# Medical malpractice insurance in Germany: a guide for doctors trained abroad > If you treat patients in Germany, you are personally liable for treatment and consent errors, with no statutory cap. Professional liability insurance for doctors (Arzthaftpflicht or Berufshaftpflicht) pays justified claims and defends you against unjustified ones. It is a professional duty for every doctor and, for doctors in the statutory health system, a licensing condition with fixed minimum limits. This page explains how the German system differs from what you may know from the UK, the US or elsewhere. Quelle/Source: https://www.nammert.com/en/insurance-broker-medical-malpractice.php Updated: 2026-11-11 ## Is malpractice insurance compulsory for doctors in Germany? Yes. The professional codes of the state medical chambers (Landesärztekammern) oblige every doctor to hold adequate liability cover for professional work. Doctors admitted to treat statutory health patients must in addition meet § 95e of Social Code Book V, in force since 20 July 2021: at least EUR 3 million per claim for bodily injury and property damage, or EUR 5 million for medical care centres (MVZ) and practices that employ doctors. Proof goes to the admissions committee, and without it your admission is at risk. ## At a glance - **Compulsory?:** Yes, under the chambers' professional codes and, for statutory health doctors, § 95e SGB V - **Minimum limit, single doctor:** EUR 3 million per claim, at least twice that per year - **Minimum limit with employed doctors or MVZ:** EUR 5 million per claim, at least three times that per year - **Limitation period:** normally three years from knowledge, 30 years at the latest for injury to health (§ 199(2) BGB) - **Premium basis:** specialty and type of work: outpatient, surgical, inpatient, obstetrics ## Two layers of obligation Germany has no single malpractice statute. The duty to insure sits in the professional code of the chamber you register with, which asks for adequate cover without naming a figure. To treat patients with statutory health insurance, doctors need an admission as a Vertragsarzt, and that is where § 95e SGB V applies. It covers admitted doctors and psychotherapists, joint practices, medical care centres and individually authorised doctors. The figures: EUR 3 million per claim and per doctor in a solo practice or a joint practice without employed doctors, with an annual aggregate of at least twice that amount. Medical care centres, and doctors or joint practices that employ doctors, need EUR 5 million per claim and at least EUR 15 million per year. The admissions committee wants a certificate from the insurer confirming that the policy meets these requirements. An ordinary policy schedule or invoice is not accepted. ## No Crown indemnity, no tail to buy later Doctors from the UK often expect a state-backed scheme for hospital work, and doctors from the US expect claims-made policies with a tail. Germany works differently. Hospital doctors are normally covered through the hospital operator's liability policy for their official duties, but that is a private insurance contract, not a public indemnity, and you should ask for written confirmation that your personal liability is included. For the period after a policy ends, what matters is the run-off clause (Nachhaftung). Claims for injury to health become time-barred three years after the patient learns of the damage and who caused it, and 30 years after the treatment at the latest. A doctor can therefore face a claim long after leaving Germany or retiring. Without agreed run-off there is no cover for damage that only occurs or surfaces after the practice has closed. Insurers offer different periods, and the German market knows five, ten and 30 years. It has to be arranged before you stop, not afterwards. ## Your policy covers the work you declared German insurers rate by specialty and by what you actually do. A GP who starts minor surgery, an orthopaedic surgeon who operates in an outpatient centre, a gynaecologist who takes on deliveries as an attending doctor in a hospital: each of these changes the risk, and each has to be in the policy before the first patient is treated that way. List everything in your application: outpatient surgery, inpatient or locum work, obstetrics, cosmetic procedures without medical indication, emergency and on-call services, expert reports, video consultations. Work outside Germany and claims brought under US or Canadian law are commonly excluded unless agreed. ## Employed doctors: what remains uncovered If you are employed by a hospital or a practice, the employer's policy usually covers your work on duty. What it does not cover is everything else: approved secondary employment, locum shifts and emergency services on your own account, expert opinions, first aid at an accident, treating friends and family. Your employer may also seek recourse from you where damage was caused with gross negligence. For this residual risk there are separate, much cheaper policies. ## What is covered - Bodily injury from treatment, diagnostic and consent errors - Damage to patients' belongings - Defence against unjustified claims, in court if necessary - Personal liability of practice staff while working for the practice - Locums in your practice and your own locum work, depending on the policy - First aid and emergency treatment outside the practice - On-call and emergency service if it is part of the declared work - Pure financial loss from incorrect certificates and reports, if included - Breach of confidentiality and data protection, depending on the policy ## What is not covered - Damage caused intentionally - Activities not declared to the insurer, such as surgery or obstetrics - Procedures without medical indication unless expressly included - Guarantees of a treatment result beyond statutory liability - Refund of fees - Fines and penalties - Practising without a German licence (Approbation) or permit - Claims before US or Canadian courts unless agreed ## Who needs it - Doctors, dentists and psychotherapists with their own practice in Germany - Medical care centres and practices that employ doctors - Locum and freelance doctors working on their own account - Employed hospital doctors, for secondary work and residual risk - Doctors from abroad starting their first German post - Retired doctors who still treat occasionally or write reports ## Who does not need it - Employed doctors with no secondary work at all, where the employer confirms in writing that personal liability is covered and first aid is covered elsewhere ## What it costs Premiums follow the specialty. Brokers quote a range for doctors in private practice from about EUR 225 a year for consulting specialties to several thousand euros for surgical ones. Obstetrics costs far more. The figures below are published market indications, not an offer. | Example | Typical range | | --- | --- | | Private practice, consulting specialty such as general medicine or psychiatry | about EUR 225 to 600 a year | | Specialist performing minor procedures | about EUR 600 to 2,500 a year | | Surgical specialty, anaesthesia or obstetrics | up to about EUR 6,500 a year and more | **What drives the premium:** - Specialty, by far the biggest factor - Outpatient surgery, inpatient work and obstetrics - Number of doctors in the practice, including employed doctors - Limit per claim and annual aggregate - Deductible - Length of the agreed run-off period - Claims history _The ranges come from figures published by German brokers and refer to policies with the statutory minimum limits. Attending doctors who deliver babies pay many times more. Your premium is fixed only in the quote._ ## The policy levels on the market - **Statutory minimum:** Meets § 95e SGB V with EUR 3 or 5 million and comes with the certificate for the admissions committee. Run-off, financial loss and criminal defence are thin or missing. - **Practice cover:** EUR 7.5 to 10 million for bodily injury, staff and locums included, separate limits for financial loss and rented premises, several years of run-off. The right frame for most practices. - **Extended cover:** High limits with a multiple annual aggregate, long or unlimited run-off, extended criminal defence, surgery and inpatient work by agreement. For surgical specialties, joint practices and care centres. ## How to recognise a good policy | Criterion | Minimum standard | Strong policy | Why it matters | | --- | --- | --- | --- | | Limit for bodily injury | EUR 3 million per claim, EUR 5 million with employed doctors | EUR 7.5 to 10 million per claim | Lifelong care and loss of earnings after one severe injury can exceed the minimum. | | Annual aggregate | twice the limit, three times with employed doctors | three times or more, also for a solo practice | Two large claims in one year should not exhaust the cover. | | Run-off after the policy ends | five years | 30 years or unlimited, also for your heirs | Health claims can arrive up to 30 years after the treatment. | | Certificate under § 95e SGB V | on request | issued unprompted and renewed after changes | The admissions committee accepts nothing else as proof. | | Outpatient surgery | only by special agreement | expressly included to the declared extent | An undeclared procedure is the most common reason for a coverage dispute. | | Pure financial loss | small sublimit | separate, adequate limit | A wrong certificate or report costs money without injuring anyone. | | Extended criminal defence | not included | defence costs from the investigation stage | After a serious incident the public prosecutor often investigates as well. | | Talking to the patient | no admission without the insurer's consent | explaining events and expressing regret expressly allowed | Silence after an incident destroys trust and often triggers the claim. | | Automatic cover for new activities | short notification period, small limit | full limit, notification at the next renewal | Practices grow, and not every new service is reported at once. | ## Insurers on the German market The German market for medical liability is small and has shrunk over the years as several insurers withdrew. The list names insurers that write liability for health professions in Germany. It describes the market and says nothing about which insurers we work with. - **HDI**: part of the Talanx group, focus on the liberal professions and healthcare - **AXA**: in healthcare also under the brand Deutsche Ärzteversicherung - **Alte Leipziger**: property and casualty arm of a mutual group, mainly sold through brokers - **Allianz**: healthcare liability for practices and hospitals, through agents and brokers - **R+V**: insurer of the German cooperative banks, practices and hospitals - **ERGO**: part of the Munich Re group, practices and hospitals - **Versicherungskammer Bayern**: public insurer based in Munich, practices and hospitals 127 insurers supervised by BaFin, the German regulator, are licensed for this class of insurance. (Allgemeine Haftpflicht). Source: BaFin company database, 2026-09-18; EU insurers without a German office excluded. ## Typical claims and who pays - **Fracture missed on the X-ray** (often six figures): A diagnostic error is the core case. Covered are damages for pain and suffering, treatment costs and loss of earnings, as far as the doctor is liable. - **Wrong sick note costs a patient money** (a few thousand euros): Nobody is injured, so this is pure financial loss. Simple policies give it a small sublimit, strong ones a separate adequate limit. - **Claim ten years after you left Germany** (depends on the injury, up to millions): Everything depends on the run-off clause. Five years have expired by then, long or unlimited periods still respond. - **Cosmetic filler offered on the side** (five to six figures): Procedures without medical indication are a separate risk. They are covered only if declared and included, even in a strong policy. - **Prosecutor investigates after a death** (defence often five figures): Liability cover defends civil claims. A defence lawyer in criminal proceedings is paid only under extended criminal defence cover. - **Patient demands the fee back** (the amount of the invoice): Refunding a fee is not compensation for damage but concerns your own service. Every policy excludes it. ## Myth or truth - „Every doctor in Germany is subject to the same statutory minimum limit." ✘ False. The figures in § 95e SGB V apply to doctors admitted to the statutory health system. The chambers' codes require adequate cover from all doctors without naming an amount. - „Employing a doctor raises the required limit from EUR 3 to 5 million." ✔ True. Doctors and joint practices with employed doctors must meet the same minimum as medical care centres, with a threefold annual aggregate. - „After three years every treatment error is time-barred." ✘ False. The three years start only when the patient knows of the damage and who caused it. Without that knowledge, health claims expire after 30 years. - „The insurer also pays for defending a claim that turns out to be unfounded." ✔ True. Defending unjustified claims is part of every German liability policy. The insurer examines liability and conducts the dispute. - „Once I leave Germany, my German liability risk ends." ✘ False. Liability for past treatment stays with you wherever you live. Without agreed run-off, no insurer stands behind it. ## Common mistakes - Assuming a foreign policy or defence organisation membership covers work in Germany - Adding outpatient surgery or cosmetic procedures without telling the insurer - Leaving Germany or retiring without arranging run-off - Hiring a doctor and staying at EUR 3 million although EUR 5 million is then required - Relying on the employer's policy without seeing it in writing - Promising a patient compensation before the insurer has been informed ## FAQ ### What limit does a doctor in private practice need? As a doctor admitted to the statutory health system, at least EUR 3 million per claim for bodily injury and property damage, with an annual aggregate of at least EUR 6 million. That is the legal floor, not a recommendation. Specialties with procedures usually choose higher limits, because one severe permanent injury can exceed the minimum. ### I work in a German hospital. Do I need my own policy? For your duties the hospital operator's policy normally covers you. Ask for confirmation that your personal liability is included. A residual risk policy is sensible for anything outside your duties and for employer recourse after gross negligence. ### Does my membership of a UK defence organisation cover me in Germany? Do not assume so. German chambers and admissions committees expect an insurance contract that meets German requirements, and for statutory health work a certificate that refers to § 95e SGB V. Clarify this before you start, not after the first complaint. ### What is Nachhaftung? Run-off cover: protection for damage arising from the insured period that occurs or is reported after the policy has ended. It matters when you close a practice, retire, change jobs or leave the country. The length differs between insurers and should match the limitation rules, which allow health claims for up to 30 years. ### Are German policies claims-made? Cover is normally tied to the treatment or the damage falling within the policy period, with run-off for what comes later, rather than to the date the claim is made. Check the definition of the insured event and the run-off period in the wording. ### Is gross negligence covered? Yes. German liability insurance excludes intent, and medical wordings also exclude knowing breaches of duty. A serious treatment error as such is not a reason to refuse cover. ### Am I covered when I give first aid on a flight? Most policies include emergency help outside the practice. Check two points: whether it applies abroad, and whether claims under US or Canadian law are excluded. ### What happens if I employ another doctor? The statutory minimum rises to EUR 5 million per claim with at least three times that per year, the same as for medical care centres. The policy must be changed before the first working day, and the admissions committee needs a new certificate. ### Can I apologise to a patient after an incident? You may explain what happened and express regret. Do not admit liability or promise money without the insurer. Good wordings state expressly that an open conversation does not endanger cover. ### How can a broker help? We describe your work completely, obtain quotes from the insurers that write your specialty, and check run-off, limits and extensions against your practice. We support you if a claim is made. ## Legal basis and sources - [Insurance Contract Act (VVG, German)](https://www.gesetze-im-internet.de/vvg_2008/) - [BaFin company database (licensed insurers)](https://portal.mvp.bafin.de/database/InstInfo/) ## Request quotes We obtain quotes and come back with a comparison, free of charge. You can write in English. https://www.nammert.com/en/insurance-broker-medical-malpractice.php#anfrage --- Your broker: Norman Nammert, trading as NAMMERT. Insurance broker licensed under section 34d(1) of the German Trade Regulation Act. Broker register no. D-C08Q-TOSD4-37. NAMMERT Assekuradeur GmbH is a separate company. It does not arrange your contract. NAMMERT Assekuradeur GmbH, Karl-Marx-Straße 4, 15711 Königs Wusterhausen, +49 3375 29 12 77, info@nammert.com. Wikidata: Q141141479.