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What Is Not Covered by Doctors' Indemnity Insurance in India?

By Best Worst Insurance Editorial TeamUpdated 25 July 2026

Some exclusions are universal and some are a lottery, and Indian doctors are rarely told which is which. Universal first: every doctors' indemnity wording we read in India excludes criminal acts, and every one excludes fines and penalties [1,2,3,4,5,6] — so the branch of a medico-legal crisis that can take your liberty is the branch no private policy funds. Then the lottery. Cosmetic surgery is excluded everywhere, but New India, National, ICICI Lombard, IFFCO Tokio and IndusInd carve back burns, trauma and scar repair while United India, Oriental and HDFC ERGO Mediserve exclude cosmetic work flat [1,2,3,4,5,7,8,9], meaning a burns-reconstruction surgeon is insured at one counter and uninsured at the next. Two insurers will not write plastic surgeons at all [10][11]. And at two carriers the published wording arguably excludes the core malpractice peril itself [12][6].

Exclusions: what is universal, and what changes by carrier

Read from the filed wordings. "Universal" means we found it in every doctors' PI wording examined; everything else varies, and the variation is where doctors get caught.

ExclusionHow widely it appliesThe practical effect
Criminal acts, fines and penaltiesUniversal [1,2,3,4,5,6]A prosecution under BNS section 106 or the PCPNDT Act is funded by you, not the insurer [17][18]
Practice under the influence of intoxicantsUniversal across the PSU-lineage wordingsNo argument available at claim stage
Acts before the retroactive dateUniversal on claims-made coverOne lapsed renewal can push years of practice outside cover [9]
Cosmetic surgeryExcluded everywhere, but five carriers carve back burns, trauma and scar repair and three do not [1,2,3,4,5,7,8,9]A reconstructive surgeon is covered at New India and uninsured at Oriental for the same operation
Plastic surgeons as a classIndusInd will not insure them at all [10]; Generali Central excludes them from covered professions [11]Eligibility, not exclusion — you cannot buy the policy in the first place
General anaesthesia given by a dentist outside a hospitalPSU-lineage wordings [2,1,4]Chairside sedation in a standalone dental clinic falls outside cover
Anaesthesia not administered by a registered anaesthesiologistHDFC ERGO Mediserve [9]Surgeon-administered or nurse-administered sedation is outside the newest wording in the market
Bodily injury itselfTata AIG [12] and, by definition, Bajaj [6]The peril the policy exists to cover cannot be verified as covered from any public document
Deliberate, conscious or intentional disregardPSU-lineage wordings and IndusIndTested and upheld — the doctor personally bore the award [16]

1. The universal exclusions

Three things are excluded by every doctors' indemnity wording sold in India, and no shopping around fixes them.

Criminal acts, and fines and penalties. We found both in every wording we read [1,2,3,4,5,6]. This is the exclusion doctors underestimate most, because Indian medical practice carries real criminal exposure: section 106(1) of the Bharatiya Nyaya Sanhita punishes causing death by a rash or negligent act, with a reduced term of up to two years where the act is done by a registered medical practitioner performing a medical procedure [17], and section 23 of the PCPNDT Act carries up to three years plus suspension of registration once charges are framed [18][18]. Your policy defends the consumer complaint. It does not defend you in either of those.

Practice under the influence of intoxicants, and acts committed before the retroactive date. The second is not really an exclusion so much as the architecture of claims-made cover, but it functions as one: a single lapsed renewal can push years of past practice outside the policy, because HDFC ERGO preserves the retroactive date only on unbroken renewal [9] and Go Digit requires documentary evidence of expiring cover before granting the back years [19].

Beyond those, the standard PSU-lineage set adds third-party property damage, AIDS and HTLV-III claims, contractual liability, statutory non-compliance, pure financial loss, libel, slander and mental anguish, war and nuclear risks, genetic injuries from x-ray or radioactive treatment, and employee injury [14,1,2,8].

2. The cosmetic carve-back, and why it is the exclusion that matters most

Every Indian wording excludes cosmetic surgery. What differs is whether reconstruction survives the exclusion. New India, National Insurance, ICICI Lombard, IFFCO Tokio and IndusInd exclude cosmesis but expressly carve back burns, trauma reconstruction and scar repair. United India, Oriental and HDFC ERGO's Mediserve exclude cosmetic surgery flat, with no carve-back at all [1,2,3,4,5,7,8,9].

The practical consequence is stark. A surgeon reconstructing a burns contracture is performing insured work at New India and — arguably — uninsured work at Oriental, on identical facts, for an identical patient. Nothing in either brochure tells you this. It is in the exclusions clause of the filed wording, which at Oriental survives publicly only in the Wayback Machine [8].

For plastic surgeons the problem starts earlier, at eligibility rather than exclusion. IndusInd will not insure plastic surgeons at all under its doctors' product [10], and Generali Central's covered-professions list names radiologists, pathologists, GPs, consultants, surgeons including dentists and anaesthetists — but states that plastic and cosmetic surgeons are not covered [11]. Meanwhile the 1991 Market Agreement that still shapes PSU pricing rated plastic surgeons and anaesthetists in its highest band at 3.0 per mille [14] — priced as the riskiest, and refused outright by two insurers.

3. Newer wordings exclude more, not less

The instinct that a 2025-26 policy must be better than a 1991-lineage one is wrong on exclusions.

Exclusions in HDFC ERGO Mediserve, the newest doctors-specific wording in the Indian market (FY2025-26), that the 1991-lineage wordings simply do not contain.

Modern exclusionWho it bites
Opioid and narcotics liability, including failure to warn [9]Pain physicians, palliative care, post-operative prescribing
E-cigarette and vaping liability [9]Cessation and respiratory practice
Clinical trials [9]Any doctor who is also an investigator
IVF and wrongful-life claims [9]Fertility practice — a growing and heavily litigated area in India
Anaesthesia unless by a registered qualified anaesthesiologist [9]Day-care surgery, dental sedation, small nursing homes without a dedicated anaesthetist
Treatment related to AIDS, hepatitis C and weight loss [9]Broader than the condition-based AIDS exclusions elsewhere — arguably bites physicians who treat HIV-positive patients
Cosmetic surgery with no burns or trauma carve-back [1,2,3,4,5,7,8,9]Reconstructive surgeons, who are covered for the same work at five other carriers

Read that list against a modern Indian practice. A pain physician prescribing opioids, a fertility specialist, a doctor who is also a trial investigator, and a day-care surgery unit where the surgeon supervises sedation are all closer to an exclusion at HDFC ERGO's Mediserve than they are at a PSU counter [9]. That same product is the best-documented in India — the only one whose insurer publishes wording, prospectus and Customer Information Sheet together [9,20] — and it also carries the harshest reporting bar in the market, a zero-day post-expiry window [9]. Transparency and generosity are different things.

4. The exclusions that are really about the insuring clause

Two carriers present a deeper problem than any exclusion list. Tata AIG's published Professional Shield — the product behind its doctors' marketing page — excludes bodily injury outright, which is the core malpractice peril [12]; its dedicated dentist page repeats the point in its own exclusions, stating that claims related to third-party bodily injury or property damage are not covered [15]. Bajaj's filed wording defines "Loss" as financial injury other than that arising out of bodily injury or property damage, so read literally the base wording does not respond to a patient's injury at all [6].

At both, doctor cover must ride on endorsements that are not published anywhere. That is not an exclusion you can plan around; it is an inability to verify what you bought. SBI General resolves the question differently by having no doctors' PI product at all, confirmed against its own filed UIN list [21], and Generali Central publishes no primary document whatsoever for the product brokers sell on its paper [11].

5. The vague exclusion that has actually been used

Buried in the PSU-lineage wordings and IndusInd's is an exclusion for a "deliberate, conscious or intentional disregard" of the need to take all reasonable steps to prevent claims. It reads like boilerplate. It is not. A doctor held liable for a delivery-related death had his indemnity claim repudiated under that clause, and a State Commission upheld the repudiation — he personally bore roughly ₹3.1 lakh [16][16]. It is one of only three outright repudiations upheld across the 25 judgments we catalogued [22,23,16,24], and the width of the wording gives an insurer real argument room.

The other two upheld repudiations are worth naming here because they behave like exclusions in practice. One was a nine-year-late notification [23]; the other was a hospital that had bought a legal-liability policy instead of professional indemnity, leaving a ₹20 lakh claim entirely unpaid [24]. Full analysis in why indemnity claims get rejected.

6. The IMA schemes exclude differently

If you hold IMA Professional Protection Scheme membership instead of, or alongside, a policy, the exclusion logic changes completely — these are mutual member-contribution pools, not IRDAI-regulated insurance, with no Ombudsman recourse [25,26].

The IMA Professional Protection Schemes are not insurance, and their exclusions run on different logic. Gujarat publishes the fullest list.

What the scheme will not coverScheme
All activity outside the state, medical camps, acts beyond one's qualification, acts against the law, misbehaviour or alleged-rape complaints, billing disputes, and non-modern-medicine procedures [27]IMA Gujarat
The hospital, nursing home, clinic or laboratory — only the member is ever covered [27]IMA Gujarat, and the schemes generally
Anything after you leave or lapse — no tail or run-off exists in any scheme document [28,26,27,29]All IMA PPS variants
Cover forfeited if you reply to a legal notice yourself or through your own advocate without the scheme secretary's permission [29]IMA Kerala
Renewal refusable after five litigations [27]IMA Gujarat
Anything retrospective — protection runs only forward from the date the fee is realised [26]IMA NPPS

The two that catch members hardest are procedural rather than substantive. IMA Kerala's rules provide that a member who replies to a legal notice personally or through their own advocate, without the scheme secretary's permission, loses coverage [29]. And no scheme document provides any tail: protection attaches to incidents occurring during active membership, so leaving or lapsing ends defence for suits filed later about incidents while you were a member [28,26,27,29]. The full comparison is at IMA PPS vs private insurance.

7. What to check before you buy

  • Get the exclusions clause of the actual wording, not the brochure. At New India and Oriental that means asking, because neither publishes it usably [1,30][8].
  • If you do reconstructive work, confirm the burns and trauma carve-back in writing [1,2,3,4,5,7,8,9].
  • If you supervise sedation, check the anaesthesia clauses at both ends — the PSU dentist-GA exclusion [2,1,4] and HDFC's registered-anaesthesiologist requirement [9].
  • If you prescribe opioids, run trials or do fertility work, read the newest wordings hardest, because that is where those exclusions live [9].
  • If your clinic is a separate entity, buy it separate paper [12][24].
  • Never settle or admit anything without written consent, and watch for a hammer clause [6,12,19].

Frequently asked questions

What is not covered by professional indemnity insurance for doctors in India?
Universally: criminal acts, fines and penalties [1,2,3,4,5,6], practice under intoxicants, and acts before your retroactive date. Then the carrier-specific set — cosmetic surgery, with a burns-and-trauma carve-back at five insurers and none at three [1,2,3,4,5,7,8,9]; general anaesthesia by a dentist outside a hospital [2,1,4]; and at the newest wording in the market, opioids, vaping, clinical trials, IVF and non-anaesthesiologist anaesthesia [9].
Does indemnity insurance cover criminal cases against doctors?
No. Every Indian doctors' PI wording we read excludes criminal acts, and every one excludes fines and penalties [1,2,3,4,5,6]. That matters because a doctor can be prosecuted for causing death by negligence under section 106(1) of the Bharatiya Nyaya Sanhita, which carries up to two years for a registered medical practitioner [17], and separately under the PCPNDT Act [18]. Doctors cite this as their reason for keeping IMA scheme membership alongside a policy [13]. Full treatment at criminal cases and your policy.
Is cosmetic surgery covered by doctors’ indemnity insurance in India?
Pure cosmesis is excluded everywhere. The difference is the carve-back: New India, National, ICICI Lombard, IFFCO Tokio and IndusInd preserve cover for burns, trauma reconstruction and scar repair, while United India, Oriental and HDFC ERGO Mediserve exclude cosmetic surgery flat with no carve-back at all [1,2,3,4,5,7,8,9]. So the same burns-reconstruction operation is inside cover at one insurer and outside it at another.
Can a plastic surgeon get indemnity insurance in India?
Yes, but not everywhere — and this is an eligibility question, not an exclusion. IndusInd (formerly Reliance General) will not insure plastic surgeons at all under its doctors' policy [10], and Generali Central lists plastic and cosmetic surgeons as not covered while listing surgeons generally as covered [11]. Check eligibility before you compare price — see professional indemnity for surgeons.
Does indemnity insurance cover out-of-court settlements?
Not on your own initiative. Every wording requires the insurer's written consent before you admit liability, make an offer or settle, so a quiet private settlement can leave the policy paying nothing. Three carriers go further with a hammer clause — Bajaj, Tata AIG and Go Digit can cap liability at a settlement figure you refused, plus costs to that date [6,12,19]. Notify and get consent before you do anything, not after.
Does my indemnity policy cover telemedicine and teleconsultation?
Only HDFC ERGO's Mediserve names telehealth providers in its insured definition, and it puts a telehealth sublimit inside the main limit [9,20]. The 1991-lineage PSU wordings predate the question entirely [14,1,2,8] and neither include nor exclude it expressly. Doctors ask about this constantly and no carrier answers it clearly on a product page — get it confirmed in writing on your schedule.
Are IVF and fertility treatments covered by indemnity insurance?
At HDFC ERGO's Mediserve, expressly not — IVF and wrongful-life claims are excluded outright [9]. The older PSU-lineage wordings contain no IVF exclusion, which means fertility work is more securely covered on 1991-vintage paper than on the newest product in the market. Newer paper is not automatically better paper.
Is my clinic or hospital covered by my personal indemnity policy?
No. Establishments need separate paper at most carriers [3], Tata AIG states that an entity named as Policyholder is not itself an Insured [12], and the IMA schemes cover only the member and never the hospital, nursing home, clinic or laboratory [27]. A Gujarat hospital's ₹20 lakh claim failed outright because it had bought a legal-liability policy instead [24].

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.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. 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. 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. 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.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. 6.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
  7. 7.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
  8. 8.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
  9. 9.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
  10. 10.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
  11. 11.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
  12. 12.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
  13. 13.r/indianmedschool — Need help finding a good indemnity insurance company (dental resident thread). https://www.reddit.com/r/indianmedschool/comments/1hvye0a/need_help_in_finding_good_indemnity_insurance/Tier C · User-generated (reported by users) · Published 2025-01-07 · Accessed 2026-07-17
  14. 14.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
  15. 15.Tata AIG General Insurance — Professional Indemnity Insurance for Dentists — product page. https://www.tataaig.com/sme-insurance/professional-indemnity-insurance/dentistTier B · Reputable publisher / carrier official · Accessed 2026-07-25
  16. 16.West Bengal SCDRC (via IndianKanoon) — Dr. Shymal Baran Mondal v. National Insurance (WB SCDRC, 2019). https://indiankanoon.org/doc/148807510/Tier A · Regulator / court / filed document · Accessed 2026-07-17
  17. 17.India Code (Government of India) — The Bharatiya Nyaya Sanhita, 2023. https://www.indiacode.nic.in/handle/123456789/21420Tier A · Regulator / court / filed document · Published 2023-12-25 · Accessed 2026-07-25
  18. 18.Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 (via IndianKanoon) — Section 23, PCPNDT Act 1994 — offences and penalties. https://indiankanoon.org/doc/95584082/Tier A · Regulator / court / filed document · Published 1994-09-20 · Accessed 2026-07-25
  19. 19.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
  20. 20.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
  21. 21.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 2026-07-08
  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.NCDRC (via IndianKanoon) — Dr. Tarunjit Dutta Roy v. New India Assurance (NCDRC, 2013). https://indiankanoon.org/doc/194587303/Tier A · Regulator / court / filed document · Accessed 2026-07-17
  24. 24.Gujarat SCDRC (via IndianKanoon) — K.M.G General Hospital v. United India Insurance (Gujarat SCDRC, 2022). https://indiankanoon.org/doc/108725571/Tier A · Regulator / court / filed document · Accessed 2026-07-17
  25. 25.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
  26. 26.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
  27. 27.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
  28. 28.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
  29. 29.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
  30. 30.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