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.
There are FIVE key providers of medicolegal insurance professional indemnity in Australia for doctors and medical professionals
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.
You may need a wide range of Medicolegal Insurance for your Practice, including:
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:
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.
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.
Useful resources like Avant Practice Hub and a good Practice Management System can help prevent complaints and litigation
Set Patient expectations as well as document all specific risks, benefits, and alternatives
Surgeons should take a leading role and work on
Preoperatively declare your policies on revisions, refunds, complications & payments.
Reference – PRS Jan 2021 – Boyd Moon et al Plastic Surgery and the Malpractice industry
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.
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:
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.
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:
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.
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:
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.
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.
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.
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.
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.
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.
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.
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.
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.
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