Lawmaker calls malpractice premiums ‘mismatched’

Leong Sun Iok

Lawmaker Leong Sun Iok has put forward a request for the government to review the city’s mandatory medical malpractice insurance, claiming private practitioners face disproportionately high premiums despite lower-risk practices.

In a written inquiry to the Legislative Assembly (AL), Leong stated the Medical Malpractice Legal System – the Medical Error Act (Law No. 5/2016) – enacted in 2017 – fails to align costs with actual risk levels.

Since the law’s enactment eight years ago, all doctors and clinics in Macau are required to carry malpractice insurance to protect against patient lawsuits.

However, citing industry reports, the lawmaker claims that many community-based private doctors handling routine care like colds and minor injuries pay premiums “severely mismatched” to their risk profiles – while hospitals that perform more complex procedures and face higher claims pay comparatively lower premiums relative to their risk.

Leong challenged the government’s long-standing position that “free market principles” and “flexible premium ceilings” sufficiently address disparities.

He wrote, “this flexibility hasn’t solved the problem,” stating that premiums remain largely uniform across insurers and leave providers little to no choice to “pay quoted prices in full.”

Leong posed three questions to authorities: First, asking how the government plans to optimize the current system.

Second, whether the government will introduce a more detailed risk classification that considers factors such as medical specialty, complexity of services, and claims history.

Third, he urged authorities to increase market transparency by “disclosing key data such as actual premium income and expenditure and loss ratio of different types of insurance companies for reference and comparison by the industry.”

Drawing inspiration from other insurance sectors like motor insurance, Leong suggests introducing no-claims discounts. This allows policyholders with a clean record to see their premiums gradually reduced to a minimum over time.

Leong proposed, “The government should take a leading role in establishing a litigation and compensation fund, investing 10 to 20% of annual premiums as a rolling reserve each year to support the industry’s litigation and compensation costs.”

He also suggested opening the market to allow malpractice insurance purchases from providers in the Greater Bay Area.

A response to the written inquiry is still pending.