protects clinicians from legal costs and claims that may arise from professional negligence, incidents or allegations of malpractice.

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Peace of mind

We are regulated by the Financial Conduct Authority (FCA) which means we’re upfront and clear from the start as to what’s covered. Our products are underwritten solely by UK insurers who are regulated by the Prudential Regulatory Authority (PRA). You can take comfort in knowing our products have the financial security to meet claims.

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Stress-free cover

Having a complaint lodged against you can be incredibly worrying. We ensure the process is stress-free from the start. Our expert in-house claims handlers and lawyers are approachable, friendly and available when you need them. We’ll never pass you over to third party claims handlers. We’ll be by your side every step of the way.

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Competitive premiums

Driven by artificial intelligence, our unique underwriting process enables us to identify safely practising clinicians and offer competitive premiums. Our quotes are based on the procedures clinicians offer and perform rather than solely based on earnings.

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Exceptional support 24/7

Regardless of the type of support you need, our specialist in-house claims handlers and lawyers are always on hand, with a dedicated, single point of contact assigned to policyholders.

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Clinical advice line

Our governance team is on hand to provide day-to-day clinical advice to our policyholders. Wherever you are on your career path, use our clinical advice line to get confidential guidance and support on patient treatment and care.

Discretionary vs contractual indemnity – what’s the difference?

Do you understand the differences between discretionary and contractual medical indemnity? Are you certain that you’re covered correctly by your current provider if a claim was made against you or your practice?

“The risk of discretionary indemnity is real. A number of clinicians have moved to THEMIS having had discretionary indemnity used on them, leaving them to fund claims personally.”
George Maughan | Director of Client Relations, THEMIS Clinical Defence
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Discretionary medical indemnity

Discretionary medical indemnity means just that — it is discretionary and down to your provider to decide whether to cover you or not. That means that there is no guarantee that the cover will pay out when you need it to.

Discretionary indemnity and a providers insurance products are not regulated to provide insurance by the FCA or the PRA. This means the provider is under no legal obligation to detail the specifics of the cover and there is no knowing whether the providers have the resources to cover new claims. Indemnity offered by The MDU, The MPS and The MDDUS — collectively known as medical defence organisations (MDOs) — typically falls into this category. Most clinicians don’t realise that this type of indemnity has zero contractual guarantees of assistance in the event of a claim.

Contractual medical indemnity

Contractual medical indemnity is guaranteed cover, dependent on the terms in your policy.

If you are a clinician working in the private sector, you will want to know that there is no risk of a claim being turned down. Contractual cover is regulated by the FCA and details the specifics of the cover you’re purchasing.

Learn more in our guide - Your guide to medical malpractice indemnity/What clinicians need to know when purchasing medical malpractice cover

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“Doctors typically enter the profession because they’re motivated to help people. Having a complaint made against you can be incredibly stressful. THEMIS make the process simple. Their in-house defence teams are approachable, friendly and always available when you need them.”
Mr Michael Savvas, Consultant Gynaecologist at Kings College NHS Trust

Malpractice claim examples

Many clinicians don’t realise that they have discretional, unregulated indemnity provided by UK MDOs in place. Where discretion was exercised by leading MDOs, medical professionals were left personally liable to meet claims. Here are just a few examples. Have you got the correct cover in place?

Case Study A
Irreversible Reputational Damage

Clinician A was originally introduced to their MDO at medical school. At no time when explaining their services (or at subsequent subscription renewals) can Clinician A recall the MDO explaining discretionary cover. Clinician A remained with their MDO for around 20 years, with subscription fees exceeding £100,000.

When an unexpected regulatory investigation was launched, it caught the attention of the press and claimant law firms. Clinician A looked to their MDO to assist with the regulatory issues and clinical negligence claims, and also enquired as to whether assistance could be provided in relation to the public media attention.

Clinician A was informed that their MDO was exercising their right to withdraw their protection, on discretionary grounds. For both the regulatory issue and the defence of clinical negligence claims, Clinician A was left to fund his own representation. They were personally liable for claims in excess of £350,000.

Given the lack of immediate support, the matter was allowed to progress extensively and has caused almost irreversible reputational damage.

Case Study B
Claim Rejected on Discretionary Grounds

Clincian B signed up to discretionary indemnity at medical school. The MDO they signed with was so well known and used by all their colleagues, that they never questioned the effectiveness of the cover. Indemnity fees were taken each year by direct debit and Clinician B assumed they had adequate cover.

Following a referral request form that documented clear symptoms and a suspected diagnosis, Clinician B saw and investigated a patient according to the usual procedure.

A claim was later brought against Clinician B for failing to notice a tumour in an area unrelated to the symptoms or suspected diagnosis.

Clinician B contacted their MDO who refused the claim on discretionary indemnity grounds.

Clinician B had never made a claim in the past, and to date, had paid thousands of pounds in membership fees.

Clinician B was left to fund their defence privately, with the claim valued in the region of £250,000.

Medical Malpractice Examples

Most healthcare professionals don’t fully understand the indemnity they have in place, or who manages their defence in the event of a claim. Most want to pay their premium and hopefully never have to use it. Unfortunately though, we know that things can and do go wrong. Where cover or a defence fails, medical professionals can be left with a damaged reputation and may be personally liable to meet claims.

Have you got the correct cover in place?

Mitrial Valve Repair

  • Severity rating 3 (severe)
  • Estimate claim value £60,000
  • Failure to correctly interpret test(s)

Claimant 1 had undergone a successful mitral valve repair surgery by an experienced surgeon. Unfortunately, the patient had suffered an iatrogenic atrial-septal defect perioperatively. It was discovered that this was a new iatrogenic atrial-septal defect as the preoperative echocardiograms excluded this defect as being present. The immediate post-operative trans-oesophageal echocardiogram (TOE) fell short of the standards expected as it lacked the detail required following this type of surgery. As a result of this missed diagnosis, the claimant’s right-sided heart strain caused symptoms of breathlessness, oedema, weight gain and a feeling of drowning. Symptoms were present for over a year.

CES Diagnosis

  • Severity rating 3 (severe)
  • Estimate claim value £220,000
  • Failure to undertake appropriate test(s), avoidable delay in referring the patient to the appropriate specialist team, failure to diagnose the condition in a timely manner

Claimant 2 had presented to the ambulance service with a history suggestive of cauda equina syndrome incomplete. The A&E clinician suspected CES but withdrew this suspicion and referred the patient to Orthopaedics for review. There was a three-hour delay for the claimant to be seen and referred for an MRI scan. Further delays in image reviews and additional scans compounded the situation. It was not until two days later, following the initial presentation, that the patient was taken to theatre. It was argued that if the patient had received treatment earlier, he would have had a high likelihood of a full recovery.

Cannula Insertion

  • Severity rating 2 (moderate)
  • Estimate claim value £30,000
  • Error in operation or procedure and failure to maintain appropriate documentation

Claimant 3 was admitted to hospital with shortness of breath, dizziness and chest pains. They had a history of heart disease, shoulder surgery and knee replacement. The patient underwent a blood test, was diagnosed with symptomatic anaemia and was due to be given a blood transfusion. A cannula was placed but was left in place for five days and became infected. The infection spread to the knee replacement and shoulder joint. As a result, this patient had to undergo a knee washout and a shoulder aspiration. A prolonged course of intravenous antibiotics was required for over a month. Poor cannula monitoring and leaving it in situ for longer than recommended, caused additional procedures, a prolonged hospital stay and a stiff knee joint.

Risk alerts for clinicians

It’s important that clinicians keep up-to-date with and are aware of emerging clinical risk trends that could lead to claims.

We make this easy by offering complimentary access to clinical risk alerts, based on advanced claims intelligence provided by our Lead Clinical Partner, TMLEP. Policyholders can stay updated by accessing the latest insights that may impact their practice.

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Patient health checklist

Risk alert 1

Generally consenting for chronic nerve pain and/or nerve damage

Although typically rare, surgery-related nerve damage can arise from a number of different procedures. The severity of nerve damage can vary greatly, from complete disability to temporary, minor chronic pain.

In order to manage patient expectations, and to defend claims involving nerve damage, generalised consent for chronic nerve pain and/or nerve damage should always be considered.

Patient holding hand in pain

Risk alert 2

Increasing Awareness of the Role of GnRH Pre-Treatment for Fibroids

It is important for gynaecologists to remain informed about the pre-treatment options available for fibroids. Several cases have shown that GnRH analogues should always be considered prior to fibroid removal surgery.

One example is if the fibroids are causing an enlarged or distorted uterus. Clinical and patient discussions regarding the risks and benefits of taking GnRH analogues should occur prior to surgery.

patient holding abdomen

Risk alert 3

Intestinal Obstruction: The Importance of Proper Examination and History Taking

Intestinal obstruction occurs when food and stool cannot move freely along the gut. Various factors can cause intestinal obstruction, including hernias, tumours, abdominal adhesions, volvulus (intestine twisting around itself), and foreign objects. Unless treated promptly, intestinal obstruction can be fatal.

This clinical alert explores why an accurate history and examination are essential for correct investigation and management.

Questions to ask your provider today

  • Are you experts in medical malpractice and do you understand my risk?
  • Is my policy discretionary or contractual?
  • Is my policy regulated by the FCA?
  • Are you, or the underlying underwriters, regulated by the PRA?
  • How can I contact my provider if I need to?
  • How readily available and responsive is your provider?
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“THEMIS provide contractual indemnity instead of discretionary cover, meaning I can practice with confidence, knowing I have comprehensive protection in place should the worst happen.”
Mr Michael Savvas, Consultant Gynaecologist at Kings College NHS Trust

What a THEMIS policy covers*

Medical malpractice
Claims for clinical negligence, including defence costs.
Medico-legal indemnity
Claims arising from the accuracy of medico-legal opinions you have prepared, including defence costs.
Good Samaritan Acts
You have an ethical duty to assist in an emergency. Cover for any treatment you administer outside of work.
Regulatory protection
Costs to defend orders, hearings and investigations you must attend, and for attendance at fitness to practice hearing.
Indemnity Reinstatement
If a medical malpractice claim is made against you that exhausts the limit of indemnity, we will reinstate it to £10,000,000.
Run-off cover
Cover after you cease to practice. This can be provided to all policyholders for a period of up to 21 years subject to policy conditions.
Inquest protection
Costs to prepare a response to a Coroner and to represent you at an inquest, following the death of a patient.
Medico-legal helpline
Advice to help you manage day-to-day issues you may encounter in your practice, such as complaints handling.
Medical manslaughter protection
Costs to represent you in relation to a clinical or gross negligence manslaughter prosecution
Reputation crisis management
PR and legal costs to respond to a public event that could damage your reputation and result in clinical negligence claims.
Data Liability Protection
Defence costs, regulatory fines, or sums ordered to pay as a result of a breach of the Data Protection Act 2018, arising from medical records data you are responsible for storing.
Cover for discretionary indemnity
Cover for claims declined by your discretionary provider subject to the terms of your policy.

* All THEMIS policies are tailored to exactly what you need, with all coverage options available for selection when you request a quote from us. If you have any questions please get in touch with us.