Medical Malpractice Insurance: Coverage, Claims to the Insurer and Compensation

Malpractice insurance secures a physician's legal liability arising from medical treatment, within the scope and limits of the policy. When the conditions are met, an injured patient or the relatives entitled to claim may demand compensation directly from the insurance company. Knowing only that the physician is insured is not enough for this. Medical liability, the harm, the correct policy period and the scope of the claim must be set out together. [1–3]

The date of a surgery, the date the harm was discovered, the date a compensation claim reached the physician and the date of the application to the insurer may all differ. Such differences can change which company, under which policy, is held responsible. In addition, the patient's direct claim, the physician's request to his or her own insurer and the insurer's claim arising from compensation paid by the administration are separate legal relationships.

This article examines compulsory physician liability insurance in Türkiye from the perspective of the patient, the patient's relatives and the physician. Coverage limits, application documents, arbitration and litigation routes, together with actual court decisions, are reviewed together. The research date is October 11, 2026. For past events, the relevant policy and the rules in force at that time must also be assessed.

What is malpractice insurance and who must have it

The official name of the insurance is the Compulsory Financial Liability Insurance for Medical Malpractice (Tıbbi Kötü Uygulamaya İlişkin Zorunlu Mali Sorumluluk Sigortası). Supplementary Article 12 of Law No. 1219 on the Practice of Medicine and Its Branches (Tababet ve Şuabatı San'atlarının Tarzı İcrasına Dair Kanun) sets out the insurance obligation for physicians and dentists working in public and private health institutions or practising as self-employed professionals, and for those who are specialists under the rules on medical specialisation. The scope should not be understood as a hospital insurance that automatically covers every activity of every health worker. [1]

For public employees, half of the premium is paid by the physician and half by the relevant public source. For employees of private institutions, the institution takes out the insurance; the burden of the premium is subject to the sharing principle set out in the law. A self-employed physician takes out the insurance personally. Who pays the premium is a separate question from which insurer the patient may approach. [1, 4]

The physician's policy and hospital liability are different

The physician's policy relates to the professional liability of the insured physician. Not all liability that may arise from a hospital's staff shortage, equipment failure, record-keeping problems or organisational gaps is paid under this policy. The hospital may have its own liability policy; its insured party, coverage and exclusions must be examined separately.

A patient's private health insurance is also a different contract. Private health insurance secures treatment costs on its own terms, whereas the malpractice policy responds to the physician's damages liability when the physician is held legally responsible. Confusing these two policies in a claim file may lead to a claim being directed at the wrong company or based on the wrong coverage.

Which harms does malpractice insurance cover?

Insurance is not a system that pays automatically whenever an undesired result occurs in medical treatment. The conduct giving rise to the physician's liability, the harm resulting from it and an appropriate causal link between them must be established. Alongside the occurrence of a complication, it is also important whether the physician recognised the complication in time and managed it appropriately.

Pecuniary losses such as treatment costs, loss of working capacity, the need for care, the effect on future earnings and, in the case of death, loss of support (destekten yoksun kalma) may be assessed once the conditions of liability and coverage are met. Non-pecuniary damages are not entirely outside the compulsory insurance. The tariff explains that the coverage amount applies to pecuniary and non-pecuniary damages and to litigation costs. Each item must be shown separately, by the person entitled to claim and by its legal basis. [3, 4, 5]

Liability in damages does not depend, in every case, on a criminal conviction of the physician. Under Article 74 of the Turkish Code of Obligations No. 6098, criminal and civil liability are distinguished; the effect of evidence and factual findings in the criminal file is assessed separately. The mere absence of a criminal conviction is not, on its own, enough to reject an insurance claim. [5]

A payment claim may be rejected where fault and causation cannot be proven

In its decision dated July 9, 2025, E. 2024/5755, K. 2025/4991, the 11th Civil Chamber of the Court of Cassation (Yargıtay 11. Hukuk Dairesi) upheld the dismissal of an insurance claim arising from allegations concerning pregnancy monitoring and prenatal information. The decision assessed, in terms of causation, the actions of the insured physician in a pregnancy monitored by several physicians, together with the findings in the file. [6]

The practical significance of this decision is that the existence of an insurance policy does not remove the examination of medical liability. The decision cannot be generalised to say that every pregnancy monitoring dispute will reach the same result, or that the burden of proof for disclosure always rests on the patient. In each case, it must be clarified which physician acted, in which period and with which information and findings.

Attorney's fees and assistance in the defence

Reasonable costs relating to a damages claim against a physician, assistance in the defence and advance on costs are regulated by the Turkish Commercial Code and the General Conditions. However, it cannot be said that the whole of the fee agreed by the physician with any lawyer may be unconditionally charged to the insurer. The insurer's participation in the process, the choice of lawyer, the type of action, the limit and the nature of the expense are all examined. Defence costs in criminal prosecution are also not subject to the same assessment as a compensation action. [2, 3]

Why the policy period and the date of the compensation claim matter

Under Sections A.1 and B.1 of the General Conditions, a compensation claim made during the contract term is decisive. There are also provisions for claims arising from professional activities in the preceding ten years; however, the start of that period cannot go back before July 30, 2009. Events occurring in periods in which the physician was without insurance for more than one month are subject to a separate restriction on coverage. For this reason, the responsible company cannot be chosen by looking only at the policy in force on the day of the intervention or only at the last policy. [3]

The first compensation claim that reaches the physician may be a formal notice (ihtar), correspondence, a petition or another application depending on its content. A mere expression of dissatisfaction and a claim for compensation for harm are not to be treated as the same thing. What matters is not only the title of the correspondence but its content and the date on which it reached whom. Nor should it be assumed that a criminal complaint alone constitutes a compensation claim in the insurance sense in every case.

Retroactive coverage and limitation answer different questions

Retroactive coverage determines under which policy an older medical intervention may be examined. Limitation, on the other hand, concerns the defence of time-bar against the assertion of a claim by way of a lawsuit. In the study by Hacı Kara, the separation of contracts based on events and on claims, the uninterrupted renewal of the policy and the joint assessment of different time limits are also addressed. This conceptual distinction is not an independent time-limit rule replacing the current General Conditions. [7, pp. 266–269]

Where professional activity has ended, additional protection is provided for claims that may arise within two years after the end of the contract, in respect of activities during the last contract period. This provision does not mean that every expired policy carries an automatic two-year additional coverage for all past practice. Ceasing to practise, changing insurer and non-renewal of a policy are facts that must be recorded separately. [3]

An actual decision on applying to the wrong insurer

In its decision dated July 8, 2025, E. 2025/162, K. 2025/4950, the 11th Civil Chamber of the Court of Cassation reviewed an insurance arbitration file concerning a claim for loss of support following a death. The Objections Arbitral Tribunal (İtiraz Hakem Heyeti) rejected the application for absence of passive legal standing, on the ground that the respondent company had no policy for the relevant period; the Court of Cassation upheld that result. [8]

The decision treats March 21, 2018 as the date of the risk. However, the text does not set out all the details of the first notice of compensation. For this reason, the decision cannot be presented as a general rule that disregards the claim-date provision of the General Conditions and takes the date of death as the basis in every file. The practical lesson is that all the policies, together with the first claim and notice documents, must be examined together.

Current coverage limits and the aggregate of the policy

The amendment published in the Official Gazette No. 32979 dated August 7, 2025 entered into force on November 1, 2025. The maximum amounts per event under the current tariff examined are as follows. These are not fixed amounts payable unconditionally to every injured party. The physician's risk group, the applicable policy and the proven harm are determined separately. [4, 9]

The aggregate limit of compensation payable under the contract is 9,000,000 TL. Presenting this aggregate limit as a per-event limit is incorrect. Nor does the fact that more than one person was harmed by the same event multiply the per-event limit automatically by the number of persons. The independence of the events, the connection between the claims and earlier payments must be examined. [4, 9]

The new amounts do not apply automatically to all earlier policies. The tariff applicable to the period must be identified from the dates of the event, the claim and the policy. Where the harm exceeds the limit, claims for the excess directed at the responsible physician, hospital or administration are assessed separately. The insurance limit is not the upper limit of the total harm or of the debts of other responsible parties.

Situations outside coverage and the insurer's right of recourse

There are limitations relating to conduct outside the physician's professional activity, activities and experiments excluded under the General Conditions, administrative or judicial fines and penal clauses. A fine is a sanction different from the compensation owed to the patient. Not all exclusions in the old optional physician insurance clauses should be carried automatically into the current terms of the compulsory policy. [3]

The insurer's relationship with the physician and its position towards the injured person must also be kept apart. Under Article 1484 of the Turkish Commercial Code No. 6102, even where the insurer is released from its performance obligation towards its insured, it remains bound to the injured person up to the amount of the compulsory insurance. For this reason, when a problem of premium, declaration or notice is raised, it may not be assumed that the patient's right has come to an end directly. The legal basis of the defence and whether it can be asserted against the injured person are examined. [2]

The General Conditions regulate grounds for recourse, such as intent, conduct under the influence of alcohol or drugs and failure to obtain a required endorsement. In relation to intent, Article 1477 of the Turkish Commercial Code and the provisions protecting the injured person in compulsory insurance are considered together. The insurer's possibility of turning against the physician after payment is not the same as a defence that it need not pay the patient. This distinction is decisive both for the patient's application and for the physician's defence. [2, 3]

How to prepare a compensation claim to the insurance company

Under Article 1478 of the Turkish Commercial Code No. 6102, an injured person may claim directly from the insurer the harm up to the insured amount. It cannot be said that in every file a final compensation judgment must first be obtained against the physician. Nevertheless, the application should be suitable for examining the physician's liability and the scope of coverage. [2]

The application should clearly state the patient, the insured physician, the healthcare institution, the dates of the medical treatment and the alleged error. The claims for pecuniary or non-pecuniary harm of each person must be separated; expenses that can be proven with the documents at hand, and losses that still have to be calculated, should be shown. Where the policy is unknown, requests for information from the institution and the physician, obtaining the relevant records in the proceedings and lawful means of inquiry are considered. The e-Government (E-Devlet) service for querying a person's policy should not be understood as giving unlimited access to all insurance information of another physician. [10]

The content of the application and its date of delivery should be kept. If hospital records are incomplete, it is not enough to merely note the gap; it should be shown which records are held by whom and which claim they would clarify. Medical assessment and calculation of damages complement each other; an expert calculation report alone does not prove the physician's fault.

Health data should be shared only to the extent necessary for examining the dispute, through secure channels. Uploading the entire patient file to public complaint platforms may disclose more personal data than the requirements of proof call for.

The insurer's payment period and advance payment

Maturity under Article 1427 of the Turkish Commercial Code and Section B.3.3 of the General Conditions is linked to the submission of documents and the completion of the investigation; the forty-five-day period set out in the regulation after notice is also taken into account. Where the investigation has been delayed for a reason that cannot be attributed to the insurer, the period may not run. For this reason, the justification of a request for missing documents and whether it actually prevents the investigation should be assessed. [2, 3]

Where the investigation cannot be completed within three months, once the conditions are met, at least fifty percent of the amount determined promptly through agreement or a preliminary expert examination ordered by the court is paid as an advance. This does not mean that half of every amount claimed in the application is paid automatically. Where the insurer's debt has become due, the rule of default without a formal notice applies. The type and start date of interest must be stated expressly in the claim; interest on the physician's liability and the insurer's own default should not be treated as identical. [2, 3]

Arbitration or litigation if the insurer does not pay

Application to the Insurance Arbitration Commission

For compulsory insurance, subject to the relevant date conditions, the fact that an insurance company is not a member of the arbitration system is not, on its own, an obstacle. First, a written application must be made to the insurance company, and it must be documented that the claim has been wholly or partly rejected, or that no written answer has been received within 15 business days. The 15-day period used for traffic insurance should not be transposed verbatim into malpractice files. [11, 12]

Where the same dispute has already been brought before a court or a consumer arbitration committee, a separate application to the Commission cannot be made. Arbitration resolves the insurance dispute; it does not automatically cover all liability of the hospital or the physician outside the policy. Where other files concerning the same event exist, the parties, the claim and the legal basis should be compared. Mandatory commercial mediation before arbitration is not a general precondition; a prior application to the insurer is a separate condition. [11–13]

The application fee, the expert fee and a possible counter-attorney's fee must be taken into account. The possibilities of objection and appeal against an arbitral award depend on the value in dispute and the current monetary limits. Historical amounts in the law should not be used as if they were the current limits. Where an objection is possible, the ten-day period running from notification of the decision by the Commission must be observed carefully. Current fees and limits should be checked against the official announcements of the Commission on the date of the procedure. [11, 12]

Competent court and mediation

Where a claim is directed at the liability insurer alone on the basis of the policy, the assessment of a commercial action and of the commercial court of first instance applies under Articles 4 and 5 of the Turkish Commercial Code. For commercial actions for a debt or compensation, the mediation requirement under Article 5/A of the Turkish Commercial Code is taken into account. An application to the insurance company does not replace mediation. [2]

Joint suit against a physician and a private hospital, the consumer nature of the transaction and the consolidation of claims may affect the assessment of jurisdiction. A claim for fault in public service directed at the administration falls within the administrative judicial route. The designation of a single court for all malpractice disputes would remove these distinctions. As regards territorial jurisdiction too, the defendant and the rules applicable to the insurance relationship and the nature of the dispute must be examined. [14, 15, 21]

Insurance and administration in an incident in a public hospital

In its decision dated March 5, 2026, E. 2025/6255, K. 2026/1311, the 11th Civil Chamber of the Court of Cassation reviewed a commercial action in which support loss arising from a death was claimed from the insurance company. The action against the administration was treated as a matter awaiting determination; the final administrative decision and the expert examination in the file were assessed, and the decision accepting the claim within the policy limit was upheld. This file is an example of how the different legal bases of a claim against the administration and a claim against the insurer may be considered together. [16]

The position of the administration after payment is also important. The provision added to Supplementary Article 18 of Law No. 3359 on Basic Health Services in 2024 governs the claim of an administration that has paid on the basis of a final judgment, concerning certain public health workers' medical acts, against the insurer. The claim is assessed in proportion to the fault of the health professional and within insurance coverage. The claim against the physician through personal recourse by the administration and its claim against the insurance company must not be confused. [17]

In its decision dated July 8, 2019, E. 2019/2062, K. 2019/5048, the 11th Civil Chamber of the Court of Cassation also held that it is not sufficient to charge the insurer with the whole amount paid by the physician to the administration. It was stated that a report determining the physician's degree of fault in a reviewable manner must be obtained, and the decision was quashed. The decision predates the 2024 amendment and should not be used as the source of the current public recourse procedure. Its contribution to the present file is to show that the fact that payment has been made does not render the examination of fault and coverage unnecessary. [18]

How limitation and application periods should be separated

Under Article 1420 of the Turkish Commercial Code, claims arising from the insurance contract are subject to the general two-year period from maturity; under Article 1482, compensation claims directed at the liability insurer are subject to a ten-year period from the event insured against. Section C.9 of the General Conditions also sets out the two- and ten-year periods together. The approach that "there are ten years, so we can wait" is not safe. The nature of the claim, its maturity, the insured event and the relationship between the periods must be determined in the concrete file. [2, 3]

The periods for claims against a physician or hospital in tort and contract, and the periods for applications and actions against the administration, are not the same. In particular, for full remedy actions arising from administrative acts, the one-year period from learning of the harm and the five-year period from the act under Article 13 of the Administrative Procedure Law No. 2577 must be followed separately. The start of the period is assessed on the basis of when the harm was learned and the specific features of the event. Continuing insurance correspondence does not automatically suspend administrative periods. [5, 15]

Mere formal notices, complaints or insurance correspondence do not in every case count as acts interrupting limitation. The effect of an action, arbitration, acknowledgment of debt and mediation on the period must be assessed under their own provisions. In selecting the type of action and any increase in the claim, the procedural amendments of July 31, 2026 and the transitional provisions must also be examined; the uncertain-claim practice of earlier decisions must not be carried automatically into new actions. [5, 13, 14, 19]

Rights to be protected during settlement and payment

In a payment offer, it must be clear which head of loss, for which rights holder and from which policy the payment is made. If a partial payment document contains wording that ends all future claims, the consequences of that wording should be assessed before signing. In a file where permanent harm has not yet been determined, a general release may make claims for care or loss of working capacity that have not been calculated contentious.

The effect on the insurer of a settlement made by the physician without the insurer's approval is examined separately under Article 1476 of the Turkish Commercial Code and Section B.3.4 of the General Conditions. From the patient's side, the effect of recovery from one liable party on claims directed at other liable parties must be determined. The same harm cannot be recovered twice; but a partial payment does not mean that the remaining harm has also been paid. [2, 3, 5]

Where there is a risk that medical records may be lost or altered, preservation of evidence may be considered; where security for the collection of a monetary claim is needed, a precautionary attachment may be considered when its conditions are met. Not every malpractice allegation automatically provides temporary protection. After a court or arbitral decision, payment, legal remedies and enforcement must be carried out according to the type of decision; the fact that an application has been made does not, by itself, produce a collection result. [14, 20]

Where a foreign patient treated in Türkiye returns to his or her country, this does not make the insurance examination unnecessary. The treatment records in Türkiye and the treatment and expense documents abroad should be prepared together; translation, representation and service needs must be identified. The geographic scope of the insurance relates in essence to the professional activity in Türkiye; the patient's nationality and the place where the intervention was carried out must not be confused. [3]

Conclusion

The success of a compensation claim under malpractice insurance depends on setting up medical liability and insurance coverage correctly within the same file. First, the treatment alleged to have caused the harm and the persons responsible must be identified; then the policies, the first compensation claim, the notices and the harm documents should be compared. If the insurance company or the route of application is chosen before this work is completed, a claim that is well-founded on the merits may become harder to recover.

For the patient, the aim is to claim provable harm from the correct addressee within the time limit. For the physician, timely notice of the event and the claims, and the conduct of the defence and the insurance procedures together, are important. When the policy limit, recourse, settlement and the different periods are assessed separately, the real scope of the insurance protection becomes visible.

Frequently Asked Questions

Must the patient first sue the doctor?

Not in every case. Article 1478 of the Turkish Commercial Code gives the injured person a direct right to claim from the insurer. Liability, coverage and the preconditions of the chosen route are still examined.

Does malpractice insurance also cover non-pecuniary damages?

Yes, the tariff of the compulsory insurance also includes non-pecuniary damages. However, the conditions of the non-pecuniary harm, the rights holder and the applicable limit are determined separately.

Is there 9,000,000 TL of coverage for each patient?

No. 9,000,000 TL is the aggregate limit of the contract. The per-event limit under the current tariff ranges from 1,000,000 to 4,000,000 TL depending on the risk group, and the relevant policy period is checked separately.

Is the insurer on the date of the surgery always the responsible one?

No. The General Conditions also attach consequences to the date of the compensation claim. Earlier and later policies, periods without insurance and the content of the first notice must be examined together.

Can arbitration be applied to immediately after the insurer's rejection?

Where there is a final answer rejecting the claim wholly or in part, an application may be made provided the other conditions are also met. If no answer has been given, the 15-business-day period applies in malpractice insurance.

Is the absence of a criminal conviction enough for the insurer not to pay?

No. Liability in damages does not depend in every case on a criminal conviction. Medical liability and insurance coverage are examined on their own legal conditions; the effect of the evidence and findings in the criminal file is assessed separately. [5]

Does a premium or notice problem completely eliminate the patient's claim?

This conclusion cannot be reached automatically. Under the rules protecting the injured person in compulsory insurance, the insurer's defences against the physician and its right of recourse are assessed together.

Does an application to the insurer suspend all litigation periods?

No. An application to the insurer, mediation, arbitration and an administrative application are different procedures. The period for each claim and the procedures affecting it must be tracked separately.

Sources and legal bases

1. Law No. 1219 on the Practice of Medicine and Its Branches (Tababet ve Şuabatı San'atlarının Tarzı İcrasına Dair Kanun), supplementary Article 12.
2. Turkish Commercial Code No. 6102 (Türk Ticaret Kanunu), Articles 4, 5, 5/A, 1420, 1427 and 1473–1486.
3. Insurance Association of Türkiye (Türkiye Sigorta Birliği), General Conditions of the Compulsory Financial Liability Insurance for Medical Malpractice (Tıbbi Kötü Uygulamaya İlişkin Zorunlu Mali Sorumluluk Sigortası Genel Şartları).
4. Dental Association of Türkiye (Türk Dişhekimleri Birliği), consolidated text of Communiqué 2010/1 (Tebliğ 2010/1) and its annexed Tariff and Instructions (Tarife ve Talimat).
5. Turkish Code of Obligations No. 6098 (Türk Borçlar Kanunu), Articles 49–56, 61–62, 72, 74, 76 and 154.
6. Court of Cassation (Yargıtay), 11th Civil Chamber, July 9, 2025, E. 2024/5755, K. 2025/4991.
7. Hacı Kara, "Yargıtay ve Hakem Kararlarına Göre Hekimin Zorunlu Mali Sorumluluk Sigortası" (The Compulsory Financial Liability Insurance of Physicians According to Court of Cassation and Arbitral Decisions), TBB Dergisi, 2021, No. 152, pp. 255–303; especially pp. 266–269.
8. Court of Cassation (Yargıtay), 11th Civil Chamber, July 8, 2025, E. 2025/162, K. 2025/4950.
9. SEDDK, Communiqué amending Communiqué 2010/1 (Tebliğ 2010/1’de Değişiklik Yapılmasına İlişkin Tebliğ), Official Gazette (Resmî Gazete) dated August 7, 2025, No. 32979; in force November 1, 2025.
10. e-Government (E-Devlet), SBM insurance query service for the Compulsory Financial Liability Insurance for Medical Malpractice.
11. Law No. 5684 on Insurance (Sigortacılık Kanunu), Article 30.
12. Insurance Arbitration Commission (Sigorta Tahkim Komisyonu), Frequently Asked Questions and current application information.
13. Law No. 6325 on Mediation in Civil Disputes (Hukuk Uyuşmazlıklarında Arabuluculuk Kanunu), Articles 16 and 18/A.
14. Law No. 6100 on Civil Procedure (Hukuk Muhakemeleri Kanunu), provisions on jurisdiction, venue, increase of claims, expert examination and preservation of evidence.
15. Law No. 2577 on Administrative Procedure (İdari Yargılama Usulü Kanunu), Articles 2, 7 and 13.
16. Court of Cassation (Yargıtay), 11th Civil Chamber, March 5, 2026, E. 2025/6255, K. 2026/1311.
17. Law No. 3359 on Basic Health Services (Sağlık Hizmetleri Temel Kanunu), supplementary Article 18.
18. Court of Cassation (Yargıtay), 11th Civil Chamber, July 8, 2019, E. 2019/2062, K. 2019/5048.
19. Law No. 7589, Articles 18–20, provisional Article 1 and entry-into-force provisions.
20. Law No. 2004 on Enforcement and Bankruptcy (İcra ve İflas Kanunu), Article 257 et seq.
21. Law No. 6502 on Consumer Protection (Tüketicinin Korunması Hakkında Kanun), Articles 3, 73 and 73/A.