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This is one of the most common questions we’re asked, and there’s no simple answer.
Medical malpractice claims can be unpredictable. Even your broker can’t guarantee that a specific limit of cover will be enough for every possible scenario. A single claim involving proven negligence that results in a patient’s permanent disability could exceed the R10 million maximum cover offered under our standard policy.
When deciding on your cover limit, think about the following:
If you’d like a limit higher than R10 million, contact us.
Please notify us immediately as we will need to:
If you do not notify us before you stop practicing, your policy will automatically lapse, and you may lose your entitlement to cover. It’s important to maintain your medical malpractice insurance until the end of the policy period in the year you cease practicing. Even if you work just one day during that year, your cover should remain active until the policy period concludes.
Retroactive cover protects you against claims made now for work you did before your current policy started. Without it, past incidents may not be covered.
Medical malpractice insurance is issued on a claims-made basis, which means the policy that responds to a claim is the one active at the time you report the incident, not the one you had when the treatment was provided.
To ensure you’re properly protected, you must have:
Your retro-active date is the date from which your insurer agrees to cover incidents from the past. If there’s a break in cover, even for a day, you could lose that retro-active protection, and claims relating to past services may be declined.
If you don’t renew your policy (or place it into run-off when you retire or stop practicing), any new claim reported after the policy has lapsed won’t be covered, even if the work was done while the policy was active.
The only exception is if you notified a potential claim in writing while the policy was still in force, and that notification was accepted and registered by your insurer.
General Extensions
Breach Of Confidentiality
Court/Inquiry Attendance Costs
Cross Liabilities
Defamation
Employers Liability (If Stated In The Schedule To Apply)
Indemnity To Others
Medical Scheme Investigation / Audits
Public Relations Expenses
Regulatory Or Statutory Body Defence Costs
Statutory Defence Costs
Wrongful Arrest
Special Extensions
Extended Reporting Period
Extended Territorial Coverage For Short-Term Services
Liability Following Employee/Volunteer Dishonesty
Run Off Cover (Up to 6 years’ included at no additional cost)
The policy document will be provided to you. It is your responsibility to ensure that you read and understand all the policy terms, conditions and exclusions and if you do not that you contact us, in writing, for clarification/explanations. We urge you to read the policy documents and to contact us if you have any questions.
Email: info@cover4profs.co.za
Please note that in the list below we are providing information in respect of some of the exclusions of cover. We urge you to carefully read the policy schedule and policy wording document which provides full details of all of the exclusions of cover.
The policy will NOT cover:
claims/complaints arising out of services rendered which fall outside your scope of practice, unless such services fall under the Good Samaritan clause where you rendered services at the scene of an emergency.
claims/complaints arising out of services rendered prior to your retroactive cover date.
claims/complaints which have not been timeously reported
fines, penalties, punitive, vindictive or exemplary damages imposed on you or awarded against you.
any amounts you pay to that patient or that you agree to pay in a medical aid audit.
allegations of sexual misconduct in the course and scope of your practice. However, if you are subsequently found not guilty or liable, then the policy will refund you your defence costs. For this reason, you should notify us of any allegations against you or your employee of sexual misconduct.
claims/complaints arising out of services rendered when you were under the influence of drugs or alcohol.
claims/complaints which you were aware of in a previous policy period but failed to notify us of at the time.
claims for cyber-liability, employment practices’ liability, directors’ and officers’ liability and commercial crime.
losses that you suffer as the result of your own employees stealing from you.
claims/complaints arising out of any dishonest, criminal or malicious act or omission, or any act or omission in violation of any law or ordinance, committed by or on behalf of your practice, save where such criminal or illegal conduct is negligent and not reckless or intentional.
claims/complaints arising out of any loss, damage, cost or expense directly or indirectly arising out of, contributed to by, or resulting from any infectious epidemic/pandemic.
The policy document will be provided to you. It is your responsibility to ensure that you read and understand all the policy terms, conditions and exclusions and if you do not that you contact us, in writing, for clarification/explanations. We urge you to read the policy documents and to contact us if you have any questions.
Email: info@cover4profs.co.za
Designed to cover the resultant costs and damages from a privacy breach or a network security breach, a cyber insurance policy covers what has previously been uninsurable providing comprehensive first and third-party coverages with an expert incident response process.
Far broader than the name cyber would imply, our policy extends to cover numerous incidents including but not limited to:
Physical data theft and loss (both devices and physical hard copy data).
Cyber extortion and malware (viruses, ransomware, or publishing of stolen data).
Denial of service (disruption to operations).
Downstream attack (a compromise of your environment resulting in damages to others).
Hacking.
Insider and privilege misuse (unauthorised access and use of systems and data by employees and service providers).
Threats posed by third-party access into a client environment.
While Cyber Liability Insurance does NOT replace good IT security practices, a cyber liability policy does provide a safety net to protect you, your business and your patients. We have negotiated discounted rates and there are two types of cyber covers to offer exclusively to our scheme policyholders.
Click here to find a table comparing the products available
A claims-made policy provides cover for claims that are made against you during the period your policy is active, provided the event or incident that gave rise to the claim happened after the policy's retroactive date.
This means:
• You must have active cover at the time the claim is made, even if the incident happened earlier.
• The incident must have occurred on or after your retroactive date (a date that’s usually set when you first take out the policy and maintained as long as you keep renewing without a break in cover).
One of the key features of a claims-made policy is that it is essential to notify your insurer of any claim or potential claim (also known as circumstances) as soon as you become aware of it, and while your policy is still active. This is because once you notify the matter, it is considered “made” for the purposes of the policy.
Provided the incident falls within the scope of cover and all the policy terms and conditions are met, the insurer will respond to the claim, even if the actual legal process continues after your policy has expired.
Why is this important?
If your policy lapses or is cancelled before you notify a claim or potential issue, you may not have any cover, even if the incident happened while you were insured. Timely notification is critical to ensure your protection under a claims-made policy.
It is a condition of the policy, that in the event that a complaint/claim/incident report is received by you/your practice, regardless of who it is from, it must be submitted immediately to us in writing.
Do not wait for formal legal action to be taken against you or to receive an official notification from your regulatory body that a complaint has been lodged against you before you notify your insurers of a claim.
If you choose to respond without guidance/consultation, the Insurer’s rights are reserved.
Email: claims.cfp@garrun-group.co.za
WhatsApp: 076 284 8108
Retroactive cover refers to the protection a claims-made policy provides for incidents that occurred before the current policy period, but after the retroactive date stated on your policy schedule.
Key Points to Understand:
The retroactive date is the date you first took out a claims-made insurance policy.
You will not be covered for any claim arising from services rendered before this retroactive date.
This date appears clearly on your policy schedule, which your insurer will provide each year.
Why Is Continuous Cover So Important?
In order to maintain your retroactive cover, you must renew your policy on time every year and ensure there are no breaks or gaps in your cover.
If your cover lapses or is not renewed promptly, you may forfeit your retroactive cover, meaning you will lose protection for past work.
Proving Your Retroactive Cover
It is essential to keep records that show you have maintained continuous insurance, as insurers may require proof of your entitlement to retroactive cover.
Keep the following documents in a safe and easily accessible place, ideally indefinitely:
Policy schedules (from all previous years)
Proof of insurance letters
Proof of payment
Purchasing Retroactive Cover on a New Policy
If you are taking out a new policy (not a renewal), insurers may offer you the option to purchase retroactive cover, often up to 3 years back. However, this will not cover any known or pre-existing issues you were already aware of before the policy started.
This is why it's important to declare any known incidents or complaints when applying for cover.
Run-off cover, sometimes referred to as an Additional Reporting Period, is an extension of your liability insurance policy that allows you to continue reporting claims or potential claims even after you have stopped practicing and are no longer paying for active cover.
What Does It Cover?
Run-off cover does not cover ongoing work or new activities.
It only provides protection for claims or complaints that arise from services you rendered while your policy was active and fully paid.
This is especially relevant for professionals who are retiring, ceasing to practice, or closing their business.
Why Is It Important?
When a claims-made policy lapses (i.e. is not renewed or cancelled), you can no longer report or claim for any incidents, even if the service in question was provided while your policy was active. This could leave you personally liable for claims made after you stop working, a risk that can extend for years.
Run-off cover is therefore crucial to protect yourself, your estate, and your family from future claims, especially in the event of your retirement, incapacity, or even death. We have seen instances where claims were brought against a practitioner’s estate long after they passed away.
Run-off cover is not automatic, we will need to activate the run off based on your entitlement.
Always review your policy and contact us before allowing your policy to lapse or choosing not to renew it.
If you are planning to cease practice, close your business, or retire, we strongly recommend arranging appropriate run-off cover in advance.
Your legal liability to someone doesn’t last forever. In South African law, a person must bring a claim against you within a reasonable time, or they lose the right to do so, this is called prescription.
Most claims prescribe after 3 years from the date the person becomes aware (or should reasonably have become aware) of the loss and who caused it. After that, they can no longer legally enforce the claim against you.
However, there are exceptions, such as claims involving minors (which can extend up to 19 years), or claims interrupted by acknowledgment of debt or legal action.
Always seek legal advice if you're unsure, these time limits can have serious consequences.
If someone makes a claim against you after the prescription period has lapsed, and you pay them anyway (either out of fear, confusion, or to avoid a dispute), the law sees that as you choosing to pay a debt voluntarily, even though legally, the debt no longer exists. Once you’ve paid, you’ve essentially waived your right to raise the prescription defence.
