India · Doctors indemnity · Compare by clause
Cosmetic and Reconstructive Surgery in Indian Doctors' Indemnity — What Each Wording Actually Excludes
Cosmetic surgery is excluded in every Indian doctors' indemnity wording we read. What separates the carriers is what they put back. New India, National, ICICI Lombard, IFFCO Tokio and IndusInd exclude cosmesis but preserve burns and trauma reconstruction and scar repair; United India, Oriental and HDFC ERGO Mediserve exclude cosmetic surgery flat, with no carve-back at all [1,2,3,4,5,6,7,8]. The consequence is that the same reconstruction, on the same patient, is inside one insurer's wording and outside the next one's. Two carriers go further and decide the question at the counter rather than in the clause: IndusInd bars plastic surgeons from eligibility on its product page [9], and Generali Central lists plastic and cosmetic surgeons as not covered while publishing no wording, prospectus or CIS anyone can check that against [10][10]. This page sets out what each document says on this one axis. It cannot tell you whether a given operation of yours would be paid — that turns on the wording attached to your schedule and on the facts of the claim — so it tells you instead what to put in writing to the insurer before you sign.
What each filed wording does with cosmetic and reconstructive work
Every cell comes from that carrier's own filed document, read on the date recorded in our ledger. Where no document exists, the cell says so — that is a result, not a blank [10].
| Carrier | Cosmetic / cosmesis position in the document | What that leaves for a mixed reconstructive and aesthetic practice |
|---|---|---|
| New India Assurance | Cosmesis excluded, with burns, trauma and scar-repair carve-backs [1,2,3,4,5,6,7,8] | The most favourable side of the split, on a wording you cannot read on the insurer's own site [1,12]. Pair it with the absence of any compulsory excess [1,20] |
| National Insurance (NICL) | Cosmesis excluded, with burns and trauma carve-backs [1,2,3,4,5,6,7,8] | Same 1991-descended clause as its sister public-sector wordings [20,1,2,7]; the same filed document states two different compulsory-excess rates [2] |
| Oriental Insurance | Cosmetic surgery excluded flat — no carve-back [1,2,3,4,5,6,7,8] | The burns reconstruction that is carved back at New India or National is not carved back here, and the wording that says so is retrievable only from the Wayback Machine [7]. It does charge no excess [7,20] |
| United India (UIIC) | Cosmetic surgery excluded flat — no carve-back [1,2,3,4,5,6,7,8] | Flat exclusion on the customer information sheet, from the carrier whose doctors' prospectus opens by describing cover for the accidental breakage of plate glass [21]. Read the operative clause, not the summary |
| ICICI Lombard | Cosmesis excluded, with burns and trauma carve-backs [1,2,3,4,5,6,7,8] | Favourable side of the split, in a wording still written in service-tax-era language [3], with an excess that is applied to defence costs as well as damages [3] |
| IFFCO Tokio | Cosmesis excluded, with burns and trauma carve-backs [1,2,3,4,5,6,7,8] | Favourable side of the split on doctors-specific paper, and the broadest post-expiry reporting trigger we found — 90 days on cancellation or non-renewal by either side [4] |
| IndusInd (ex-Reliance) | Cosmesis excluded with burns, trauma and scar carve-backs in the wording [1,2,3,4,5,6,7,8] — but plastic surgeons are excluded from eligibility [9] | The carve-back is academic for the specialty it would matter most to. If you are a plastic surgeon the product page rules you out before the exclusion is reached |
| HDFC ERGO Mediserve | Cosmetic surgery excluded flat — no burns or trauma carve-back [1,2,3,4,5,6,7,8] | The strictest cosmetic position in the market sits on the only doctors' policy you can read in full before buying [8,11], alongside exclusions for IVF, clinical trials, opioid and vaping liability [8] |
| Generali Central (ex-Future Generali) | Plastic and cosmetic surgeons listed as not covered [10] | Nothing to verify it against: no wording, no prospectus, no CIS, and the product is absent from the insurer's own filed-product list [10] |
| Bajaj General | Does not appear on either side of the cosmesis split we catalogued [1,2,3,4,5,6,7,8] | The prior question is bigger: the published wording defines Loss as financial injury other than that arising out of bodily injury, so on its face it does not respond to malpractice at all [14] |
| Tata AIG | No medical cosmesis clause in the published wording [1,2,3,4,5,6,7,8] | The wording behind the doctors' marketing page excludes bodily injury outright [13] — the cosmetic boundary is moot if the core peril is not there |
| Go Digit | Not in the cosmesis split either way [1,2,3,4,5,6,7,8] | A generic professional-liability wording whose limits are set purely by the schedule, with nothing comparable published in advance [22]. What is covered depends on how the schedule defines your professional services |
| SBI General | No position — no doctors' PI product exists, confirmed against its own filed UIN list [15] | Nothing to buy, and nothing to compare |
| IMA Professional Protection Schemes | Not insurance and not clause-drafted the same way; IMA Gujarat excludes acts beyond one's qualification or training and non-modern-medicine procedures [23] | A mutual pool with no IRDAI regulation and no recourse to the Insurance Ombudsman [24,25]. Scope questions are settled by a managing committee, not by a filed exclusion |
1. One clause, two opposite answers, same operation
Cosmetic work is the dimension on which Indian doctors' indemnity is least consistent. Every wording we read excludes it. Only some of them put part of it back.
Five carriers — New India, National, ICICI Lombard, IFFCO Tokio and IndusInd — exclude cosmesis but preserve reconstruction after burns and other trauma, and scar repair. Three — United India, Oriental and HDFC ERGO Mediserve — exclude cosmetic surgery flat, with no carve-back [1,2,3,4,5,6,7,8]. The practical effect is blunt: a surgeon rebuilding a contracture after a burn is working inside a preserved category at one insurer and outside the exclusion boundary entirely at the next, on identical facts, for a premium that differs by very little.
This is not a difference in the marketing. It is a difference of one sentence in the exclusions, and it is the reason this page exists as its own comparison rather than a line in a table.
2. Where the boundary actually sits — and where the documents go quiet
The carve-back wordings name their preserved categories: burns, other trauma, scar repair [1,2,3,4,5,6,7,8]. What none of them do is define the edge. A revision of a previous elective procedure, a rhinoplasty done for airway function, a reconstruction after oncological resection where the aesthetic result is part of the point — these are the operations where a claim would turn on classification, and the classification is not written anywhere in the paper.
That silence should change what you do at proposal stage rather than what you assume at claim stage. These are policies where the insurer holds consent rights over settlement, where defence costs come out of the limit rather than sitting on top of it [1,21,2,7,3,8,4,5,14,13,22], and where the litigation record shows insurers contesting liability or coverage in roughly 22 of the 25 judgments we catalogued, paying voluntarily in none [26]. An unresolved definitional question in a policy with those mechanics is not a neutral gap; it is an argument waiting for the worst possible moment.
Nothing on this page tells you that a given procedure of yours is covered or is not. That answer lives in the wording attached to your schedule and in the facts of the claim. What the documents can tell you is which side of the split your carrier is on, and what to have confirmed in writing before you rely on it.
3. The two carriers that decide it at the door
For one specialty the exclusion never gets read, because the product does not open.
IndusInd — the old Reliance General book, re-issued under IndusInd branding — excludes plastic surgeons from eligibility for its doctors' professional indemnity product, on the product page [9]. Its wording is otherwise on the favourable side of the split, with burns, trauma and scar carve-backs intact [1,2,3,4,5,6,7,8]. Both things are true at once, and the second one does the plastic surgeon no good whatsoever.
Generali Central, formerly Future Generali, lists the professions its doctors' indemnity covers — radiologists, pathologists, GPs, consultants, surgeons including dentists, anaesthetists — and states that plastic and cosmetic surgeons are not covered [10]. It is also the carrier that publishes no primary document of any kind for the product, which does not appear on its own 984-row filed-product list [10]. A specialty bar with no wording behind it cannot be read for scope: there is no clause to tell you whether it means all plastic surgery, or aesthetic practice, or the specialty registration.
Two carriers decide this at the door rather than in the exclusions. Neither decision is in a policy wording — both sit in product literature, which is where a doctor is least likely to look.
| Carrier | What the document says | What it means before you get to the exclusions |
|---|---|---|
| IndusInd (ex-Reliance) | Plastic surgeons are excluded from eligibility for the doctors' PI product, stated on the product page [9] | You are outside the product, not merely outside a clause. The burns and trauma carve-back in its own wording [1,2,3,4,5,6,7,8] is unreachable |
| Generali Central (ex-Future Generali) | The product literature lists covered professions and states that plastic and cosmetic surgeons are not covered [10] | A specialty bar published by a carrier that publishes no wording, prospectus, CIS or UIN for the product at all [10] — there is no primary document in which to check the bar's scope |
4. Why this specialty is treated differently, and has been since 1991
The market's instinct about cosmetic work is old enough to be documented. The 1991 all-India Market Agreement on Rating of Professional Indemnity Insurances — the common ancestor of all four public-sector doctors' wordings [20,1,2,7] — placed plastic surgeons and anaesthetists at the top of its rate ladder, at 3.0 per mille of the annual limit [20]. Surgeons sat at 2.0 [20] and physicians, pathologists and radiologists at 0.5 [20]. Six times the physician rate, for the specialty two carriers now decline outright.
So the underwriting judgment and the exclusion language come from the same source document, and the public sector has carried both forward for thirty-five years. It is worth knowing when a broker tells you the cosmetic exclusion is standard boilerplate. It is standard, and it is boilerplate, and it is also the exact place where the wordings diverge from one another.
5. What to verify before you buy
What to put in writing before you buy, if any part of your list is aesthetic. Ask for answers on the insurer's letterhead or in an endorsement, not from a portal chat.
| Ask for | Why it decides the outcome | What a usable answer looks like |
|---|---|---|
| The operative wording for the exact UIN on your quote — not the brochure | The split between a carve-back and a flat exclusion lives in one sentence of the wording [1,2,3,4,5,6,7,8], and at New India and Oriental that sentence is not published by the insurer [1,12][7] | A PDF of the wording whose UIN matches your schedule, sent before you pay |
| Confirmation that your specialty is eligible at all | Two carriers bar the specialty rather than the procedure [9][10] | Your registered specialty written into the schedule, matching the qualification you hold |
| Your procedure list classified in the proposal, reconstructive and aesthetic separately | The carve-back preserves reconstruction after burns and other trauma and scar repair [1,2,3,4,5,6,7,8]; nothing in the wordings defines the boundary for a mixed list | Each procedure named in the proposal and the proposal referenced in the schedule, so a later dispute is about disclosure you made, not disclosure you skipped |
| Whether the excess applies to defence costs | Defence spend comes out of the limit at every Indian carrier [1,21,2,7,3,8,4,5,14,13,22], and at ICICI Lombard the excess is charged against it too [3] | A stated excess amount and a stated answer on whether it bites legal costs — New India charges none at all [1,20] |
| The post-expiry reporting window in writing | A cosmetic dispute often surfaces long after the operation, and late notification is the most litigated reason doctors' claims fail in India [26] | 90 days is the market standard [1,2,7,3,4,5]; HDFC ERGO Mediserve accepts nothing after expiry [8] |
6. How the carriers rank on this one dimension
For a practitioner whose list mixes reconstructive and aesthetic work, ranked on cosmetic and reconstructive treatment alone — not on price, and not on the rest of the policy:
- New India Assurance — the carve-back is preserved [1,2,3,4,5,6,7,8] and there is no compulsory excess to erode a contested claim [1,20]. The cost of this choice is verification: the wording is not published on New India's own website [1,12], so insist on being handed it before you sign.
- IFFCO Tokio — the same favourable side of the split on doctors-specific paper [1,2,3,4,5,6,7,8], plus the broadest post-expiry reporting trigger we found, 90 days on cancellation or non-renewal by either side [4].
- National Insurance — the carve-back intact on the same 1991-descended clause [1,2,3,4,5,6,7,8][20,1,2,7], marked down for a filed document that states two different compulsory-excess rates [2].
- ICICI Lombard — carve-back intact [1,2,3,4,5,6,7,8], but its excess is applied to defence costs as well as damages [3] and the wording still speaks in service-tax-era language [3]. A boundary dispute here is expensive before it is resolved.
- IndusInd — a good clause you may not be allowed to buy. Carve-back intact [1,2,3,4,5,6,7,8]; plastic surgeons excluded from eligibility [9].
- HDFC ERGO Mediserve — the flat exclusion [1,2,3,4,5,6,7,8] inside the market's most modern exclusion set [8], on the only fully published document set [8,11]. Wrong shape for reconstructive work; the best-evidenced policy in the market for a practice with no cosmetic component.
- Oriental and United India — flat exclusions [1,2,3,4,5,6,7,8] on documents you largely cannot check: Oriental's wording survives only in the Wayback Machine [7], and United India's doctors' prospectus opens by describing cover for the accidental breakage of plate glass [21].
- Generali Central — a published specialty bar [10] with no published wording behind it [10]. Last on this dimension because there is nothing to read.
Not ranked, because the prior question fails: Tata AIG's published wording excludes bodily injury outright [13]; Bajaj's defines Loss to exclude bodily injury [14]; Go Digit's professional-liability paper sets everything from the schedule with nothing comparable published in advance [22]; and SBI General has no doctors' PI product at all [15]. The IMA Professional Protection Schemes are a different instrument entirely — mutual pools outside IRDAI regulation and outside the Insurance Ombudsman [24,25], with scope questions such as acts beyond one's qualification or training decided by scheme rules rather than filed exclusions [23].
7. How we know, and what this comparison cannot do
Every cell above comes from a filed wording, prospectus, customer information sheet or carrier product page, read in full. Where an insurer does not serve its own documents we recovered them from IRDAI's library, a bank distributor, an intermediary or the Wayback Machine, and where nothing exists we have said so rather than filled the gap with broker copy.
What we cannot do is tell you how these clauses behave when a cosmetic claim is actually made, because no Indian regulator publishes claim-settlement data for professional indemnity in any form [16,17,18,19]. Anyone offering you a cosmetic-claims league table for these insurers has invented it. The honest available signal is the litigation record — insurers contested liability or coverage in roughly 22 of the 25 judgments we read [26] — and the wordings themselves, which is what this page compares.
If your list is mixed, the single most useful hour you can spend is getting your procedures classified in the proposal and the wording sent to you by UIN. Then read the rest of the terms in our clause-by-clause comparison of every Indian doctors' policy, check where your carrier sits on the post-expiry reporting window — a cosmetic dispute rarely arrives promptly [26] — and on the documentation-transparency ranking, which decides whether you can verify any of this yourself. If the wording you are offered is one of the three that may not respond to malpractice at all, start instead with the policies that exclude bodily injury, then come back to the full best and worst ranking of professional indemnity insurance for doctors and, if you also operate outside aesthetics, the surgeons' page.
Frequently asked questions
Does professional indemnity cover cosmetic surgery in India?
I do reconstruction after burns and trauma. Am I covered?
Which insurer will not cover plastic surgeons at all?
Where exactly is the line between reconstructive and cosmetic?
Is HDFC ERGO Mediserve a bad choice for an aesthetic practice?
Why is this specialty treated differently from the rest of medicine?
Does a hospital policy or the clinic's cover solve this?
What should I do if my current insurer will not answer in writing?
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.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
- 2.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
- 3.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
- 4.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
- 5.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
- 6.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
- 7.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
- 8.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
- 9.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
- 10.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
- 11.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
- 12.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
- 13.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
- 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.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
- 16.IRDAI — IRDAI Annual Report 2024-25. https://irdai.gov.in/documents/37343/366637/%E0%A4%86%E0%A4%88%E0%A4%86%E0%A4%B0%E0%A4%A1%E0%A5%80%E0%A4%8F%E0%A4%86%E0%A4%88+%E0%A4%B5%E0%A4%BE%E0%A4%B0%E0%A5%8D%E0%A4%B7%E0%A4%BF%E0%A4%95+%E0%A4%B0%E0%A4%BF%E0%A4%AA%E0%A5%8B%E0%A4%B0%E0%A5%8D%E0%A4%9F+_+IRDAI+Annual+Report+2024-25.pdf/06f02832-66a3-6308-a16f-f46a6640fc93Tier A · Regulator / court / filed document · Published 2025-12-30 · Accessed 2026-10-02
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- 20.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
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