How to Pay Less for Medical Indemnity for GPs

Once a year the anonymous white envelope from your defence union arrives announcing your renewal premium: another 10% increase year upon year upon year. Cost increases are rocketing up a couple of thousand quid per annum for those doing clinical work full time.

Defence costs are soaring hanks to several high profile apparently “difficult-to-defend” claims, a culture that encourages complaints (the GMC website has a button on its front page for ‘concerns about doctors’ but there is no equivalent channel for praise) and rogue, high charging law firms.

Changes to the law means that these firms have had their invoices capped and this may trickle down to halt the premium price bubble but there are still old cases still in the system.

If you really want to be annoyed, this article in the Guardian reckons that 70% of legal costs goes to the lawyer, not the claimant.

Happier now? Probably not.

So, what can you do to reduce our premiums? Is it worth the effort? Or are do you just end up gaining more in paperwork than savings?

Shop around

Spiralling fees are eating away at customer loyalty  and many GPs are moving around providers.

Network Locum has obtained the following figures from a GP looking for cover for 4 sessions a week as a locum GP:

  • MPS: £5468
  • MDU: £4584
  • MDDUS: £3254 (a saving of £2K)

Some view walk in centres as less risky than OOH. Be specific with them about what you and don’t do.

Some are asking for 6 weeks to process your application. Others are charging for leaving if you leave in the middle of the year.  Change only when your premium is up for renewal and start planning well in advance.

GP locums: record your hours

Different defence unions refer to sessions as different chunks of time. The MPS state that a session is 3.5 – 5 hours but many sessions in London are only 2 to 3 hours.

Keep a spreadsheet and submit your hours when it is time to renew your premium.

Saving for the GP Columnist: £2000 rebate in 2014.

Check you are on the right rate

Sounds obvious? Portfolio GPs who do something unusual or off the main bandwidth need to make sure your defence organisation fully understand what you do.

One GP who discovered they were paying double the premium of everyone else in their niche thanks to a corridor chat. Result: a £5000 rebate from the defence organisation who backdated the overpayments over several years.

Ask to go on your practice scheme

Only applies to salaried GPs. The practice manager has to ring the defence union on your behalf, then you have to go back to the defence union, then back to the practice manager…

Hassle factor: can be large for small savings.

Salaried GPs: ask employers to pay your defence fees

The worst that can happen is they say no and you might save thousands.

Benefit from Crown Indemnity

GPs working for hospital-run urgent care centres benefit from Crown Indemnity for those sessions.  Some doctors have decided therefore that they do not need cover for this work.

While this will cover you if you are sued, it won’t help you if you have a GMC investigation. In this age of the investigation epidemic, you might be better off buying the cover anyway.  Basically this is cheap until something starts hurting.

One to watch

South London GP Dr Jonny Christopher is negotiating with a commercial insurer on behalf of an entrepeneurial consortium of GPs to gain a better package for medical indemnity.  Full details of this scheme are yet to emerge.

You can find details of this group on Facebook at Medical Indemnity – A Better Deal. 


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Ram Arora

Good article

April 7, 2015 at 10:50 pm Reply


    Thanks Ram. Indemnity fees are shocking for GPs these days. The more we can share info and do things for ourselves the better in this climate.

    April 7, 2015 at 10:59 pm


You mentioned hospital run utc in your report that are covered by crown indemnity. Where are these utc’s?

July 26, 2015 at 1:47 am Reply


I don’t know how many sessions per week I’m going to get. How do I choose my indemnity then? What happens if I declare more or less sessions than I actually work?

August 31, 2015 at 11:44 am Reply


    Hi Alex, I cannot speak for all providers but some will refund you if you haven’t worked the full quota of sessions. You would need to check when you obtain the quote how each provider handles this scenario but it’s not uncommon that people’s working circumstances change through the year, either by choice or illness/maternity or whatever.

    August 31, 2015 at 12:06 pm


Hi. I was happy with corporate indemnity from my private employer, and a top up (at reduced rate) from my defence union to cover me for advice / GMC investigations. However the defence union is now saying this:
“we are unable to extend the benefits of defence union membership (including assistance with GMC complaints, coroners’ enquiries and other complaints arising from this work) for work undertaken that is indemnified by a third party insurer or indemnifier (other than in the case of the Clinical Negligence Scheme for Trusts (CNST) or NHS indemnity). The reason for this is because significant conflict could arise between the defence union and the third party insurer or indemnifier if a matter were to be notified to both parties. This could occur, for example, if a complaint were reported by you which subsequently evolved into a claim.”

I really don’t understand the reason given. What “significant conflict” could arise with a 3rd party private insurer that wouldn’t also arise under NHS indemnity?

February 24, 2016 at 9:27 pm Reply


Can a GP use other private insurers for Indemnity cover apart from the 3 defence unions

March 5, 2016 at 1:56 am Reply


Good article. Something definitely needs to be done to cap indemnity fees to make working possible. How about a no claim bonus scheme or a reduction for those who have not lost a case brought against them (meaning a patient who brings a claim but the doctor was not in the wrong). It isnt fair to ake me pay for others who might repeatedly need or use the service.
Im currently retraining so I can quit medicine, and I am not encouraging my child into the profession either.

March 14, 2016 at 8:54 am Reply


I got a cheaper quote by being a new customer rather than existing customer from same organisation. I just phoned round for quotes but didn’t say who I was currently with.

March 24, 2016 at 2:31 pm Reply

Amjed Munir

The only consolation is that the indemnity and GMC fee is tax deductible
Make sure your accountant is factoring this in to reduce your tax bill

Truly sometimes it feels like having the indemnity certificate
Is more important than having the degree certificate

October 2, 2016 at 6:58 am Reply

Amjed Munir

Heard in the last year or so that the GMC was going to make an issue of checking Doctors maintained the right level of cover
Remember getting a letter in the post
GMC and Indemnity…

October 2, 2016 at 7:08 am Reply


Surely you are right a lot goes to solicitors or
Barristers , but no way that the poor Doctors ,
Have any way of knowing WHY AND HOW ,
That figure has came about , but to ACCEPT..
Even in most cases , prove your Innocence

May 5, 2017 at 8:12 pm Reply