of

1. Any intentional criminal act, fraud, dishonesty, or deliberate violation of laws or regulations.
2. Medical services provided while under the influence of alcohol, drugs, or any intoxicating substances.
3. Fines, penalties, or damages imposed to punish the insured rather than to compensate the patient.
4. Liabilities accepted under a contract that exceed the scope of professional responsibility or legal duty.
5. Claims related to incidents, errors, or circumstances known to the insured before the commencement of the policy.
6. Any collusion or direct participation in criminal activities, including premeditated murder.
7. Involvement in the trade, sale, or procurement of live human organs for transplantation.
8. Illegal possession, prescription, or dispensing of prohibited drugs
9. Unauthorized or illegal experimentation or medical procedures
10. Practicing without a valid medical registration, license, or certificate
11. Non-compliance with Government Acts, municipal or health authority regulations related to medical practice, establishment operations, licensing, signage, or patient care facilities.
12. Any illegal or unethical conduct in fertility treatments, impotence management, or reproductive health procedures.
13. Falsification or substitution of death certificates, alteration of cause-of-death records, or tampering with cadavers.
14. Collusion or involvement in cases involving substitution, misidentification, or exchange of newborn babies.

1. You must immediately notify your insurance broker / agent / service provider and the insurer in writing, even if you believe the claim is baseless and forward the demand letter, summons, or complaint received. You must not admit fault, make any offers, or respond to the claimant without the insurer's prior written consent to your professional liability carrier or insurance broker right away.
2. Immediately pull the complete, original medical record related to the case (physical and electronic) and secure it in a locked location.
3. The record must remain exactly as it was when the claim was received. Even a good-faith addendum made later can be misinterpreted by the court as a fraudulent attempt to cover up an error.
4. Within the hospital/clinic, assign a risk manager or specific individual to be the sole contact for the legal team and insurer. This controls the flow of information.
5. Cooperate fully with your insurer and their appointed defence counsel. Provide them with all requested documents, staff contact information, and a narrative of the events.
6. Review the incident and the patient's care against the hospital's established protocols and clinical guidelines. This helps identify if an alleged deviation occurred.

DON'T Contact the Patient or Family. Direct communication with the claimant (patient) or their family after receiving a formal claim can be viewed as interference, obstruction, or an admission of guilt. All communication must go through legal counsel.

NEVER backdate, erase, delete, or rewrite any part of the patient's record after receiving notice of a claim. This is an ethical and potentially criminal violation that is devastating to a legal defence.

Avoid discussing the details of the case with colleagues, nurses, or other hospital employees outside of a formal, confidential internal investigation or with your defence counsel. These conversations are not privileged and can be discovered in court.

While professional responsibility includes apologizing for poor outcomes, do NOT apologize or admit fault after a claim has been made. Even well-intended statements can be used by the plaintiff's attorney as a legal admission of liability.

Continue to treat your current patients with the same reasonable standard of care. Obsessing over the lawsuit and allowing it to compromise your current clinical judgment is a separate risk.

Treat all digital communications (personal email, text, social media, even "private" chat groups) as discoverable evidence. Never mention the claim, the patient, or the adverse outcome online.