Medicolegal Insurance for Plastic Surgeons and Specialist Practices

Medicolegal Insurance and Professional Indemnity in Australia for Plastic Surgeons

Every plastic surgeon and specialist practice in Australia operates under a significant level of medicolegal risk. From routine procedures to complex reconstructions, patients may experience complications, dissatisfaction, or unexpected outcomes that can lead to complaints or claims. Having the right medicolegal insurance and practice systems in place is not only a legal safeguard — it is an essential part of running a sustainable, reputable practice.

This article provides an overview of the major medical indemnity insurers in Australia, specialist brokers who support surgeons, and practical tips for reducing medicolegal exposure. It also draws on international experience and closed claim studies to highlight the patterns, pitfalls, and best practices every surgeon should know. By understanding your insurance options and implementing effective systems, you can protect both your practice and your peace of mind.

Medical Indemnity Insurers in Australia

There are FIVE key providers of medicolegal insurance professional indemnity in Australia for doctors and medical professionals

1. AVANT – avant.org.au – insures about 300 plastic surgeons
2. TEGO – Berkshire Hathaway Specialty Insurance (distributed by Tego Insurance) – tego.com.au – newest medicolegal insurer in Australia
3. MDA National – mdanational.com.au
4. MIGA – Medical Insurance Group Australia – miga.com.au
5. MIPS – Medical Indemnity Protection Society – mips.com.au

Use a Medical Indemnity Specialist Broker

Here are some Expert insurance brokers that can help medical practitioners and plastic surgeons with Medicolegal Insurance – they may help you get a better deal and manage any claims.

• Medical and General Risk Solutions – Chris Mariani
• Experience Insurance Services
• Whitbread

Different Types of Medicolegal Insurance for a Private Specialist Practice

You may need a wide range of Medicolegal Insurance for your Practice, including:

1. Doctor’s medicolegal insurance
2. Practice medicolegal insurance
3. Cover for associates and staff
4. Tail or run-off cover for retirement
5. Cyber liability
6. Public liability
7. Employment practices liability
8. Directors & Officers cover

Medicolegal Statistics made easy – Here’s what you could expect….

Plastic Surgeons who are starting out and winding down their careers tend to have more patient claims. This may be because they lack the full time support of a practice. This is usually surgeons billing less than $1m in surgeon fees.  Busy, mid-career surgeons tend to have more practice support, more expertise and better health – which can reduce medicolegal risk.

For an average plastic surgeon:

• 1 in 10 patients has a Suboptimal Result – a concern like slow healing
• 1 in 100 patients is Unhappy with the Result and wants some form of compensation
• 1 in 1000 is so unhappy that they want to sue you – Patient Litigation for $$$$$$

There are some exceptional, conservative, risk-averse surgeons who have never had a patient litigation claim in their career.

Manage Your Higher Patient RISKS – High BMI, Smoking, Comorbidities, Post Weight loss, BBL, Revision Surgeries, Startup and Closing down practices –

Don’t be Superman or Mother Theresa – If you can’t help or shouldn’t help the patient, refer them elsewhere.

Remember – You never regret the patient you declined to perform surgery on.

FIVE Best Medicolegal Tips

1. Practice Good Patient Selection & Qualifying
2. Better Documentation & Photos – consenting & risks
3. Managing Post-Op Complications and Listening for Complaints
4. Better Communication & Mediation for Speedier Settlement
5. Seek more Medicolegal Support if required – Get opinions from other Surgeons

Study Past Medicolegal Claims and Learn the Lessons – Read the Plastic Surgery Closed Claims Study by TDC The Doctors Company in USA – 1438 plastic surgery claims from 2007 to 2015.

Reduce Patient Litigation with Solid Practice Systems

Useful resources like Avant Practice Hub and a good Practice Management System can help prevent complaints and litigation

• maintaining detailed office and surgical notes
• always obtaining informed consent
• adequately following and monitoring patients after surgery
• ensuring compliance by communicating frequently and effectively
• documentation of specific risks, benefits, and alternatives

Set Patient expectations as well as document all specific risks, benefits, and alternatives

TIPS to avoid Patient Claims for Litigation

• Postoperative infection is the single costliest adverse outcome – proactively deal with it

Surgeons should take a leading role and work on

• Improving perioperative checklists
• Embrace patient education – Printed, Web, Videos
• Checking for complete and accurate medical records
• Participate in hospital-based programs of prophylaxis

Preoperatively declare your policies on revisions, refunds, complications & payments.

Reference – PRS Jan 2021 – Boyd Moon et al Plastic Surgery and the Malpractice industry

Top Tips for Defending a Patient Litigation Claim (from Doctors Agency USA)

• Do not add to, delete from, or otherwise alter a medical record
• Place the medical record in a safe place
• After making a report, keep copies of your correspondence in a safe place—not in the patient’s chart—for future consultation
• Always require the patient’s or the patient’s legal representative’s signature to release a copy of the medical record or any information within it.
• Do not discuss the event with anyone other than your claim specialist or defense attorney.
• Do not make contact with anyone associated with the case except your claims specialist or defense attorney.
• https://www.doctorsagency.com/plastic-surgery-medical-malpractice-insurance

Helpful Patient Complaint Resolution Tips from Other Plastic Surgeons

• “The patient you want to call the LEAST is the One You need to call the MOST”
• “GOOD Patient Selection – comes from BAD patient selection”
• “Just LISTEN to an Unhappy Patient and Don’t Interrupt – Listen REALLY HARD until they feel heard!!”
• Ask “What would you have me Do?”
• Give a genuine & sincere apology & compensate them in some way

How Medicolegal Insurance Premiums Are Calculated

The cost of medicolegal insurance varies widely between doctors, even within the same specialty. Insurers use a combination of risk factors to assess how likely you are to face claims and how costly those claims might be to defend or settle. Understanding these factors can help you anticipate costs and manage them over time.

Key elements that influence premiums include:

• Specialty and procedures – High-risk areas such as plastic and cosmetic surgery typically attract higher premiums than lower-risk specialties. Procedures like Liposuction, BBL, revision surgery, or complex reconstructions are seen as carrying greater medicolegal exposure.

• Claims history – Past complaints, notifications, or litigation are a strong predictor of future risk. Even if claims were successfully defended, a history of legal disputes raises premiums.

• Practice profile – The size of your practice, number of associates, and annual revenue all contribute to the overall risk calculation. Larger practices with higher patient volumes face proportionately higher exposure.

• Geography and setting – Practising in metropolitan centres with more competitive markets and more litigious patient populations may attract higher rates than regional areas. Hospital affiliations and day surgery accreditation can also be factored in.

• Risk management systems – Insurers look favourably on practices that can demonstrate strong governance, detailed documentation, regular patient follow-up, and use of structured consent processes. Some providers even reduce premiums for surgeons who participate in risk-education programs or use endorsed practice management systems.

Premiums can range from modest for low-volume practitioners to very significant for surgeons performing complex cosmetic procedures at scale. By engaging with specialist brokers, surgeons may be able to compare providers, negotiate better terms, and access risk-management discounts.

 

Common Insurance Exclusions and Hidden Gaps to Check

Not all medicolegal insurance policies are created equal. Many surgeons only discover the limitations of their cover when they try to make a claim. Understanding what is excluded — or not fully covered — is just as important as knowing what is included.

Some of the most common exclusions and gaps include:

• Cosmetic and aesthetic procedures – Certain policies exclude elective cosmetic surgery or non-surgical treatments such as injectables, lasers, or cosmetic dermatology unless specifically added to the policy.
• New and emerging procedures – Operations like BBL (Brazilian butt lift) or experimental techniques may not be covered if considered outside standard practice. Surgeons adopting innovative techniques should always check coverage first.
• International patients and medical tourism – Treating overseas patients or engaging in cross-border practice often falls outside standard indemnity. Special arrangements may be required.
• Non-medical risks in practice ownership – Standard indemnity usually does not include cover for cyberattacks, staff claims (harassment, unfair dismissal), or accidents on premises. These require separate policies (cyber liability, employment practices liability, public liability).
• Shared care or team-based procedures – If complications arise when multiple practitioners are involved, insurers may dispute responsibility unless roles are clearly documented.
• Social media and advertising – Some policies exclude reputational claims arising from online advertising, promotional videos, or patient testimonials. This is increasingly relevant in the age of digital marketing.

These gaps highlight why reading the fine print — and asking specific questions of your insurer or broker — is essential. Surgeons should never assume that “all procedures” or “all risks” are automatically covered. Clarifying scope at the outset prevents unpleasant surprises when claims arise.

 

Emerging Risks in Plastic Surgery

The medicolegal landscape for plastic surgeons is changing rapidly. New procedures, shifting patient expectations, and the influence of social media are creating risks that did not exist even a decade ago. Surgeons who understand these trends are better positioned to manage claims and protect their practices.

Key emerging risks include:

• High-risk procedures – Operations such as BBL (Brazilian butt lift), large-volume liposuction, use of stem cells and combined procedures carry higher complication rates. They are also more visible in litigation data and media coverage, increasing the chance of claims.
• Revision and secondary surgeries – Patients who have had multiple operations often present with complex anatomy and high expectations. These cases are among the most likely to result in dissatisfaction and disputes.
• Post-weight loss body contouring – Large excisions and long operating times can lead to wound-healing problems, infections, and scarring complaints. Patients with high BMI or comorbidities are at particularly high risk.
• Injectables and non-surgical treatments – With more surgeons running MedSpa-style clinics, adverse events such as vascular compromise or infection from injectables are an expanding area of litigation. Policies may not always cover these unless specified.
• Social media-driven expectations – Patients now compare their results with influencers and heavily edited online images. Unrealistic expectations, fuelled by marketing or social media, are a leading cause of disputes.
• Start-ups and closures – Surgeons starting a new practice or winding one down face elevated risk. Early growth phases may involve rushed systems, while closure requires careful management of records, follow-up, and run-off cover.

Recognising these emerging risks allows surgeons to adapt — through more cautious patient selection, clearer communication of risks, and tighter practice systems. Insurers also factor these developments into premium calculations and exclusions, making it vital to regularly review coverage as your practice evolves.

---

 

A Checklist for Choosing the Right Medicolegal Policy

Selecting the right medicolegal insurance policy is not just about finding the lowest premium. It’s about ensuring the cover matches the specific risks of your practice now — and into the future. Use this checklist when comparing insurers and brokers:

• Scope of cover
  • Does the policy specifically include cosmetic procedures, non-surgical treatments, and revision surgery?
  • Are you covered for telehealth consultations and interstate practice?
• Exclusions and limitations
  • Which procedures are excluded or require additional approval?
  • Are injectables, laser treatments, or emerging techniques (e.g., BBL) included?
• Run-off and retirement cover
  • What protection exists for claims made after you retire, sell, or close your practice?
  • Is run-off cover guaranteed, or is it conditional on continuous membership?
• Team and practice cover
  • Does the policy extend to nurses, anaesthetists, or junior doctors under your supervision?
  • Is there separate protection for the company or clinic entity, not just the individual surgeon?
• Support services
  • Does the insurer offer 24/7 medico-legal advice hotlines, risk-education seminars, or complaint-handling support?
  • Are there practice resources, such as template consent forms or compliance guides?
• Financial transparency
  • Who owns the policy — you or the insurer?
  • Are there hidden fees for administration, hosting, or mandatory extras?
  • How are premiums adjusted year-on-year based on claims history?
• Crisis management and PR support
  • Will the insurer help with reputational damage following a patient complaint or media issue?
  • Is there assistance for responding to online reviews and social media disputes?
• Broker or direct
  • Would a specialist broker help compare policies and negotiate terms?
  • Is there a cost-benefit to going direct with a major indemnity organisation?

Surgeons should revisit this checklist at least every few years — or sooner if expanding services, adding new practitioners, or adopting high-risk procedures. The right policy is one that evolves with your practice, not one that leaves gaps as your work changes.

FAQs about Medicolegal Insurance for Plastic Surgeons

 

Medicolegal Coverage and Policy Design FAQs

Q: Why do some policies exclude cosmetic surgery even if they cover reconstructive procedures?
Because elective cosmetic surgery is considered higher risk, insurers often treat it separately. Surgeons may need to add cosmetic endorsements or specialist policies to ensure full cover.

Q: Can a single medicolegal insurance policy cover both a surgeon and their clinic entity?
Not always. Some policies insure only the individual doctor, leaving the company or staff uncovered. A separate practice policy may be required to reduce their risk.

Q: How do policies treat non-surgical services like injectables or laser treatments?
Many indemnity products do not automatically include non-surgical procedures, especially if performed by nurses. Surgeons should confirm that these services are explicitly included.

Q: Why is “run-off” or “tail” cover so critical for retired surgeons?
Claims can arise years after retirement, particularly in plastic surgery. Without run-off cover, retired surgeons may face litigation without any insurance protection.

---

Medicolegal Insurance Premiums, Costs, and Value FAQs

Q: Why do two surgeons in the same specialty sometimes pay very different premiums?
Insurers assess individual risk factors — such as claims history, patient demographics, and procedure mix — not just specialty. One surgeon’s past complaints may drive their premium much higher than a colleague’s.

Q: Can insurers reduce premiums for good risk management practices?
Yes. Some insurers reward surgeons who complete risk education, adopt practice management systems, or attend compliance training with lower premiums.

Q: Do premiums rise automatically after a single patient complaint?
Not always. Insurers distinguish between minor complaints, defended claims, and large payouts. A well-managed complaint that is resolved early may have little or no impact on premiums.

Q: Is it cheaper to go direct to an insurer rather than through a broker?
Sometimes, but not always. Brokers may secure better terms or spot hidden exclusions that outweigh cost differences. The value is often in the quality of cover, not just the price. Always use  an expert rather than be exposed to risk.

---

Exclusions and Hidden Risks FAQs

Q: Why are high-risk procedures like BBL often excluded or restricted?
Because of their elevated complication rates and global litigation profile, insurers may limit cover or impose higher excesses for these procedures.

Q: Are surgeons covered if a complication arises from a device or implant failure?
Not always. Some policies exclude claims linked to product liability, leaving the surgeon to defend themselves until the manufacturer is proven at fault.

Q: Does standard indemnity cover reputational damage from social media?
No. Most policies exclude defamation, negative reviews, or PR crises. Surgeons may need separate cover for reputational risk.

Q: What happens if a surgeon performs a new or experimental procedure not yet standard in Australia?
Many policies exclude unproven procedures unless specifically declared. Without disclosure, claims may be denied. For many years, fat transfer surgery was treated as experimental.

---

Complaints, Claims, and Litigation FAQs

Q: Why are poor documentation and missing photos the most common cause of claim failures?
Because in litigation, “if it’s not written, it didn’t happen.” Without clear records of risks discussed or consent obtained, insurers may be unable to defend the surgeon effectively.

Q: Can a surgeon be sued even if no clinical error occurred?
Yes. Dissatisfied patients may still lodge claims alleging poor outcomes or inadequate consent. Even defensible cases cost time and money.

Q: Why is early resolution of complaints often better than “fighting it out”?
Early mediation or settlement can prevent escalation into full litigation. Insurers often prefer resolution because drawn-out cases increase costs, stress, and reputational harm.

Q: What mistakes do surgeons make when first notified of a claim?
Common errors include altering records, discussing the case with colleagues, or contacting the patient directly. These actions weaken the defence and may void cover.

---

Practice Systems and Risk Management FAQs

Q: How does poor patient selection increase litigation risk?
High BMI, smokers, revision cases, and patients with unrealistic expectations are consistently over-represented in claims. Screening out unsuitable candidates is the best risk reduction.

Q: Why is a clear revision and refund policy essential before surgery?
Because many claims arise from disputes over financial expectations, not medical outcomes. Transparent policies reduce conflict and protect against litigation framed as “contract disputes.”

Q: How can cyberattacks create medicolegal exposure?
If patient data is stolen or leaked, privacy breaches can trigger regulatory investigations and patient lawsuits. Standard indemnity won’t cover this — separate cyber insurance is required.

Q: Why should surgeons review their indemnity cover every few years?
Because practices evolve — new procedures, additional staff, or new clinic locations can create gaps. What was adequate five years ago may now leave significant risks uninsured.

---

Medicolegal Risk of International Surgery FAQs

Q: How does the litigation climate in Australia compare to the USA?
Australia has fewer lawsuits overall, but payouts are increasing. In contrast, the USA faces more frequent litigation and much higher damages, making their premiums far higher.

Q: Can Australian surgeons rely on their indemnity if treating patients overseas?
Generally no. International work often requires separate local cover, and claims brought abroad may not be recognised under Australian indemnity policies.

Taking Action on Insurance

Medicolegal insurance is more than a box to tick — it is a foundation of professional protection in an environment where risk can never be fully eliminated. The right policy, combined with solid documentation, communication, and complaint-resolution strategies, can make the difference between a minor issue and a prolonged legal battle.

Surgeons who proactively manage risk — through careful patient selection, strong consent processes, and clear postoperative support — are less likely to face litigation and better prepared if it occurs. Partnering with insurers, brokers, and practice management systems that understand the realities of plastic surgery is one of the most powerful steps you can take to safeguard your career and your patients.

For more resources and practical guidance on running a safe and successful specialist practice, explore further reading from Specialist Practice Excellence and stay informed about the latest medicolegal developments.

Further Reading – Useful References about Medicolegal Insurance for Specialist Practices

• Medical Indemnity Insurance Australia
• New Bill Makes Changes to Run-off Cover (ROC) Scheme
• Medico-legal Closed Case Trends in Canadian Plastic Surgery: A Retrospective Descriptive Study – PRS Article Aug 2021
• USA The Doctors Company – Plastic Surgery Closed Claims Study – DOWNLOAD THE REPORT

 

Disclaimer

This information is general in nature and is not comprehensive nor constitutes legal or medical advice. You should seek legal, medical or other professional advice before relying on any content, and practice proper clinical decision-making about individual circumstances. Persons implementing any recommendations contained on this website must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice.

David Staughton and Specialist Practice Excellence are not responsible to you or anyone else for any loss suffered in connection with the use of this information.

Please seek professional advice.

All information on this page is of a general nature only and has not been presented with any knowledge of your personal objectives or financial needs.