Claims guide
Notify your insurer as soon as reasonably practicable and preserve clinical records from the outset.
If a patient makes a complaint, alleges harm, or you become aware of an incident that might lead to a claim, follow the notification process in your policy wording and schedule. Late notification can affect cover, especially on claims-made policies.
Every policy differs by insurer, retroactive date and notification rules. This guide describes the usual process for UK healthcare professionals but your own policy documents are definitive. For general insurance terms, see the BIS-Nationwide insurance glossary.
Locate your current schedule and policy booklet. These set out:
If you cannot find your documents, contact MMI 4u and we will help you identify the correct insurer or claims contact for your policy.
Clinical care comes first. Follow your duty of candour, local serious incident procedures and employer policies. Insurance notification is separate from clinical governance and regulator reporting.
Most indemnity policies require notification as soon as reasonably practicable when you become aware of a circumstance that may give rise to a claim — not only when solicitors are instructed. The timeframe and method are set out in your wording.
Contact your insurer or their claims handler directly using the details on your schedule. Provide your policy number, a factual summary, dates of treatment, and copies of any written complaint received.
Do not admit liability to patients or their representatives without insurer agreement. If you are unsure whether to notify or which number to use, check your schedule first, then contact us.
Do not alter or backdate records. Secure contemporaneous notes, results, imaging, consent documentation, prescriptions and correspondence. If records are held by an employer or practice, notify them and request preservation.
After notification, the insurer or their claims handlers may appoint medico-legal advisers or solicitors. Respond honestly and promptly to them — not to the claimant directly. Withhold nothing material; misrepresentation can affect cover. Keep copies of everything you submit.
You may have separate duties to employers, CQC-registered providers, or regulators such as the GMC, GDC or NMC. Follow those requirements in parallel with your insurance notification as required by your policy wording.
On claims-made cover, the policy in force when you notify the circumstance usually responds (subject to retroactive date and policy terms stated on your schedule). If you change insurer or retire without run-off cover, you may have no cover for later notifications about past work. See our guide on claims-made v claims occurring.
If cover is declined, the insurer should explain why with reference to your policy wording. You can ask us to help you understand the decision or raise a complaint through our complaints process. Eligible customers may refer complaints to the Financial Ombudsman Service.
When you stop practising, arrange run-off or extended reporting cover as set out in your policy. Declare claims and circumstances accurately at renewal. If you are unsure whether to notify, check your schedule first, then contact MMI 4u or read our FAQs.
If you cannot find your policy documents or are unsure who to notify, we can help you identify the correct claims route for your policy.