BestWorstInsurance

India · Doctors indemnity · Questions

What Is a Claims-Made Policy and a Retroactive Date in Doctors' Indemnity Insurance?

By Best Worst Insurance Editorial TeamUpdated 25 July 2026

Indian doctors' indemnity is written on a claims-made basis, which means the policy responds to claims first made against you during the policy period — not to treatment you gave during it. The bridge back to your earlier practice is the retroactive date, and it is fragile. HDFC ERGO's Mediserve preserves the retroactive date only on continuous renewal without a break [1], and Go Digit will grant back years only against documentary evidence of expiring cover running to that date [2]. Bajaj's published wording has no retroactive machinery at all — both the incident and the claim must fall inside the policy period [3]. And the window to report after cover ends runs from IFFCO Tokio's 90 days on either side's cancellation [4] to HDFC ERGO's zero [1]. This is the mechanism that decides whether a claim about a 2019 operation is covered in 2026.

Retroactive cover and reporting windows, carrier by carrier

The reporting window is the clause that decides whether a claim arriving after you switched or retired is covered at all. It is not in any brochure.

CarrierRetroactive machineryReporting window after cover ends
New India, National, OrientalClaims-made with a retroactive date, plus a notification-extension clause turning circumstances into deemed claims, capped by the Limitation Act90 days if no replacement cover is taken [5,6,7,8,4,9]
United IndiaClaims-made with a retroactive date per its CISNot stated in the CIS or prospectus — the operative wording is not published anywhere [14]
ICICI LombardPeriod runs from the retroactive date to expiry; a notified circumstance becomes a deemed claim only if the actual claim follows within 3 years [8]90 days where no replacement cover is taken [5,6,7,8,4,9]
IFFCO TokioRetroactive date runs from inception and thereafter renewed without break90 days, triggered by cancellation or non-renewal by either side — the broadest trigger we found [4]
IndusInd (ex-Reliance)Claims-made with a retroactive date; retro continuity on renewal is not addressed in the wording, which is a gap90 days where no replacement cover is taken [5,6,7,8,4,9]
HDFC ERGO MediserveClaims-made and reported; the retroactive date survives only on continuous renewal with no break [1]None. No claim may be reported after expiry [1]
BajajNone in the base wording — the incident and the claim must both fall inside the policy period, though the doctors' proposal form asks for a retroactive date [3]30 days, free, but only if Bajaj cancels or refuses renewal, and only for incidents already reported [3]
Tata AIGClaims-made and reported; the breach must post-date the retroactive date90 days, but only if the insurer cancels or non-renews, and void if cover is replaced [15]
Go DigitRetroactive cover conditional on documentary evidence of expiring cover back to the retroactive date [2]Schedule variables not fixed in the filing, and unavailable if the policy was cancelled or avoided
Generali CentralRetroactive date restoration where there is no break, per the broker page that is the only public description [16]Reporting no later than 60 days after becoming aware, or 60 days after expiry if not renewed — secondary only
IMA PPS schemesOccurrence during active membership — the opposite trigger to every insurance policy [10,11,12,13]None. No tail or run-off exists in any scheme document [10,11,12,13]

1. The trigger most doctors have backwards

Ask a doctor which policy covers a complaint about an operation performed in 2019, and most will say the 2019 policy. On Indian doctors' indemnity paper, that is wrong. These are claims-made policies: the policy that responds is the one in force when the claim is first made against you, which for a 2019 operation might be the 2026 policy, or the 2031 one.

That inversion is not academic in India, because the lag between treatment and complaint is long. Indian dental malpractice cases decided between 2018 and 2022 took an average of four years from the treatment complained of to judgment [17], with a mean wait for final judgment of 1,945 days [18]. One NCDRC obstetric order came roughly sixteen years after the delivery [19]. Under the Consumer Protection Act a complaint must be filed within two years of the cause of action, but a commission may condone delay for sufficient cause with reasons recorded [20] — and it frequently does.

The bridge back across those years is the retroactive date.

2. The retroactive date, and why it is fragile

The retroactive date is the earliest treatment date the policy will look back to. Acts before it are excluded at every carrier. On paper it stays fixed at your first inception and rolls forward with each renewal; in the wordings, it is conditional.

HDFC ERGO's Mediserve preserves the retroactive date only on continuous renewal without a break [1]. One lapsed day and every year of past practice falls outside cover. Go Digit makes retroactive cover conditional on evidence of expiring cover running back to the retroactive date, and its continuous-cover forgiveness applies only where Digit was the insurer throughout [2] — so a doctor who cannot document unbroken prior insurance does not get the back years, whatever the truth of their history. IndusInd's wording does not address retro continuity on renewal at all, which is a gap rather than a rule.

Bajaj is the outlier: its published base wording contains no retroactive machinery whatsoever, requiring both the incident and the claim to fall inside the policy period, even though its own doctors' proposal form asks for a retroactive date — implying an endorsement whose filed wording is not public [3]. A doctor buying Bajaj on the published paper alone has no cover for any past act at all.

Four situations where the claims-made trigger produces an outcome doctors do not expect.

SituationWhat happens
You switch insurers and the new policy starts a fresh retroactive dateEverything you did before the new date is uninsured. Ask the new insurer to match your original retroactive date in writing before you cancel the old policy
You let cover lapse for a month, then reinstateAt HDFC ERGO the retroactive date resets, so all past practice falls out [1]; at Go Digit you must document the unbroken prior cover you no longer have [2]
You retire, and a complaint arrives four months laterOutside the 90-day window at every carrier that offers one [5,6,7,8,4,9], and outside HDFC ERGO's entirely [1]. Indian claims routinely arrive years after treatment [19]
You report a worrying incident but no claim ever formally arrivesAt Bajaj that notice is expressly not notice of a claim [3]; at ICICI the deemed-claim protection expires 3 years after the notification is accepted [8]
Several patients sue over one incident, spread across yearsTreated as a single claim made when the first was, and the series is guillotined 3 years after that first claim [5,6,7,8,4,9]
You leave the IMA scheme and a suit is filed later about an incident while you were a memberNo scheme document provides any tail — leaving or lapsing ends all rights and privileges [10,11,12,13]

3. The reporting window, and the worst clause in the Indian market

When a policy ends, most carriers allow a short grace period in which a claim can still be reported. This is the extended reporting period, and it varies more than any other term in the product.

Ninety days is the standard: New India, National, Oriental, ICICI Lombard, IFFCO Tokio and IndusInd all provide it, generally on condition that no replacement cover has been taken [5,6,7,8,4,9]. IFFCO Tokio has the best version in India, because its 90 days are triggered by cancellation or non-renewal by either side [4] — most carriers grant the window only when the insurer ends the policy, which excludes the commonest real-world case of a doctor switching or forgetting.

That asymmetry is exactly where Bajaj and Tata AIG sit. Bajaj gives 30 days, free, but only if the company cancels or refuses renewal, and only for incidents already reported during the period [3]. Tata AIG gives 90 days but only if the insurer cancels or non-renews, and the window is void if cover is replaced [15]. In both, a doctor who lapses or moves gets nothing.

HDFC ERGO's Mediserve is the harshest reporting bar we found anywhere in the market: the claim must be intimated within 90 days or during the policy period, whichever is earlier, and "no claims should be reported post expiry of Policy" [1]. Zero days. That the same product is the best-documented in India — the only one publishing wording, prospectus and CIS together [1,21] — is the sharpest illustration in this vertical that transparency and generosity are unrelated.

4. Circumstances, deemed claims and the three-year guillotines

Between "nothing has happened" and "I have been sued" sits the circumstance: an outcome you know may generate a complaint. The PSU-lineage wordings handle it with a notification-extension clause that converts a properly notified circumstance into a deemed claim, capped by the Indian Limitation Act. That is the mechanism to use when a case goes badly and you expect trouble.

Two carriers restrict it in ways worth knowing. Bajaj states outright that notice of an incident is not notice of a claim [3] — a doctor who reports a worrying event and assumes the job is done may find the claim itself was never validly notified, which is precisely how the top repudiation ground in the Indian record is triggered [22]. ICICI Lombard treats a notified circumstance as a deemed claim only if the actual claim follows within three years of the notification being accepted [8]; a complaint arriving in year four is outside it.

A second three-year guillotine runs alongside. New India, National, Oriental, ICICI Lombard, IFFCO Tokio and IndusInd all carry a claims-series clause treating related claims from one originating cause as a single claim made when the first was, with the series cut off three years after that first claim [5,6,7,8,4,9]. That has two effects: the whole cluster shares one Any One Accident limit rather than several — which is an argument for a 1:1 ratio, covered in the AOA:AOY ratio explained — and late members of the series can fall outside cover entirely.

5. The IMA schemes run on the opposite logic

If you rely on IMA Professional Protection Scheme membership, none of the above applies, and the replacement is not better. Scheme protection attaches to incidents occurring during active membership — an occurrence trigger, the opposite of every insurance policy's claims-made form — and no scheme document provides any tail or run-off: leaving or lapsing ends all rights and privileges, and dropped members rejoin as new [10,11,12,13]. NPPS protection also runs only forward from the date the membership fee is realised, with nothing retrospective [11].

The occurrence trigger is genuinely superior in one respect: an incident during membership is protected even if the complaint arrives much later, which is what a doctor actually wants. It is undermined by the absence of any tail and by the discretion built into the schemes, which are not IRDAI-regulated and offer no Insurance Ombudsman recourse [23,11].

6. The rules that follow from all of this

  • Renew before expiry, every year, with no gap. This single discipline protects your retroactive date [1] and your reporting window [3] at once.
  • When switching insurers, get the retroactive date matched in writing on the new schedule before cancelling the old policy — and never let the two policies fail to overlap.
  • Keep every schedule from every year, forever. Go Digit will require documentary evidence of prior cover [2], and insurers denied that a policy existed in three of our 25 judgments [22].
  • Notify circumstances as well as claims, and notify them separately [3][8].
  • Treat retirement as the moment of maximum exposure, not minimum. Ninety days is the most protection available [5,6,7,8,4,9], claims arrive years later [19], and liability now survives death up to the value of the estate [24].
  • Check the reporting window before the premium. It is the clause most likely to decide whether you are covered, and it is the clause least likely to appear in a quote comparison. Our carrier-by-carrier verdict is in the best and worst ranking.

Frequently asked questions

What does claims-made mean in professional indemnity insurance?
It means the policy responds to claims that are first made against you in writing during the policy period, for acts committed after a retroactive date — not to treatment you happened to give while insured. So the policy that has to answer a complaint about a 2019 operation is your current one, and only if your cover has run continuously back past 2019.
What is a retroactive date on a doctor’s indemnity policy?
It is the earliest date of treatment the policy will look back to. Acts before it are excluded outright at every carrier. On unbroken renewal it usually stays fixed at your first inception, but that continuity is conditional: HDFC ERGO preserves it only on continuous renewal without a break [1], Go Digit requires documentary evidence of the expiring cover before granting the back years [2], and IndusInd's wording does not address retro continuity on renewal at all.
What happens if my indemnity policy lapses?
Two things, both bad. Your retroactive date can reset, pushing every year of past practice outside cover [1], and a lapse initiated by you rather than the insurer forfeits the extended reporting period at Bajaj and Tata AIG, which grant it only when the insurer cancels [3][15]. IFFCO Tokio is the exception, triggering its 90 days on cancellation by either side [4].
How long after my policy expires can I report a claim?
Ninety days at New India, National, Oriental, ICICI Lombard, IFFCO Tokio and IndusInd, provided no replacement cover is taken [5,6,7,8,4,9]. Thirty days at Bajaj, and only if Bajaj cancelled [3]. Ninety at Tata AIG, but only if Tata AIG terminated, and void if you replaced the cover [15]. Nothing at all at HDFC ERGO Mediserve, whose wording states that no claims should be reported post expiry [1].
Can I get run-off or tail cover when I retire in India?
Not as a published product. What exists is the extended reporting period built into the wording, which is 90 days at best [5,6,7,8,4,9] and zero at one carrier [1]. Given that Indian medical-negligence claims routinely surface years after treatment — one NCDRC order arrived roughly sixteen years after the delivery complained of [19] — retirement is the point of maximum exposure, and the Supreme Court has now held that proceedings survive a doctor's death, with heirs substitutable up to the value of the estate [24].
If I switch insurers, do I keep my retroactive date?
Only if the new insurer agrees to match it, in writing, on the schedule. Nothing carries it across automatically. Ask for the retroactive date to be set to your original first inception, get it confirmed on the schedule before you cancel the old policy, and keep the old schedules as proof — Go Digit will demand documentary evidence of the expiring cover [2], and insurers have denied a policy ever existed in three of the 25 judgments we catalogued [22].
Is reporting an incident the same as making a claim?
No, and at two carriers that gap is explicit. Bajaj's wording states that notice of an incident is not notice of a claim [3], and ICICI Lombard treats a notified circumstance as a deemed claim only where an actual claim follows within three years of the notification being accepted [8]. Report both, separately, and get both acknowledged in writing.
Does the IMA Professional Protection Scheme work the same way?
No — it uses the opposite trigger. Protection attaches to incidents occurring during active membership rather than to claims made during a policy period, and no scheme document provides any tail or run-off, so a doctor who leaves or lapses loses defence for suits filed later about in-membership incidents [10,11,12,13]. NPPS protection also runs only forward from the date the fee is realised, with nothing retrospective [11]. See IMA PPS vs private insurance.

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. 1.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
  2. 2.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
  3. 3.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
  4. 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. 5.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
  6. 6.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
  7. 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. 8.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
  9. 9.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
  10. 10.IMA Karnataka PPS (KPPS) — Registered Constitution of IMA-KPPS. https://www.imakppsbengaluru.org/PDF/Constitution-Of-IMA-KPPS.pdfTier B · Reputable publisher / carrier official · Accessed 2026-07-08
  11. 11.Indian Medical Association (national) — IMA National Professional Protection Scheme (NPPS) — brochure. https://www.ima-india.org/branch/cms/images/8746_NPPS.pdfTier B · Reputable publisher / carrier official · Accessed 2026-07-08
  12. 12.IMA Gujarat State Branch — Professional Protection Scheme — Gujarat State Branch rules. https://imarajkot.org/uploads/file/professional-protection-scheme-gujarat-state-branch.pdfTier B · Reputable publisher / carrier official · Accessed 2026-07-08
  13. 13.IMA Kerala State Branch — IMA Kerala Professional Protection Scheme — scheme page and rules. https://www.imakerala.com/schemeTier B · Reputable publisher / carrier official · Accessed 2026-07-08
  14. 14.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
  15. 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. 16.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
  17. 17.Journal of International Society of Preventive & Community Dentistry — Vadde et al. Indian Dental Malpractice Claims and Lawsuits: A Medico-Legal Analysis (2024). https://pmc.ncbi.nlm.nih.gov/articles/PMC11458094/Tier A · Regulator / court / filed document · Published 2024-09-01 · Accessed 2026-07-25
  18. 18.Journal of Forensic and Legal Medicine — Thavarajah R, Vijayakumar S, Bhavanisankar P. The Indian dental litigation landscape: an analysis of judgments on dental negligence claims in Indian Consumer Redressal Forums. J Forensic Leg Med 2019;68:101863. https://pubmed.ncbi.nlm.nih.gov/31494526/Tier A · Regulator / court / filed document · Published 2019-11-01 · Accessed 2026-07-25
  19. 19.DailyRounds (reporting NCDRC) — NCDRC orders ₹1 crore against Indraprastha Apollo Hospitals and Dr Sohini Verma (order dated 22 April 2015; delivery 10 June 1999). https://www.dailyrounds.org/blog/15-years-after-delivery-ncdrc-orders-rs-1-crore-as-compensation-for-medical-negligence/Tier B · Reputable publisher / carrier official · Published 2015-04-22 · Accessed 2026-07-25
  20. 20.Consumer Protection Act 2019, section 69 (via IndianKanoon) — Section 69, Consumer Protection Act 2019 — Limitation period. https://indiankanoon.org/doc/36183074/Tier A · Regulator / court / filed document · Published 2019-08-09 · Accessed 2026-07-25
  21. 21.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
  22. 22.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
  23. 23.Indian Journal of Ophthalmology (via PMC) — IJO editorial on medico-legal protection and the IMA/AIOS Professional Protection Scheme (Jan 2020). https://pmc.ncbi.nlm.nih.gov/articles/PMC6951135/Tier A · Regulator / court / filed document · Published 2020-01-01 · Accessed 2026-07-17