This Policy shall specify the minimum limits of Medical Malpractice liability coverage in accordance with the terms, conditions and exceptions provided herein or attached hereto. In consideration of the Insured having paid the premium to the Company, the Company agrees to provide insurance coverage subject to the terms, conditions and exclusions of this Policy, and shall provide coverage up to the amounts and limits stated in this Policy, or as amended by Endorsement

The Company and the Insured shall not be entitled to agree on liability limits lower than those set herein. However, the Company and the Insured may agree on additional coverage not specified herein.

The following words and phrases, wherever they occur herein, shall have the meanings assigned thereto, unless the context requires otherwise:

1- The Company: The licensed Insurance Company that practices insurance businesses in

accordance with Cooperative Insurance Companies Control Law.

2- Policy: The Standard Insurance Policy of Medical Malpractice.

3- The Insured: the medical

practitioner as defined in Law of Practicing Healthcare Professions, who has entered into an insurance contract.

4- Medical Malpractice: Any bodily, physical injury or mental injury, sickness, illness, disease, or death of any patient caused by the Insured’s negligent act, error or omission during ordinary, Emergency Medical Treatment, home medical visits and telehealth care within the scope of the job or profession during the presence in the Kingdom of Saudi Arabia.

5- Other Emergency Medical Treatment: medical treatment provided by the Insured at the scene of the sudden event, who was present either by coincidence or in response to an emergency call following the sudden event.

6- Claim: A Claim for Indemnity of damages or losses caused by Medical Malpractice covered under the Policy.

7- Defense Costs: All cost, fees, and expenses incurred in defending the Insured or for the purpose of settling any Claim within the limits of coverage stated in the Policy Schedule.

8-Products: Any solid, liquid or

gaseous substance or component part thereof.

9- Extended Reporting Period: the benefit, which provides the Insured with an extended period to report any Claims occurring during the Policy period, which start from the expiry date of the Policy or the date of cancelation till the end of the Extended Reporting Period.

10- Administration Fees: The

amount charged towards the administrative costs for the issuance of the Policy.

11- Premium: Amount paid by the Insured to the Company in exchange for the Company’s acceptance to indemnify the Insured; in accordance with insurance coverage stated in the Policy.

12- Deductible: The portion of the loss amount mentioned in the Policy Schedule, which is to be borne by the Insured.

13- Indemnity: The amount to be paid by the Company based on a verdict against the Insured due to Medical Malpractice including Defense Costs in accordance to the limit insurance coverage.

14- Compulsory Retroactive Insurance: Compulsory Coverage for a period prior to the inception date the Policy.

15- Additional Retroactive Insurance: the coverage that the Company decided to provide to the Insured for a period prior to the inception date of the Policy.

16- Retroactive Date: the inception date of either Compulsory or Additional Retroactive Insurance.

17- Material Fact: Any information, which may affect the Company’s decision in specifying the Premium amount by 25% or more, or the terms of the Policy, or the Claim approval.

18- Policy Schedule: The schedule annexed to the Policy containing information about the Insured; which is considered an integral part of the Policy.

First: Insurance coverage period starts in accordance to Policy terms and conditions- without prejudice to the transitional provisions issued by SAMA- as follows:

1. In case the Policy being issued and renewed by the same Company without interruption in the insurance coverage: The Company must provide Compulsory Retroactive Insurance starting from the inception date of the coverage under the first Policy being issued by the Company till the expiry date of the last Policy being issued by the Company.

2. In case the Policy being issued by a new Company or being renewed by current company with interruption not more than 14 calendar days :

The Company must provide Compulsory Retroactive Insurance starting from the inception date of the coverage Under the first Policy being issued either by the current Company or by previous Company (ies) of the Insured.

3. In case the Policy being issued by a

new Company, or being renewed by

current Company: with interruption

for more than 14 calendar days :

The insurance coverage shall start from the inception date of the coverage being issued by the Company, however, the Company may elect to provide Additional Retroactive Insurance staring from the inception date of the first Policy being issued for the Insured either by current Company or previous Company ( ies) or otherwise as agreed.

- In any of the above cases, The Company must state the type of Retroactive Insurance (Compulsory or additional)provided and Retroactive Date in Policy Schedule.

- The Company shall not be obliged – at the time of concluding the policy- to cover the Additional Retroactive Insurance which have been provided to the Insured by previous Policies

- The Company is not obliged to indemnify for any Medical Malpractice occurred within either Compulsory or Additional Retroactive Insurance unless it is unknown to the insured at the time the policy is being concluded .

Second: this Policy covers, as specified herein, the following:

a- Indemnity for all amounts for which the Insured is legally liable to pay to others, due to Medical Malpractice based on a final verdict issued by judicial component body.

b- Indemnity of Defense Costs.

The total Indemnity stated in subtitle (a) and (b) of this article shall not exceed the limit of insurance coverage stated in the Policy Schedule

Third: Limit of Insurance Coverage The Company and the Insured must agree on the maximum limit of insurance coverage provided that it should not be less than the limit stated in the Policy Schedule.

The insurance coverage of the Policy does not include the following:

1. Any Medical Malpractice from the Insured who does not hold a valid and proper license during the Policy period.
2. The Deductible(s) stated in the Policy Schedule
3. Any Medical Malpractice, Claim or Lawsuit instituted outside of the Kingdom of Saudi Arabia
4. Any Claim arising out of a specific liability assumed by the Insured under contract which goes beyond the duty to use such skill and care as is usual in the exercise of the Insured’ activities stated in the registration card issued by the component authority and/or job contract.

5. Any claim arising out of Medical Malpractice occurred :

   A) Prior to inception date of the Policy stated in the Policy Schedule if Compulsory or Additional Retroactive Insurance is not applicable.

   B) Prior to Retroactive Insurance Date stated in the Policy Schedule if Compulsory or Additional Retroactive Insurance is applicable.

6. Any Claim arising out of the manufacture of any Products, or the construction, alteration, repair, repacking, servicing or treating of any Products sold, supplied or distributed by the Insured, or any Claim arising out of the failure of any product to fulfil the purpose for which it was designed, or to perform as specified, warranted or guaranteed.
7.  Any Medical Malpractice occurred during the performance of experiments, or academic research, or the prescription of drugs or medicines or use of drugs or medicines for the purposes of clinical trials, or for testing the effectiveness or otherwise of such drugs or medicines.
8. Any Medical Malpractice arising out of the performance of general anesthesia unless performed by anesthesia specialist / consultant.

9. Any Medical Malpractice directly or indirectly caused by or contributed to:

   a. Any act in violation of any Saudi laws or regulations, any fines, penalties, punitive or exemplary damages.

   b. Any dishonest, fraudulent or criminal act or willful misconduct of the Insured.

   c. The performance of the activities of the Insured whilst under the influence of alcohol, drugs, or medical medications that are not medically permitted to perform duties after taking them.

10. Any Claim directly or indirectly caused by, or contributed to by, or arising from ionizing radiation(s) or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel or from the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof. However, this exclusion does not apply to the use of radioactive substances or radiation as far as they are only needed for customary medical treatment or examination , provided that it is kept and used with the usual standard precautions for these hazardous substances.
11. Any Claim arising out of war, invasion, acts of foreign enemies, hostilities, (whether war be declared or not), civil war, rebellion, revolution, insurrection, mutiny, civil commotion, military or usurped power, riot, strike, lockout, military popular uprising or confiscation or nationalization or requisition or destruction of or damage to property by, or under the order of, any government or public or local authority.
12.  Any Medical Malpractice arising out of the performance of procedures or operations for non- emergency case in a place medically unqualified -except home medical visits and telehealth care- subject to adherence of the component authorities’ standards & regulations
13.  Claims arising from the patient's dissatisfaction in the results of plastic/aesthetic surgery and/or silicon implants due to the lack of improvement in his/her aesthetic appearance.
14.  The procedures of blood banks except where these are purely providing blood or blood products for any medical procedures undertaken by the Insured.
15. Any Claims arising out of possession, application, use, handling, or maintenance of asbestos or asbestos containing products.
16. Any Medical Malpractice during abortions, unless in compliance with competent authorities.
17.  Genetic damages/manipulation.

1- Notification

A- In case of any accident or circumstance that may give rise to an admissible Claim, the Insured must notify the Company as soon as possible, provided that notification shall be during the Policy period based on the provisions of the Extended Reporting Period stated in this Policy and the Policy Schedule.

B- The Insured shall notify the Company –from the date of knowledge- in any of the cases below:

1. The receipt of notice from any person of an intention to hold the Insured responsible for any Medical Malpractice; or
2. Any conduct or circumstance which is likely to give rise to a Claim for Medical Malpractice being made against the Insured.
3. Every Claim, summons, or warrant.

4. Any change in Material Fact.

   2- Claims Settlement:

   A. Defense Costs:

   1- The Company has the right to defend and to appoint a lawyer for the Insured in any lawsuit arising out of Medical Malpractice covered by the Policy. And the Insured may appoint the lawyer after agreeing with the Company; whereas the Company shall bear the Defense Costs paid by the Insured.

   2- The Company may sue in the name of the Insured or for its own benefit to Claim any Indemnity raising from the Policy.

   3- The Company shall have the right to conduct any negotiations or proceedings on the settlement of any Claim subject to the consent of the Insured who has the right to refuse any settlement recommended by the Company or its legal representatives and elects to continue any legal procedures.

   However, in such a case, the liability of the Company shall not exceed the sum of settlement proposed, in addition to the Defense Costs or other costs agreed with the Company till the date of the Insured objection on the settlement subject to the limit of insurance coverage stated in the Policy Schedule

   4- The Insured shall assist and cooperate in the defense of any Claim.

   B. The Company shall not be obligated to indemnify, or to continue undertaking defense of any suit or proceeding after the limit of insurance coverage stated in the Policy Schedule has been exhausted.

   C. Series of Claims:

   If series of Claims arising from one Medical Malpractice have been submitted, it shall be considered as one Claim, and one Deductible shall apply.

1. The Company must offer the Insured the benefit of Extended Reporting Period and explain its importance specially in the following cases:-

A. Retirement of the Insured

B. Expiry or termination of the Insured’s license

C. Expiry or termination of the Insured’s contract with medical service providers.

D. Cancellation of the policy.

2. In case the Extended Reporting Period has been added and the Insured concludes the policy with new Company without interruption exceeding 2 months, the Company who issued the policy including Extended Reporting Period is responsible for Indemnity provided that Medical Malpractice has been occurred within the policy period of the Company who issued the policy with the benefit.

1. In Case the Insurance is mandatory:

The Insured and the Company shall not cancel the Policy except in the following cases:

1- The existence of an alternative Policy that covers the remaining period of the Policy to be cancelled.

2- Expiry or Termination of practitioner’s license for any reason.

2. In case the insurance is not mandatory:-

The Insured has the right to cancel the policy anytime.

In both cases the refunded premium to be calculated as follows:-

In the event of cancelation, the Company shall refund the Insured the due amount payable for the uncovered period by depositing the remaining amount to their bank account via IBAN, within three working days from the date on which the Company becomes aware of the occurrence of any of the cases mentioned above. The due amount payable to the Insured for the uncovered period is calculated by subtracting the elapsed days from the total Policy term (in days) and then dividing the result by the total Policy term. The result is then multiplied by the insurance Premium less Administrative Fees and the cost of Extended Reporting Period benefit to determine the return Premium:

(365 - elapsed days) /365 ×insurance Premium less administrative fees and the cost of Extended Reporting Period benefit( if any) = return Premium

The Company is exempted from its obligation to pay the due amount in the case that there is a Claim related to the Policy to be cancelled with a value exceeding the amount to be refunded as per the calculation formula mentioned above.

1- The Insured obligations:

a. Maintain accurate descriptive records of all professional services used in procedures, which shall be available for inspection and use by the Company or their duly appointed representatives in so far as they pertain to any Claim hereunder.

b. Provide the Company or their duly appointed representative such information, assistance, signed statements or depositions as the Company may require within the scope of this Policy.

c. Not to claim responsibility with the intention of harming the Company, pay, undertake, or propose to pay any amount to any party harmed from the Medical Malpractice without obtaining an approval from the Company.

2- Fraud:

The Insured must provide and declare a correct statement. The rights and benefits arising from this Policy shall be forfeited if the Claim involves proven fraud or it was submitted or used false statements, or if the Insured or his representative used fraudulent approaches or methods to gain benefit from this Policy or if the liability or damage results from a deliberate act by, or collusion with, the Insured.

3- Judicial Jurisdiction and Governing law:

The Policy and any dispute that arises concerning this Policy shall be subject to the laws and regulations in force in the Kingdom of Saudi Arabia and shall be settled by the Committees for Resolution of Insurance Disputes and Violations.