- PURPOSE
This communication clarifies that Genoa’s Medical Malpractice and Professional Indemnity Policy (“the Policy”) insures only Health Care Services performed in private or partial private practice, within the practitioner’s HPCSA-registered scope of practice and Practice Type.
It does not extend to public or military health sector work, except where expressly endorsed.
- LEGAL FRAMEWORK DEFINING SCOPE OF PRACTICE
2.1 Health Professions Act 56 of 1974
Section 17(1) states that no person may practice a health profession without HPCSA registration. Scope of practice is determined by the practitioner’s registered profession and Practice Type.
(Health Professions Act 56 of 1974, s 17(1))
Section 33(1) allows the Minister to define the scope of practice by regulation.
(Health Professions Act 56 of 1974, s 33(1))
2.2 HPCSA Ethical Rules of Conduct (GN R717 of 2006)
Rule 21 states:
“A practitioner shall perform, except in an emergency, only those acts for which they are adequately educated, trained, and sufficiently experienced and which fall within the scope of their profession.”
(Ethical Rules GN R717/2006, Rule 21)
2.3 HPCSA Ethical Guidelines (Booklet 2: Ethical and Professional Rules)
Paragraph 3.2.2 notes that in an emergency, a practitioner may act outside their routine scope where no other qualified practitioner is available but must refer when possible.
(HPCSA Booklet 2, para 3.2.2)
- RELEVANT POLICY WORDING SECTIONS
3.1 Cover Limited to Private Sector Health Care Services
The Policy defines “Health Care Services” as treatment provided in a private facility, within the Practice Type stated in the Schedule, and for which the practitioner is appropriately registered:
(Policy, A.4.22 and A.4.26)
Importantly:
“No indemnity shall apply where a Practitioner has performed Health Care Services for or on behalf of the State or in a State facility.”
(Policy, A.4.22)
3.2 Insuring Clause
The Insurer indemnifies the Insured for civil liability arising from Medical Malpractice or Professional Negligence in the course of their Health Care Services, provided they are acting within their HPCSA-registered Practice Type:
(Policy, B.1.1 and B.1.2(a)-(b))
- CLINICAL PRACTICE IN PRIVATE SETTINGS: LAWFUL SCOPE ONLY
A practitioner’s practical experience does not expand their legal scope of practice.
Example:
- A Medical Officer who assists in surgical procedures during state employment cannot lawfully perform independent surgery in private practice unless registered as a specialist surgeon under the Health Professions Act.
Scope of cover follows the Practice Type recorded on the HPCSA register and the Genoa Policy Schedule, not the practitioner’s level of experience.
- LIMITED EMERGENCY EXCEPTIONS IN PRIVATE PRACTICE
The Policy allows for limited indemnity in private settings for:
- Good Samaritan Acts / Emergency First Aid (Policy, B.13)
- Incidental Emergency Obstetrics (Policy, B.14)
These are strictly limited to unforeseen, urgent situations in private settings and do not justify routine or repeated scope breaches.
- PUBLIC AND MILITARY HEALTH SERVICE WORK EXCLUDED
The policy wording excludes cover for State sector work, which falls under the indemnity provided by the State Liability Act 20 of 1957.
(State Liability Act 20 of 1957, s 3)
This means:
- Practitioners working exclusively in the public sector or military are not covered by Genoa unless endorsed for specific private work.
- The public employer remains liable for acts within state employment.
- PRACTICAL PRIVATE SECTOR SCENARIOS
| Scenario (Private Practice) | Cover Position under the Policy |
| GP performs basic minor procedures in their rooms | Covered |
| GP performs caesarean section without specialist registration in private hospital | Excluded unless an isolated emergency (B.14) |
| MO assists a specialist surgeon in private theatre | Covered within assisting role if under clinical supervision |
| GP with an ultrasound course performs diagnostic scans in their private rooms | Covered if within diagnostic GP scope |
| MO performs solely in state or military hospital | Excluded unless otherwise endorsed |
- BROKER GUIDANCE POINTS
Confirm HPCSA Registration: The Schedule should reflect the correct Practice Type (e.g., General Practitioner, Family Physician, etc.).
Clarify Private vs State Work: Advise practitioners that public sector work is excluded unless endorsed.
Disclose Material Scope Changes: Underwriters must be notified of new clinical activities, as this constitutes a Material Change.
(Policy, A.4.29 – Material Change)
Emphasise the Private Sector Focus: This cover applies only to private or partial private sector work.
- CLAIMS IMPLICATIONS
If a practitioner performs a procedure outside their HPCSA-registered Practice Type in private practice, cover may be declined unless:
- The procedure was an emergency, and
- No other better-qualified practitioner was available.
Practitioners remain personally liable if acting beyond their lawful scope.
- SUMMARY
Covered: HPCSA-registered procedures performed in private or partial private practice.
Not Covered: Specialist procedures without registration, public/military health work (unless endorsed), routine scope breaches.
- LEGAL AND REGULATORY REFERENCES
- Health Professions Act 56 of 1974, ss 17(1), 33(1)
- Ethical Rules of Conduct GN R717 of 2006, Rule 21
- HPCSA Ethical Guidelines Booklet 2, para 3.2.2
- State Liability Act 20 of 1957, s 3
- SUPPORT CONTACTS
For underwriting or claims queries:
010 590 9449
