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AOA:AOY Ratios Compared — Which Indian Insurers Let a Doctor See the Ratio Before Buying?
This is not the explainer — what AOA and AOY mean, and why the ratio decides how much of your cover one claim can draw, is set out in the AOA:AOY ratio explained. This page answers the question that comes next and that nobody in the market answers: which insurers will tell you the ratio before you buy? We went through every filed wording, prospectus, Customer Information Sheet and product page we could obtain for Indian doctors' indemnity, looking only for a published ratio structure. Two carriers publish one. IndusInd publishes its menu with the rupee bands attached — 1:1 up to ₹50 lakh of Any One Accident, 1:4 only up to ₹12.5 lakh [1]. New India publishes the full 1:1, 1:2, 1:3, 1:4 menu and states that doctors keep all of it [2]. Everybody else leaves the ratio to the schedule, which is written at quote time — Go Digit's wording carries no ratio structure at all [3], National relabels the same mechanic as Any One Occurrence and aggregate [4], and the only public description of Generali Central's 1:1-only product is a broker page, because the insurer publishes nothing [5,6][5]. Layer on the finding that holds at every Indian carrier we verified — defence costs are paid from inside the limit, never on top of it [7,8,4,9,10,11,12,13,14,15,3] — and the practical ceiling on a single claim is lower than the AOA, which is already lower than the headline sum insured.
Ranked on one axis only: what a doctor can learn about the ratio before buying
Ranked by pre-purchase disclosure, best first. "Nothing published" means we searched that carrier's filed wording, prospectus, CIS and product page and found no ratio structure in any of them — that is the finding, not a gap in the research. Read the rank as a transparency score, not as a verdict on the cover: the two carriers at the top are not the two best policies in India.
| Carrier | What is published about the ratio | What a buyer is left doing |
|---|---|---|
| IndusInd (ex-Reliance) | Full menu with rupee bands attached — 1:1 for AOA ₹1 lakh to ₹50 lakh, 1:2 to ₹25 lakh, 1:3 to ₹16.5 lakh, 1:4 to ₹12.5 lakh [1] | Comparing before quoting — the only carrier where both the ratio and its rupee ceiling are readable up front. The bands imply an annual limit capped around ₹50 lakh, and plastic surgeons are not eligible for the product at all [1] |
| New India Assurance | Full menu 1:1, 1:2, 1:3, 1:4, with the doctors' entitlement stated — the 25%-of-aggregate restriction is for engineers, CAs and lawyers, not doctors [2] | Choosing the ratio knowingly, then asking for the wording separately — India's largest general insurer publishes no wording, prospectus, CIS or UIN on its own site [7,2] |
| Generali Central (ex-Future Generali) | 1:1 only — but the source is a broker page, not the insurer [5,6] | Taking a third party's word for it. The insurer publishes no primary document at all, and the product does not appear on its own filed-product list [5] |
| Oriental Insurance | Nothing published in the wording. Its 1991 Market Agreement ancestry sets the doctors' guideline at AOA equal to AOY, i.e. 1:1 [17,7,4,9] | Inferring the ratio from a 1991 rating agreement — and retrieving the wording itself from the Wayback Machine, because it is no longer on the insurer's site [9] |
| United India | Nothing published — the CIS states an Any One Accident limit and an Any One Year limit as opted by the insured, with no ratio structure | Asking the agent. The prospectus that should explain the product opens by describing cover for "the accidental breakage of plate glass" [8] |
| National Insurance | Nothing published, and the labels differ: Any One Occurrence and aggregate rather than AOA and AOY [4] | Translating before comparing. The same filed document also states two different compulsory excess rates, 0.25% in the clause and ½% in the specimen schedule [4] |
| ICICI Lombard | Nothing published — no fixed menu appears in any primary document we obtained | Reading the ratio off the schedule after purchase, on a wording still written in service-tax-era language [10], where the excess is charged against defence costs as well as damages [10] |
| HDFC ERGO Mediserve | Nothing published — Any one Incident and Any one Year limits, schedule-driven | Reading everything else instead: Mediserve is the only doctors' product whose insurer publishes wording, prospectus and CIS together [11,19]. Full transparency on the document set, none on the ratio |
| IFFCO Tokio | Nothing published — AOA (defined as one originating cause) and AOY, set free-form on the proposal form | Proposing a ratio rather than picking from one. Nothing is published to check the proposal against |
| Bajaj | No menu. The one worked premium example in its own doctors' brochure is written at 1:1 [18] | Inferring a default from an illustration. The retained amount is applied to defence costs as well as damages [14] |
| Tata AIG | No menu, no ratio published — a schedule-set Limit of Liability only | A prior question: the published Professional Shield wording excludes Bodily Injury outright, so the core malpractice peril cannot be verified as covered at all [15]. The retention also applies to defence costs [15] |
| Go Digit | No ratio structure whatsoever — Each Occurrence and Aggregate limits set purely by the schedule [3] | Nothing about the ratio can be compared before a quote is issued. A Participation Percentage coinsurance also applies above the deductible, and buying cover for it voids the policy [3] |
| SBI General | Not applicable — there is no doctors' indemnity product to publish a ratio for [20] | Looking elsewhere. Confirmed absent against SBI General's own filed UIN list, not merely unlocated |
1. What this page does, and what it deliberately does not
The mechanics are settled elsewhere. Any One Accident caps what the policy pays for one incident, Any One Year caps what it pays across the policy year, and the ratio between them decides how much of your cover a single claim can reach — all of that, with the arithmetic worked through, is in the AOA:AOY ratio explained. Start there if the terms are new.
What follows is the comparison. We read every filed wording, prospectus, Customer Information Sheet and insurer product page we could obtain for doctors' indemnity in India and asked one question of each document set: can a doctor find out the ratio structure before buying? Not what the ratio should be — whether the carrier will say.
Two will. Every other product in the ranking at the top of this page either leaves the ratio to the schedule or has no ratio structure to disclose at all. That gap is the finding, and it is one no carrier, broker or aggregator has any reason to publish, because almost all of them are on the wrong side of it.
2. Reading the disclosure ranking
The ranking at the top of this page orders every carrier on that one question, best first. Two things in it are worth separating carefully, because conflating them is the standard mistake.
The first is that the two carriers at the top are not the two best policies in India. New India publishes the fullest ratio menu in the market [2] and simultaneously refuses to publish its wording, prospectus, CIS or UIN anywhere on its own site — the document we read came from an intermediary [7,2]. IndusInd publishes bands more precise than anyone else's [1] and a Customer Information Sheet that tells a doctor to notify claims to "the Carriers, Port Authorities or other Bailees" [16]. Meanwhile HDFC ERGO Mediserve, which publishes nothing about its ratio, is the only doctors' product in India whose insurer publishes wording, prospectus and CIS together [11,19]. Ratio disclosure is one axis. The whole-document picture is in the transparency ranking.
The second is that "nothing published" is not one condition but several. Oriental publishes no ratio in its wording, but its wording descends from the 1991 Market Agreement whose doctors' guideline set AOA equal to AOY, so 1:1 is at least the documented ancestry [17,7,4,9] — although the wording itself now survives publicly only in the Wayback Machine [9]. Go Digit is at the other extreme: no ratio structure exists in the product at all, only Each Occurrence and Aggregate limits written into a schedule [3]. And Generali Central is a third case entirely — a ratio of 1:1 is described, but by a broker, because the insurer publishes no primary document for the product and it does not appear on the insurer's own filed-product list [5,6][5]. A number that cannot be checked against a filed document is not disclosure.
3. Why the ratio is a pricing decision disguised as a coverage one
The premium is not charged on the number the ratio protects. The 1991 all-India Market Agreement — the rating ancestor all four public-sector wordings still visibly follow [17,7,4,9] — rated doctors as a per-mille of the Any One Year figure.
The 1991 all-India Market Agreement rated the premium as a per-mille of the Any One Year limit — the figure the ratio does not protect. Presented as the ancestry of public-sector pricing, which the PSU wordings still visibly follow [17,7,4,9], not as a current quoted rate.
| Specialty, as rated in 1991 | Rate, per mille of the Any One Year limit |
|---|---|
| Physicians, pathologists and radiologists | 0.5 per mille (0.05%) [17] |
| Non-surgical specialists and diagnostic establishments | 1.0 per mille (0.1%) [17] |
| Surgeons | 2.0 per mille (0.2%) — four times the physician rate [17] |
| Plastic surgeons and anaesthetists | 3.0 per mille (0.3%), the highest doctor rate; unqualified staff attracted a further 7.5% loading [17] |
Follow the incentive. Where the rate is charged on the annual limit, the cheapest way to put an impressive number on a schedule is to raise the annual limit and lower the ratio. "₹1 crore of cover" at 1:4 reads exactly like "₹1 crore of cover" at 1:1 in a WhatsApp message from an agent, and costs materially less to write. The number that changes is the one nobody quotes: what a single claim can actually draw.
No Indian insurer publishes a loading for choosing a higher ratio, so the trade-off cannot be priced from public documents either. IndusInd's response is structural rather than financial — it caps the AOA by band, so the higher ratios are simply unavailable above certain rupee limits [1]. And the single carrier-published premium illustration that exists anywhere in this market, Bajaj's ₹1,250 general-pathologist example, is written at ₹5 lakh / ₹5 lakh — that is, 1:1 [18]. The one worked example a carrier was willing to put its name to does not use a discounted ratio.
4. What the ratio is worth once defence costs are taken out
Here is the compounding that makes the ratio matter more than it looks. At every Indian doctors' indemnity product we could verify, defence costs are paid from inside the limit of indemnity and never in addition to it [7,8,4,9,10,11,12,13,14,15,3]. The AOA is not a compensation fund with legal fees handled separately; it is one budget covering both.
So the sequence a doctor actually experiences is: the headline sum insured is the annual limit, the ratio cuts that down to the AOA, and the defence spend comes out of the AOA before anything reaches the patient. At ICICI Lombard, Tata AIG and Bajaj there is a fourth cut, because the excess is applied to defence costs as well as damages [10][15][14]. New India and Oriental charge no compulsory excess at all [7,17][9,17]; United India charges 0.50% of the limit with a ₹5,000 floor and a ₹1,00,000 ceiling [21]; the full picture on that term is in compulsory excess compared.
The illustration below shows what that does to the money. It is an illustration. The sum insured is hypothetical, and the assumption that a defence consumes one-fifth of the AOA is a stated assumption of the example — no Indian insurer publishes defence-cost data from which a real fraction could be derived, and we are not going to invent one. What is not hypothetical is the structure: defence really does come out of the AOA everywhere [7,8,4,9,10,11,12,13,14,15,3], and the awards in the right-hand column are real.
An illustration, not market data. It assumes a ₹1 crore Any One Year limit and a defence that consumes one-fifth of the Any One Accident limit. No Indian insurer publishes defence-cost figures, so that one-fifth is a stated assumption of this example and nothing more. What is *not* assumed is that defence comes out of the AOA at all: that holds at every Indian doctors' indemnity product we could verify [7,8,4,9,10,11,12,13,14,15,3]. The comparison column uses real awards.
| Ratio on a ₹1 crore annual limit (illustration) | AOA — the ceiling for one claim | Left for damages after a defence costing one-fifth of the AOA (illustration) | Set against the award record |
|---|---|---|---|
| 1:1 | ₹1 crore | ₹80 lakh | Short of the ₹1.38 crore and ₹1.1 crore top awards in the NCDRC's 2015-2019 caseload [22], and well short of the ₹2 crore directed in the 2026 wrong-kidney order [23] |
| 1:2 | ₹50 lakh | ₹40 lakh | Comfortably above the ₹13,78,300 average anaesthesiology payout, the highest specialty average in that dataset [22]; nowhere near the crore-level tail |
| 1:3 | About ₹33 lakh | About ₹27 lakh | Still above the specialty averages, which run from ₹4,95,400 in general medicine to ₹13,78,300 in anaesthesiology [22] |
| 1:4 | ₹25 lakh | ₹20 lakh | A fifth of the headline number is what actually meets the claim. For scale, ₹10 lakh was the most common sum insured across the 2000-2015 judgments in our sweep [24], and even that left doctors paying gaps personally [25] |
Two features of that table survive any change to the assumption. First, the ordering never reverses — a lower ratio always leaves less, and no defence-cost assumption makes 1:4 competitive with 1:1 on a single claim. Second, the money is not restored afterwards. No PSU wording, and none from ICICI Lombard, IFFCO Tokio or IndusInd, reinstates the Any One Year aggregate once it is exhausted, and ICICI's wording refuses reinstatement even in exchange for additional premium [7,4,9,10,12,13].
And the multi-claim year that a low ratio is supposed to insure against is largely defined away before it starts: a claims-series clause at New India, National, Oriental, ICICI Lombard, IFFCO Tokio and IndusInd treats claims arising from one originating cause as a single claim made when the first was made, guillotined three years later [7,4,9,10,12,13]. One episode, one AOA — however many patients it involved.
The real-world version of this arithmetic is on the record. In a Kerala case, ₹10 lakh was awarded against a policy limit of ₹4.75 lakh; the insurer paid to the limit and the hospital and surgeon personally covered the ₹5.25 lakh gap [25]. That was a limit problem rather than a ratio problem, but the ratio is the fastest way to manufacture the same shortfall on a policy whose headline number looked adequate — and ₹10 lakh was the most common sum insured across the 2000-2015 judgments in our sweep [24].
5. Comparing two quotes when only one of them shows you a ratio
- Convert the ratio to rupees on the spot. Ask for the Any One Accident figure as a number, not as a ratio, and put it beside the annual figure you are being sold. If the answer is not on the quote, the quote is incomplete.
- Check the labels before you check the numbers. National writes Any One Occurrence and aggregate [4], Go Digit writes Each Occurrence and Aggregate with nothing behind it [3], HDFC ERGO writes Any one Incident and Any one Year. Same mechanic, four vocabularies — the labels are the reason side-by-side comparison usually fails.
- Do not accept a broker's ratio as the insurer's. Generali Central's 1:1 is a broker statement about a product for which the insurer publishes no document at all [5,6][5].
- Ask what defence costs do to it, knowing the answer is the same everywhere in India: they come out of the limit [7,8,4,9,10,11,12,13,14,15,3]. Then ask whether the excess also applies to them, because at three carriers it does [10][15][14].
- Ask what happens after the aggregate is exhausted and get it in writing. At seven carriers, nothing happens — there is no reinstatement [7,4,9,10,12,13].
- Check that the peril is covered before optimising the ratio. Tata AIG's published Professional Shield wording excludes Bodily Injury outright [15], and SBI General has no doctors' indemnity product at all [20]. A perfect ratio on a policy that does not respond to malpractice is worth nothing.
Every dimension of these policies, compared side by side, is in the master comparison; the document-integrity defects we found while reading the same paperwork are in document defects; and where each insurer lands overall is in the best and worst ranking of professional indemnity insurance for doctors.
Frequently asked questions
Which Indian insurers publish their AOA:AOY ratio menu?
Why does it matter that the ratio is only in the schedule?
Does IndusInd publishing rupee bands mean it offers less cover?
Does choosing 1:1 instead of 1:4 cost more?
Do defence costs change what the ratio is worth?
If the ratio is not published, what should I ask the insurer for?
Is a low ratio ever the right choice?
Is ratio disclosure a good proxy for policy quality?
Sources
Every figure on this page is footnoted to one of the primary documents below. Reliability tiers: A = regulator, court or filed document; B = reputable publisher or carrier official page; C = user-generated (reported by users).
- 1.IndusInd General Insurance — Professional Indemnity Insurance — product page. https://www.indusindinsurance.com/smes-insurance/professional-indemnity-insuranceTier B · Reputable publisher / carrier official · Accessed 2026-07-08
- 2.New India Assurance Co. — Professional Indemnity Insurance — product page. https://www.newindia.co.in/professional-indemnity-insuranceTier B · Reputable publisher / carrier official · Accessed 2026-07-08
- 3.Go Digit General Insurance — Digit Professional Liability Policy — retail policy wording. https://www.godigit.com/content/dam/godigit/directportal/en/downloads/others/policy-wordings-digit-professional-liability-policy.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 4.National Insurance Co. (NICL) — Professional Indemnity (for Doctors & Medical Practitioners) — full wording + specimen schedule. https://nationalinsurance.nic.co.in/sites/default/files/2026-04/Prof.Indmn%20Doctor%20Medical%20estb%20prospectus.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 5.Generali Central Insurance (ex Future Generali) — Complete filed-product list for website (984 rows). https://www.generalicentralinsurance.com/footer-pdf/product-list-for-website.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 6.SecureNow (broker) — How much does a doctor's professional indemnity insurance cost?. https://securenow.in/insuropedia/how-much-does-a-doctors-professional-indemnity-insurance-cost/Tier B · Reputable publisher / carrier official · Published 2024-01-01 · Accessed 2026-07-17
- 7.New India Assurance Co. — Professional Indemnity Policy for Doctors and Medical Practitioners — policy wording. https://www.iosweb.net/m-documents/DRINDEMCLAUSE.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 8.United India Insurance Co. — Professional Indemnity Insurance Policy for Doctors — prospectus. https://uiic.co.in/web/sites/default/files/Policy-Document/Professional%20Indemnity%20Insurance%20Policy-%20for%20Doctors.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 9.The Oriental Insurance Co. — Professional Indemnity Policy for Doctors & Medical Practitioners — policy wording (Wayback copy). https://web.archive.org/web/20230402045912id_/https://orientalinsurance.org.in/documents/10182/5106103/Terms+%26+conds+of++PROFESSIONAL+INDEMNITY+POLICY+FOR+DOCTORS+%26+MEDICAL+PRACTITIONERS.pdf/065f44d4-58e6-6bca-a65e-a414a2197132Tier A · Regulator / court / filed document · Accessed 2026-07-08
- 10.ICICI Lombard (hosted by IRDAI) — Professional Indemnity Policy (For Doctors & Medical Practitioners) — policy wording. https://irdai.gov.in/documents/37343/993134/6_Policy+Wordings+Doctors+and+Medical+Practitioners_Misc+21_GEN073.pdf/dcdecdb3-f154-806d-88d7-1ebffee7eb61?version=1.1&t=1668243606849&download=trueTier A · Regulator / court / filed document · Accessed 2026-07-08
- 11.HDFC ERGO General Insurance — Mediserve Professional Indemnity — policy wording. https://customer-portal-assets.hdfcergo.com/documents/MediserveProfessionalIndemnity-PolicyWordings-526654013238.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 12.IFFCO Tokio General Insurance — Professional Indemnity Policy — wording for Doctors, Medical Practitioners and Medical Establishments. https://www.iffcotokio.co.in/content/dam/iffcotokio/policy-wordings/motor/professional-indemnity-policy-wording-doctors.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 13.IndusInd General Insurance (ex Reliance General) — IndusInd Professional Indemnity Policy for Doctors and Medical Practitioners — policy wording. https://www.indusindinsurance.com/Downloads/professional-indemnity-policy-for-doctors-and-medical-practictioners.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 14.Bajaj General Insurance (ex Bajaj Allianz) — Professional Indemnity Insurance Policy — policy wording (generic, retail UIN). https://www.bajajgeneralinsurance.com/download-documents/commercial-insurance/professional-indemnity-insurance-policy/Professional-Indemnity.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 15.Tata AIG General Insurance — Professional Shield — policy wording (generic professionals' E&O). https://www.tataaig.com/s3/professional_shield_417d979962.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 16.IndusInd General Insurance — IndusInd Professional Indemnity Insurance — Customer Information Sheet (generic umbrella PI). https://www.indusindinsurance.com/Downloads/indusind-professional-indemnity-insurance-policy.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 17.All-India general insurers (Oriental-branded copy) — Market Agreement on Rating of Professional Indemnity Insurances (1991). https://telearogya.com/assets/PROFESSIONAL_INDEMNITY-MARKET_AGREEMENT.pdfTier A · Regulator / court / filed document · Published 1991-12-01 · Accessed 2026-07-08
- 18.Bajaj Finserv (Bajaj General distributor) — Bajaj doctors' professional indemnity — 1-page brochure. https://cms-assets.bajajfinserv.in/is/content/bajajfinance/bajaj-allianz-policy-broucherpdf?scl=1&fmt=pdfTier B · Reputable publisher / carrier official · Accessed 2026-07-08
- 19.HDFC ERGO General Insurance — Mediserve Professional Indemnity — Customer Information Sheet. https://customer-portal-assets.hdfcergo.com/documents/MediserveProfessionalIndemnity-CIS-840893480119.pdfTier A · Regulator / court / filed document · Accessed 2026-07-08
- 20.SBI General Insurance — SBI General filed UIN product list. https://content.sbigeneral.in/uploads/Product_list_for_website_2_New_896efc8d9c.pdfTier A · Regulator / court / filed document · Accessed 2026-08-17
- 21.United India Insurance Co. — Professional Indemnity Insurance Policy — Customer Information Sheet. https://uiic.co.in/web/sites/default/files/Policy-Document/Professional%20Indemnity%20Insurance%20Policy%20CIS.pdfTier A · Regulator / court / filed document · Published 2024-10-01 · Accessed 2026-07-08
- 22.Indian Journal of Medical Ethics — Medical negligence in cases decided by the NCDRC: a five-year retrospective review (2015-2019, n=253). https://ijme.in/articles/medical-negligence-in-cases-decided-by-the-national-consumer-disputes-redressal-commission-a-five-year-retrospective-review/Tier A · Regulator / court / filed document · Published 2023-02-01 · Accessed 2026-07-17
- 23.Bar & Bench — Removal of wrong kidney: NCDRC awards ₹2 crore compensation to patient's family. https://www.barandbench.com/news/litigation/removal-of-wrong-kidney-ncdrc-awards-2-crore-compensation-to-patients-familyTier B · Reputable publisher / carrier official · Published 2026-05-25 · Accessed 2026-07-21
- 24.IndianKanoon (catalog compiled by Best Worst Insurance) — Doctors' PI judgments sweep — 25-case catalog of insurer conduct (consumer fora, High Courts, Supreme Court). https://indiankanoon.org/search/?formInput=%22professional%20indemnity%22%20doctorTier A · Regulator / court / filed document · Accessed 2026-07-17
- 25.Kerala SCDRC (via IndianKanoon) — United India Insurance v. Lathika (Kerala SCDRC, 2015). https://indiankanoon.org/doc/4522398/Tier A · Regulator / court / filed document · Accessed 2026-07-17
