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For patients

Patient insurance – your protection in case of medical error

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Most healthcare goes well. But if something goes wrong, you don’t have to face it alone — patient insurance is there for you.
what is compensated

Harm that could have been avoided

Patient insurance helps you when a healthcare provider has made a mistake during diagnosis, treatment or another activity and this has caused you harm to your health that with ordinary care could have been prevented.

May be compensated

  • A fracture or change visible on a scan was missed
  • An organ was injured during surgery through negligence
  • An infection caused by a breach of sterility rules
  • The wrong medicine or the wrong dose was given
  • A known allergy was overlooked and the wrong treatment followed
  • An injury caused by faulty equipment or during transport

Usually not covered

  • The natural course of an illness or treatment
  • A known complication or side effect of correct treatment
  • A defect in a medicine or an implant
  • Treatment provided outside Estonia
  • Losses below 200 euros
  • Queues, invoices and waiting times without harm to health

You do not have to know yourself whether it was a treatment error, nor argue with the healthcare provider — it is enough to report the incident, and the insurer then assesses the situation. The examples above are illustrative; your case is always assessed on its own specific circumstances.

Four simple steps

What to do if something has happened to you

1

Report the harm

Fill in the simple claim form here. Report as soon as you can — ideally within four weeks of learning about the error. If four weeks have already passed, report it anyway — the claim itself only expires three years after you learned about the breach and the harm.

2

The insurer reviews your claim

Please be patient — the insurer may take up to 180 days to decide whether it is an insured event. During that time the insurer may contact both you and your healthcare provider to clarify further circumstances.

3

Submit a compensation claim

If the decision is positive and it is an insured event, you can submit a claim for the harm you have suffered.

4

Compensation of the harm

The insurer determines and pays out the compensation within a reasonable time.

If you are not satisfied with the insurer's decision

You have the right to turn to the liability insurance conciliation committee operating at the Health Board. It is an independent pre-court body and reviewing your application is free of charge. Conciliation does not take away your right to go to court later.

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How much protection

Compensation limits

The law sets the upper limits of compensation; the amount you receive depends on the actual harm you have suffered and on the circumstances.

100 000 €
per entitled person
300 000 €
per insured event
3 000 000 €
total per year
30 000 €
for non-pecuniary damage per entitled person
100 000 €
for non-pecuniary damage per insured event
Frequently asked questions

Find answers to the most common questions

What is patient insurance?
It is the healthcare provider’s compulsory liability insurance. If you — the patient — suffer harm during healthcare for which the provider is liable by law, this insurance helps compensate the harm.
Do I have to pay for it myself?
No. The premium is paid by the healthcare provider. For you as a patient, the protection is free.
Who is the beneficiary of patient insurance?
The beneficiary, or entitled person, is you — the patient, your dependant(s), heir(s) or other persons entitled to compensation under the law and the insurance terms.
What kinds of harm are compensated?
For example: treatment costs, costs of medicines and aids, loss caused by incapacity for work, care costs, funeral costs and, to the extent provided by law, non-pecuniary (moral) damage.
How long do I have to submit a claim?
A claim expires 3 years after you learned about the breach and the harm — but no later than 10 years after the incident occurred. The insurer should be notified as soon as possible, ideally within four weeks, but reporting later does not take away your right to compensation.
Where does patient insurance cover apply?
The insurance applies only to healthcare services provided in Estonia, and only to those services for which a valid activity licence has been issued.
What does patient insurance not cover?
Harm below €200; harm arising outside Estonia; harm arising from product liability or clinical trials; consequences caused intentionally or while intoxicated; incidents causing avoidable harm that occurred before the patient insurance act entered into force on 1.11.2024.
What is the deductible?
The deductible is an amount agreed in the insurance contract up to which the healthcare provider itself covers the harm. It does not affect your right to compensation.
How do I submit a claim?
The easiest way is to fill in the claim form right here on this website. Report as soon as you can after learning about the breach in the healthcare service.

Do you have more questions?

Get in touch and we will be happy to help.

Call: +372 5605 4189

Write: info@medmal.ee