Starting from August 14th 2014, doctors and medical staff professionals shall undersign a professional indemnity insurance so to cover damages to patients arising from medical malpractice. The obligation above was first provided for by Law Decree no. 138 / 2011, converted by Law no. 148 / 2011. The deadline had been set to August 2013 but was subsequently postponed until August 14th 2014 by means of Law Decree no. 69 / 2013, converted by Law no. 98 / 2013.

This obligation does not apply to doctors and medical staff professionals (state employees) of the National Health Service, bound to take out an insurance policy only when carrying out extramural activity (so called “extramoenia”). This is due to the fact that, pursuant to Article 28 of the Italian Constitution, “officials and employees of the State are directly responsible of acts in violation of rights, according to the criminal, civil and administrative laws. In such cases, the liability extends to the State and public bodies”: therefore, the damaged third party shall be entitled to request the payment of damages directly to the public body.

It is estimated that approximately 211,000 doctors should be covered by an health professional indemnity insurance. Otherwise they shall be subject to a disciplinary action.

Doctors and medical staff professionals of the National Health Service (approximately 115,000), as mentioned, will not be affected. However, in case of gross negligence, they could be subject to an action of recourse by the State Auditors' Department to recover the amount of the sums paid by the National Health Service. Therefore, even if a general practitioner operates only as a public employee, he/she can (even if there is no such duty) undersign an insurance policy aimed at guaranteeing him/her only in cases of gross negligence (please consider that fraud cannot be insured). As an indication, the above kind of insurance can cost 500-600 Euros per year.

Local health authorities of the National Health Service and private companies providing health services shall be forced to take out an insurance policy coverage or other similar measures for third party liability and civil liability towards workers, in order to protect patients and medical staff.

The number of claims against doctors and local health authorities seems to decrease. According to ANIA (Italian National Association of Insurance Companies) there were 33,700 claims registered in 2010, reduced to 31,200 in 2012: a reduction of -8 per cent. Not a sharp fall, but very significant if it is considered that since 1994 the number of such claims has increased by over 200%.