Cover for Surgical Assistants and Fellows, Cyber enhancement and Remote Consulting

Incision believes that its medical indemnity and related cover for surgeons in private practice is second to none. But as the market leader, we also strongly believe in looking for improvements to the scope of our Members' cover, even where our competitors are not yet offering any extra cover.

Therefore we are proud to announce three major enhancements to the scope of Incision cover. Existing Members will have the benefit of this enhanced cover straight away, and new Members will have the benefit of this enhanced cover when they join.

Surgical Assistants and Surgical Fellows

Incision cover now includes, as standard, medical indemnity insurance for Surgical Assistants and Surgical Fellows. This cover will apply where the Surgical Assistant or Surgical Fellow is performing or assisting with surgery, under your direct supervision in person, and where they don't already have their own individual medical indemnity arrangement.

We anticipate that this enhancement will benefit Members, Surgical Assistants and Surgical Fellows, and also your patients. It will enable Surgical Assistants or Surgical Fellows to work with you on private patients where they might not otherwise have been able to.

Surgical Assistants and Surgical Fellows are obliged to hold a suitable medical indemnity arrangement if they provide clinical care to a private patient. After all, they are performing a highly skilled and responsible role in the surgery, albeit working under your supervision, and it is possible that they could make a negligent error and harm the patient even where you personally have not been negligent. It is possible that the Surgical Assistant or Surgical Fellow personally could be sued by a private patient, so medical indemnity for them is essential.

But relatively few of them hold their own independent medical indemnity insurance. Many of them are NHS employees and their NHS work would be covered by State Indemnity. For most the cost of obtaining their own independent medical indemnity would not be worthwhile. Their work is rarely covered by a private hospital's indemnity arrangement either.

Therefore you (and your patient) could face a situation where surgery for a private patient is being planned, but a Surgical Assistant or Surgical Fellow would have to refuse to assist because they don't have their own medical indemnity. You and the patient could face delays while you identified a Surgical Assistant or Surgical Fellow who did have the necessary insurance, or delays while your first choice of Surgical Assistant or Surgical Fellow obtained their own insurance, or otherwise potentially compromise on the patient's safety and go ahead without a Surgical Assistant or Surgical Fellow.

The Incision enhancement solves this problem. If Surgical Assistant or Surgical Fellow doesn't have their own indemnity, then your Incision cover will provide it. If they were later sued in their own name, then they will be covered under your Incision policy even if for some reason you personally have not also been sued.

There is no need to inform your Incision insurers every time you will be performing or supervising surgery on a private patient with a Surgical Assistant or Surgical Fellow who will be covered for that procedure under your policy, so there is no extra administrative burden for you. But the usual notification terms apply if a claim is made or threatened against that Surgical Assistant or Surgical Fellow, so you would need to contact Incision if that ever happened. Remind your Surgical Assistant or Surgical Fellow to tell you if a patient indicates that they intend to seek compensation.

We hope that this enhancement to cover is welcome news, especially as so many surgeons will be working hard to clear the backlog of surgery caused by the pandemic and will need all the assistance they can get!

Bodily injury caused by a Cyber Event

There are numerous ways for a Cyber Event to happen, but among the most potentially dangerous include network extortion threats, incidents where a malicious third party locks you out of your own computer system or email account, or a computer virus that locks you out or deletes data.

The risk for you and your patients is that this will adversely affect patients' care. Patient records could be lost or deleted and would take a long time to recreate. Inviting and arranging follow-up appointments could be severely disrupted. Delays in follow up could result in diseases including cancer going undiagnosed and untreated, or serious post-op complications not being managed. There are so many situations where a delayed follow up could result in very severe clinical consequences for the patient.

In short, there are situations where a Cyber event could lead to bodily injury to your patients, not just financial loss and inconvenience to you.

Many other policies have a lacuna in cover here. Most medical indemnity policies contain exclusions to ensure that the medical indemnity insurer does not inadvertently become liable to pay the financial cost of a Cyber incident. And similarly most Cyber policies contain exclusions to ensure that the cyber insurer does not inadvertently become liable to pay clinical negligence compensation claims. The combined effect could be that a clinical negligence claim where the 'negligence' was clearly caused by a Cyber incident, might not be eligible for cover under either policy.

The enhancement to the Incision medical indemnity policy is designed to solve this problem. The wording has now been amended to make it clear that even where the patient's claim for bodily injury arises from a Cyber event over which the surgeon had no control, the patient's claim for compensation for those injuries is still covered.

Remote consultations

There has been an enormous increase in the use of remote consultations by telephone and video conference since the start of the pandemic.

Incision's view has always been that claims arising from remote consultations by telephone or video, as part of the usual overall care of the patient, are covered under the Incision policy as usual. Of course anyone who decided to set up a pure telemedicine service, would need to seek advice about whether they needed to buy a fresh policy to cover the risks associated with that new venture.

However, we have received a number of queries from Members and prospective Members who were keen to double-check that they would still be covered even if the claim arose from a remote consultation rather than an in-person consultation.

Therefore to put everyone's minds at rest, we have amended the policy wording to expressly confirm that remote consultations as part of your usual business are covered.


We hope that these enhancements are welcome news, and we are delighted to be able to provide them. While cover will always be subject to the overall terms and conditions of the policy, we hope it reassures to know that we are always working hard to identify ways to protect our Members, and their patients, in the best way.

Incision Members can contact the 24/7 Incision Medico-Legal helpline if they ever need to discuss or notify these or any other incidents arising from their practice.

Incision Indemnity

December 2021