Legal Expense Insurance

Legal expense protection gap

An important gap in the protection of Quebec physicians

Quebec physicians (whether they are members of the FMSQ or the FMOQ) are at constant risk for medico-legal issues related to their practice.

Medico-legal issues facing physicians can be divided into two broad categories: issues related to patient care and those not-related to patient care. And both medico-legal categories are of high risk to physicians with important consequences to their wellbeing, financial status, and future patient care.

Non-patient care related medico-legal issues have increased at a steady pace over the last years, as evidenced by increasing Collège des médecins du Québec inquiries, patient complaints, hospital disciplinary issues, and RAMQ billing issues.

Consequences of non-patient care related medico-legal issues could be dire. Physician depression, anxiety, and even suicide have been related to these issues. Economic consequences can also be critical, as evidenced by excessive suspensions of licenses. Billing code issues on technicalities can result in loss of income into the hundreds of thousands of dollars. Of course, these issues can also negatively affect the care offered by the physician to their patients.

The lack of adequate legal coverage involving non-patient care related issues is a glaring and urgent need to address. As such, the DEFENSEMD Legal Expense Insurance program was developed specifically to cover non-patient care related legal issues and bridge the gap in the protection of Quebec physicians.

"Doesn't the CMPA cover me already?"

That’s the question we get asked most frequently by physicians. Currently, physicians are well protected for medico-legal issues related to patient care, notably via the CMPA or other malpractice insurances recognized as a pre-requisite to practice.

However, there is no adequate coverage in Quebec for physicians for non-patient care related issues. In medico-legal cases, once an issue is unrelated to patient care, current malpractice coverage ends and the physician is advised to hire their own lawyer.

Doesn't the CMPA cover me?

Unfortunately, the vast majority of physicians are surprised and unprepared when facing such a situation, mistakenly believing that their insurance adequately covers them. This is a critical moment where they need to be represented, but are left to their own devices.

Of note, the CMPA does offer some assistance for certain non-patient care issues, but at their discretion. However, this assistance is not the same thing as legal defense. This is clearly evident since the CMPA does not cover appeal processes for these issues . This is another important gap in the protection of physicians.

As of 2020, the CMPA has reduced their fees for Quebec physicians because they generally do not cover these issues and so their costs have reduced.

In addition to non-patient care related legal issues, physicians who work or run clinics outside of hospitals are exposed to legal issues regularly as well. These include acts related to employees, commercial contracts, etc. These issues related to commercial practice are outside of the scope of the CMPA’s medical malpractice coverage.

General legal aid is also sorely lacking for physicians. In general, CMPA coverage will offer advice by physician councilors, but not lawyers.

With CMPA coverage, the client of the legal counsel is the CMPA and not the physician. What is needed is for the physician to be the client of the legal representation.

Unique medical legal expense coverage

For a variety of issues that may affect your professional standing, your right to practice and your financial wellbeing

Unlimited access to a lawyer

For immediate general advice on any matter of a professional nature, via a toll-free Telephone Legal Advisory Service

Underwritten by Lloyd's of London

For your peace of mind, the Lloyd’s of London underwrites the professional and commercial legal expense insurance