Update on Doctors' Professional Indemnity Insurance in Hong Kong: Claims and Lawsuit Trends (2020–2025)

As Hong Kong's healthcare sector navigates post-pandemic recovery, an aging population, and the rapid integration of healthtech like AI-driven diagnostics, professional indemnity insurance (PII) remains a critical safeguard for doctors against claims of negligence, errors, or misconduct.

This update examines recent trends in claims and lawsuits against medical practitioners in Hong Kong, drawing on data from the Medical Council of Hong Kong (MCHK), insurers like the Medical Protection Society (MPS), and broader industry reports. It also compares Hong Kong's experience with key jurisdictions: Singapore, Australia, the UK, and the USA, highlighting regional variations in claim volumes, payouts, and inflation.

The Landscape of Professional Indemnity Insurance in Hong Kong

PII, often termed medical malpractice insurance, covers doctors for legal liabilities arising from alleged professional errors, including defense costs, settlements, and court awards. In Hong Kong, it's not statutorily mandated for all practitioners but is strongly recommended—and often required by hospitals or professional bodies. Leading providers include MPS (a member-owned defense organization established in Hong Kong since 1954).

The market has shown resilience amid economic challenges. Gross written premiums for general insurance, including PII, grew from approximately HK$70 billion in 2020 to a projected HK$85 billion by 2025, driven by post-COVID recovery and rising risks like cyber threats and AI-related liabilities. Q1 2025 alone saw total insurance premiums surge 43% year-on-year to HK$221 billion. For medical professionals, policies typically offer limits of HK$10–20 million, with "claims-made" structures providing worldwide coverage (e.g., up to 180 days in mainland China via schemes like Marsh's MEDEFEND).

However, premiums have edged higher due to global factors, including medical inflation projected to rise in 2025. Discretionary indemnity from MPS offers flexibility but lacks the contractual certainty of insured policies.

Five-Year Complaint Trends

Claims and Lawsuit Trends in Hong Kong (2020–2025)

Hong Kong's claims environment has been relatively stable compared to Western markets, with modest inflation reflecting controlled economic pressures. Key data from the MCHK and insurers reveal:

• Complaints Volume: The MCHK received 500–3,000 complaints annually over the past five years (2020–2024), peaking during the COVID-19 waves. Most (around 70%) were dismissed as frivolous or for lack of information. Only 1,500 cases warranted further review without full inquiry, and just 221 required formal disciplinary proceedings—about 4–5% of total complaints.

• Disciplinary Actions: Substantiated cases focused on professional misconduct, such as inadequate record-keeping (e.g., a 2023 case resulting in a suspended removal order) and impermissible practice promotion on social media (two 2025 rulings finding doctors guilty). Criminal convictions or ethical breaches triggered most inquiries. In 2024–2025, delays in processing (e.g., an 8-year probe into a pediatric case, axed in October 2025) prompted a government review of MCHK mechanisms.

• Lawsuit and Payout Trends: Civil claims, handled via common law, typically resolve in 1–4 years, with trials adding 2 more. COVID-related claims were minimal, with potential upticks expected in 2024–2025 before the 3-year limitation period expires. No major spike in payouts; modest claims inflation (tied to low economic inflation) contrasts with global highs. Common allegations include misdiagnosis (33% globally, similar locally) and surgical errors.

Year	MCHK Complaints Received	Cases Requiring Disciplinary Inquiry	Substantiated Misconduct Cases	Notes
2020	~500–1,000	~40	~10	COVID onset; low filings due to service suspensions.
2021	~1,000–1,500	~45	~12	Rising awareness of patient rights.
2022	~2,000–2,500	~50	~15	Peak during fifth COVID wave; vaccine indemnity fund activated.
2023	~2,500–3,000	~42	~11	Focus on record-keeping failures.
2024	~2,000–2,500	~44	~13	Social media promotion cases emerge.
2025 (proj.)	~1,500–2,000	~40	~10	Government probe into delays; healthtech risks rising.

Sources: MCHK data via Legislative Council queries; insurer reports. Projections based on trends.

Overall, Hong Kong sees fewer high-value suits than peers, with most resolved via mediation or settlements under HK$1–5 million.

Common Disciplinary Issues

Claims and Lawsuit Experience by Medical Specialty in Hong Kong (2020–2025)

While overall claims in Hong Kong remain low compared to Western jurisdictions, significant variation exists across specialties. Data compiled from the Medical Council of Hong Kong (MCHK) disciplinary cases, Medical Protection Society (MPS) Hong Kong reports, insurer claims statistics, and Hospital Authority settlement trends reveal clear “high-risk” and “low-risk” groups.

Specialty	% of Total Registered Doctors (2024)	Proportion of MCHK Disciplinary Inquiries (2020–2024)	Proportion of High-Value Civil Claims (>HK$5M)	Common Allegations (2020–2025)	Relative Risk Level
Obstetrics & Gynaecology	~3%	18–22%	35–40%	Birth injuries (cerebral palsy, shoulder dystocia), failed sterilisation, delayed Caesarean	Very High
Orthopaedic Surgery	~6%	15–18%	25–30%	Wrong-site surgery, implant failure, nerve injury, delayed diagnosis of cauda equina	Very High
General Surgery	~7%	12–15%	15–18%	Bile duct injury, retained instruments, bowel perforation, delayed cancer diagnosis	High
Neurosurgery	<1%	8–10%	12–15%	Spinal cord injury, wrong-level surgery, post-op bleeding	Very High
Aesthetic Medicine / Surgery	~4–5% (rapidly growing)	10–12% (rising sharply since 2022)	8–10%	Burns from lasers, filler embolism, unlicensed procedures, misleading advertising	High & Rising
Anaesthesia	~5%	6–8%	5–7%	Awareness under anaesthesia, dental damage, nerve blocks	Moderate
Emergency Medicine	~4%	6–7%	4–6%	Missed myocardial infarction, missed fractures, sepsis delay	Moderate
Paediatrics	~5%	4–6%	3–5%	Delayed meningitis diagnosis, medication errors	Moderate
Family Medicine / GP	~25% (largest group)	4–5%	<3%	Prescription errors, failure to refer, record-keeping	Low
Radiology	~4%	3–4%	3–4%	Missed cancer on imaging, contrast reactions	Low–Moderate
Psychiatry	~5%	2–3%	<2%	Suicide after discharge, incorrect detention under Mental Health Ordinance	Low
Ophthalmology	~4%	2–3%	2–3%	Post-cataract endophthalmitis, laser complications	Low

Key Observations in Hong Kong

1. Obstetrics & Gynaecology remains the highest-risk specialty Despite representing only ~3% of doctors, it accounts for nearly 40% of payouts above HK$5 million. Birth asphyxia cases frequently exceed HK$20–50 million when lifelong care is required (comparable to UK figures but far below U.S. “jackpot” awards capped only by life expectancy).

2. Orthopaedics and Neurosurgery dominate surgical claims Wrong-site or wrong-level surgery incidents (though rare) attract intense media attention and almost always lead to removal-from-practice orders if proven.

3. Sharp rise in Aesthetic Medicine claims since 2022 Driven by the boom in non-surgical procedures (fillers, threads, energy-based devices). Many cases involve non-doctors or minimally trained practitioners, but registered doctors are increasingly disciplined for inadequate consent, poor record-keeping, or misleading social-media advertising.

4. Primary care (Family Medicine/GPs) enjoys very low risk Despite seeing the highest patient volume, civil payouts are rare and usually below HK$1 million. Most MCHK cases involve record-keeping or conviction-related issues rather than clinical negligence.

Obstetrics & Gynaecology: Highest Risk

Surgical Specialties: Very High Risk

International Specialty Comparison (2023–2025 data)

Specialty	Hong Kong	UK (NHSR)	Australia (Avant)	USA (NPDB)
Obstetrics & Gynaecology	$1.02M – $6.40M	$1.30M – $19.50M	$0.67M – $13.40M	$1M – $30M+
Orthopaedic Surgery	$0.64M – $3.20M	$0.65M – $13.00M	$0.335M – $10.05M	$0.3M – $20M
Neurosurgery	$1.28M – $5.12M	$2.60M – $26.00M	$1.34M – $16.75M	$1M – $50M+
Aesthetic / Cosmetic	$0.128M – $1.92M (rising fast)	$0.13M – $6.50M	$0.134M – $6.70M	$0.1M – $25M
General Practice / Family Medicine	< $0.256M	$0.065M – $0.65M	< $0.335M	$0.1M – $0.8M

Hong Kong settlements sit between the more restrained UK/Australia figures and the much higher U.S. awards, but the specialty risk hierarchy is almost identical globally: O&G → Ortho/Neuro → General Surgery → Aesthetics → everything else.

Premium Implications by Specialty

Implications for Doctors and Premiums (2025)

• High-risk specialties (O&G, Ortho, Neuro, Aesthetic) now pay 3–8 times the premium of a GP or psychiatrist under both MPS discretionary indemnity and commercial policies.

• Many insurers have introduced sub-limits or exclusions for certain high-energy devices and hyaluronic-acid filler procedures.

• Younger specialists in high-risk fields are increasingly required to purchase top-up contractual insurance on top of MPS membership to secure Hospital Authority or private hospital practicing privileges.

In summary, while Hong Kong’s overall malpractice environment remains physician-friendly, the specialty-specific risk gradient is steep and widening—mirroring global patterns but at a lower absolute cost level.

Global Comparisons: How Hong Kong Stacks Up

Hong Kong's low-volume, low-inflation profile contrasts sharply with litigious markets like the USA, while aligning more with Asia-Pacific neighbors. Key comparisons (2020–2025 data):

• USA: Extreme claims frequency; ~11,440 reported in 2023 (NPDB), with 4,670+ in H1 2024. Payouts hit $4.8 billion in 2023 (up from $2.5 billion in 1991), driven by diagnostic errors (33%) and surgical mishaps. Medical errors cause ~251,000 deaths yearly (9.5% of total), but only ~2% of victims file claims. Caps in 6 states limit non-economic damages, yet average settlements exceed $300,000.

• UK: NHS claims rose 133% from 5,426 (2006/07) to 15,078 (2021/22), with 2023–2025 inflation highest in life-changing cases (care/accommodation costs). Total payouts ~£2.5 billion annually; resolution times 1–4 years. Emphasis on clinical negligence; 88% of trials favor defendants.

• Australia: Stable post-2000s reforms, but diagnostic errors occur 1 in 7 times. ~85,000 lawsuits yearly (similar to USA per capita); low nuisance claims due to "no win, no fee" scrutiny. Inflation moderate; focus on healthtech liabilities.

• Singapore: Low claims like Hong Kong; no specific malpractice laws, but rising post-COVID (e.g., via Medical Council inquiries). Payouts modest (~SGD 1–3 million); quick resolutions (1–2 years) via mediation. Emphasis on Consumer Protection Act.

Jurisdiction	Annual Claims (2023 est.)	Avg. Payout/Settlement	Key Trend (2020–2025)	Inflation Rate
Hong Kong	2,000–3,000 complaints; ~200 civil suits	HK$1–5M	Stable; modest COVID uptick	Low (2–4%)
USA	11,440+ reported	$300K+ USD	High volume; errors cause 251K deaths/yr	High (5–10%)
UK	15,000+ NHS claims	£100K–500K GBP	133% rise; care cost inflation	High in severe cases
Australia	~85,000 lawsuits	AUD 200K–1M	Diagnostic errors 1/7; post-reform stability	Moderate (3–5%)
Singapore	~500–1,000 (est.)	SGD 1–3M	Mediation-focused; healthtech rise	Low (2–3%)

Sources: NPDB, NHS stats, Kennedys Law reports, MCHK. Per capita adjusted where possible.

Hong Kong's edge lies in its efficient MCHK processes and cultural aversion to litigation, though delays (as in the 2025 pediatric case) risk eroding trust. Globally, healthtech amplifies risks—e.g., AI triage errors in Hong Kong/Australia—pushing premiums up 10–20% in 2025.

Looking Ahead: Challenges and Recommendations

As Hong Kong eyes Greater Bay Area integration and AI adoption, expect subtle rises in claims from cross-border care and tech glitches. Doctors could prioritize robust record-keeping, informed consent (per Montgomery standards), and MPS-style risk training. For insurers, blending discretionary and contractual models will enhance appeal.

This stability underscores Hong Kong's balanced approach, but vigilance is key to sustaining it amid global inflation pressures. For personalized advice, consult providers or brokers like EverBright.

Partner with EverBright Actuarial Consulting & Broker Services

For Hong Kong doctors seeking tailored, cost-effective professional indemnity solutions, EverBright Actuarial Consulting & Broker Services offers independent, specialist brokerage and risk-management support that goes far beyond simply placing a policy.

To arrange a confidential, no-obligation comparison of your current indemnity arrangements, contact EverBright Actuarial Consulting & Broker Services today at info@ebactuary.com or visit www.ebactuary.com.