Medical Council advances compulsory civil liability insurance for healthcare providers

Alvis Lo

The Medical Council recently discussed updates to the compulsory professional civil liability insurance system for both healthcare providers and patients.

At its 13th plenary session, the council focused on updates to the insurance system, including how newly introduced “day hospitals” will be covered differently from traditional hospitals.

According to the Health Bureau’s (SSM) statement, the meeting brought together 47 representatives from the Macao Monetary Authority (AMCM), the insurance industry, SSM, and medical groups.

Discussions centered on enhancing the existing legal framework and addressing ongoing challenges in safeguarding medical personnel and their patients.

Law No. 5/2016, also known as the “Legal Regime for Medical Malpractice,” which came into effect on February 26, 2017, was highlighted by Medical Council chairman and SSM director Alvis Lo.

Article 36 of the Medical Malpractice Law requires all healthcare providers, as defined in Article 4 of the law, to obtain civil liability insurance covering medical incidents. According to the AMCM, these include claims arising from violations of medical regulations, professional ethics, or standards that result in bodily or mental injury to patients.

In simple terms, all licensed healthcare providers are required to purchase the compulsory insurance.

A key focus discussed by the meeting’s attendees concerned plans to expand the insurance coverage scope to include services delivered by “day hospitals,” a new category anticipated under the upcoming “Legal Regime for Private Healthcare Institutions Business” bill currently drafted by the SAR Government.

This new classification brings distinct insurance requirements, differing from those of traditional hospitals, and will broaden the scope of compulsory insurance coverage.

Notably, Wilson Vong, executive director of the AMCM, highlighted the protective function of compulsory professional civil liability insurance during the meeting.

He noted that it is particularly effective in managing compensation claims filed by patients or their families following medical malpractice claims.

Lo also highlighted strong cooperation between SSM, AMCM, insurers, and the medical sector over the past several years.

According to the statement, this collaboration has involved detailed consultations, feedback collection, and continuous efforts to refine the system to better serve the healthcare community.

Meeting participants also raised concerns regarding the scope of coverage and called for premium adjustments reflecting the varied risk profiles of different medical professions and service types.

This issue was recently highlighted by lawmaker Leong Sun Iok at the Legislative Assembly (AL), where he claimed 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.