This is a claims made policy. Except to such extent as may otherwise be provided herein, the coverage of this policy is limited generally to liability for only those acts, omissions or errors committed by the insured at the time there is cover and the claim or claims arising therefrom are made and reported to the company when there is cover, provided that there has not been any break of cover with the company from the date of the alleged act, omission or error.

Whereas the Insured in the Schedule having applied to the Insurers for the Insurance, and having agreed that any proposal or other information supplied by the Insured or on their behalf shall be the basis of this Contract of Insurance, the Insurers agree to indemnify the Insured subject to the Terms, Exclusions and Conditions of this Polic

NOW THIS POLICY WITNESSETH THAT if at any time during the said period or during any subsequent period in respect of which the insured shall pay and the Company shall consent to receive a renewal premium the Company shall subject to the terms provisions exceptions and conditions contained herein or endorsed hereon indemnify the insured against claims, including claimants costs and expenses arising from rendering or failure to render professional services, subject to the limit set out in the schedule, provided such claims are made first to the insured and reported to the Company during the policy period.

1. COMPANY’S LIABILITY

   The Company’s liability is subject to the annual limit of indemnity as well as the policy terms, conditions and exclusions.

   
   

   The Company will pay all sums which the insured becomes legally liable to pay compensation(including claimant’s costs, fees and expenses) in accordance with the law of any country but not in respect of any judgment, award, payment or settlement made within countries which operate under the laws of the United States of America or Canada (or to any order made anywhere in the world to enforce such judgment, award or settlement whether in whole or in part) as a result of damages arising out of bodily injury to or death of any patient caused by or alleged to have been caused by malpractice.

   PROVIDED ALWAYS THAT:

   1. The indemnity granted herein applies only to claims first made against the insured and notified to the Company during the period of insurance.

   2. The claim arises from your rendering of or failure to render professional services within the territorial limits as set out in the schedule.

   3. The claim and the professional services rendered are within the scope of the policy cover and are not in any way excluded there from.

      
      

2. COSTS TO BE BORNE BY THE COMPANY.

   Subject to the annual limit and the terms and the conditions set out in the policy, the Company will meet all costs and expenses incurred in defending any claim lodged against the insured in connection with the insured rendering or failure to render professional services, but subject to the following conditions:

   1. The indemnity granted herein applies only to claims first made against the insured and notified to the Company during the period of insurance.

   2. The claim arises from your rendering or failure to render professional services within the territorial limits.

   3. The annual limit as set out in this policy has not been exhausted.

1. The total liability of the Company;

   1. per claim or series of claims arising from one originating cause or source, including interest thereon, all claimant's costs, fees and expenses and defence costs;

   2. in respect of all claims per policy period; shall not exceed the limit of liability stated in the schedule

2. Claims costs and expenses.

   Subject to the annual limit and the applicable deductible as set out in the schedule, the Company will pay all costs and expenses incurred with their written consent arising in any connection with any claim which forms the subject of indemnity under this policy.

3. Deductible.

The deductible stated in the schedule will be applied to each and every claim falling within the terms of the policy. Such deductibles will first be applied to any costs and expenses incurred by the Company in the defense of any claim, with any balance thereof being offset against the amount payable with regard to indemnity.

Unless otherwise provided this policy does not cover any claim which results from the following:

1. Any claim which results from the administration of general anesthesia unless performed in a hospital or clinic equipped for such a procedure and the procedure is carried out by a specialist anesthetist.

2. Any claim arising out of laminectomy or discectomy (total or partial) of the cervical, thoracic or lumbar spine and including:

   1. Decompression following an accident or degenerative disease leading to canal stenosis.

   2. Fusion of the spine.

   3. Any others that might be specifically excluded by an endorsement to the policy.

3. Any claim which results from any act or omission on the part of the employee of the insured whilst such an employee is not acting within the scope of his duties.

4. Any claim which results from the rendering of professional services outside the territorial limits as set out in the schedule; unless the Company’s prior written consent has been obtained.

5. Any claim which arises from the use of any prosthesis not approved by the pharmacy and poisons board.

6. Any loss, injury or damage which is reasonably foreseeable having regard to all the circumstances.

7. Loss or damage arising out of professional services rendered by the insured to his/her spouse or any member of the

   insured’s immediate family.

8. Any claim based upon, arising out of, or in any way attributable to the insolvency or the bankruptcy of the insured.

9. Any claim arising out of loss of or damage to property in the insured’s care, custody or control or loss, damage or mislaying of any document of whatever nature whether written, printed or reproduced by any other method, or any computer based or electronically stored information or material entrusted to or in the care, custody or control of the insured.

10. Pollution or contamination of whatsoever nature unless such pollution or contamination is directly caused or attributable to the rendering professional services as defined by the Company.

11. Any contractual liability falling to be borne by the insured unless the Company’s prior written consent has been obtained.

12. Liability for any injury, sickness or death of any employee under a contract of employment with the insured.

13. Any claim which results from insured rendering professional services when the insured’s practicing certificate has been revoked, surrendered or restricted in any way.

14. Any claim which results directly from commission of any fraudulent criminal or malicious act by the insured.

15. Any claim resulting directly or indirectly from alcoholism or substance abuse.

16. Any claim which results from the insured guaranteeing the results of professional services.

17. Any claim which results either directly or indirectly from false arrest, detention or imprisonment.

18. ‘‘Needle stick’’ injuries to the insured

19. Any liability which is insured by or would, but for the existence of this insurance, be insured by any other existing insurance(s) except in respect of any excess beyond the amount which would have been payable under such other insurance(s) had this insurance not been effected.

20. Any claim made against the insured for malpractice committed or alleged to have been committed prior to the Retroactive Date specified in the schedule;

21. Claims arising from the deliberate modification of hereditary features or of the characteristics of an organism by treatment to transfer certain genes or by manipulating genetic material

22. Any claim:

    1. or circumstance which has been or should have been notified under any other policy or certificate of insurance attaching prior to the inception of this policy;

    2. arising from the conduct of the business in the United States of America and/or Canada;

    3. for fines, penalties, vindictive or exemplary damages;

    4. arising out of the insolvency of the insured;

    5. up to the amount of the deductible;

23. Any legal liability of whatsoever nature directly or indirectly caused by or contributed to or arising from atomic energy risks or handling or use of radioactive materials except in respect of occupational risks arising from radio iso-topes or radium or radium compounds when used away from the place where such are made or produced and when used exclusively incidental to ordinary medical, medical research or medical educational pursuits;

24. Any claim arising from loss or damage occasioned by or through or in any consequence, directly or indirectly of any of the following:

    1. War, invasion, act of foreign enemy, hostilities or war like operations (whether war be declared or not), civil war.

    2. Mutiny, civil commotion assuming the proportions of or amounting to a popular rising, military uprising, insurrection, rebellion, revolution, military of usurped power, martial law or state of siege or any of the events or causes which determine the proclamation or maintenance of martial law or state of siege.

    3. Permanent or temporary dispossession resulting from confiscation, commandeering or requisition by any lawfully constituted authority.

    4. Any act of terrorism committed by a person or persons acting on behalf of or in connection with any organization.

       
       

25. COMPUTER LOSS EXCLUSION:

    Notwithstanding any provision of this Policy including any special Exclusion or extension or other provision not included herein which would otherwise override a general Exclusion, this Policy does not cover any legal liability of whatsoever nature directly or indirectly caused by or contributed to by or consisting of or arising from the incapacity or failure of any computer, correctly or at all,

    1. to treat any date as the correct date or true calendar date, or correctly or appropriately to recognize manipulate interpret process store receive or to respond to any data or information, or to carry out any command or instruction, in regard to or in connection with any such date; or

    2. to capture save retain or to process any information or code as a result of the operation of any command which has been programmed into any computer, being a command which causes the loss of data or the inability to capture, save retain or correctly to process such data in regard to or in connection with any such date; or

    3. to capture, save, retain or to process any data as a result of the action of any computer virus, or other corrupting, harmful or otherwise unauthorized code or instruction including any trojan horse, time or logic bomb or worm or any other destructive code, media or programme or interference.

    A computer includes any computer, data processing equipment, microchip, integrated circuit or similar device in computer or non-computer equipment or any computer software, tools, operating system or any computer hardware or peripherals and the information or data electronically or otherwise stored in or on any of the above, whether the property of the Insured or not.

    
    

26. TERRORISM EXCLUSION

    The Company shall not be liable to indemnify the Insured in respect of claims directly or indirectly caused by, resulting from happening through or in connection with any act of terrorism regardless of any other cause contributing concurrently or in any other sequence to the loss.

    For the purpose of this Exclusion, terrorism means an act of violence or any act dangerous to human life, tangible or intangible property or infrastructure with the intention or effect to influence any government or to put the public or any section of the public in fear.

    In any action suit or other proceedings where the Company alleges that by reason of this Exclusion a loss is not covered by this insurance the burden of proving that such loss is covered shall be upon the Insured.

    
    

27. NUCLEAR EXCLUSION

    This Policy does not cover any legal liability, loss, damage, cost or expense whatsoever or any consequential loss directly or indirectly caused by or contributed to by or arising from:

    1. ionizing, radiations or contamination by radio-activity from any nuclear fuel or from any nuclear waste from the combustion or use of nuclear fuel;

    2. nuclear material, nuclear fission or fusion, nuclear radiation;

    3. nuclear explosives or any nuclear weapon;

    4. nuclear waste in whatever form;

       regardless of any other cause or event contributing concurrently or in any other sequence to the loss. For the purpose of this Exclusion only, combustion shall include any self-sustaining process of nuclear fission.

       
       

28. ASBESTOS EXCLUSION

Notwithstanding any provision of this Policy including any Exclusion, exception or extension or other provision which would otherwise override an Exclusion, this Policy does not cover any legal liability, loss, damage, cost or expense whatsoever or any consequential loss directly or indirectly caused by, arising out of, resulting from, in consequence of, in any way involving, or to the extent contributed to by, the hazardous nature of asbestos in whatever form or quantity.

1. You are ’the insured’ if you are the medical practitioner named in the schedule.

2. ‘Professional Services’ means the rendering of or the failure to render medical or surgical treatment, diagnosis, opinion or advice.

3. ‘Malpractice’ shall mean any negligent act, error or omission in the professional services rendered, or which should have been rendered, by the insured.

4. ‘Claims’ means, written notice, demand, cross-claim or law suit (Including an arbitration proceeding) which is first made during the currency of the policy or death to a patient arising from the insured’s rendering or failure to render professional services.

5. ‘Deductible’ shall mean that first amount of each and every claim to be borne by the insured, it being understood and agreed that if any expenditure is incurred by the Company which, by virtue of the deductible, is the responsibility of the insured, then such expenditure shall be forthwith reimbursed by the insured. The deductible shall apply per claim or series of claims arising from one originating cause or source.

6. ‘The policy period’ stated on the schedule is the period of time commencing with the effective date of the policy and

   continuing until the date of cancellation and/or expiry of the policy.

7. ‘The effective date of the policy’ is the commencement date of cover as stated in the schedule.

8. ‘Endorsements’ may be issued from time to time to cater for changes in the cover granted under the policy. The changes take effect from the date stated in the endorsement and continue until the date of cancellation of the endorsement, or expiry or cancellation of the policy whichever shall first occur.

   
   

   SECTION 2: POLICY CONDITIONSPART 1: UTMOST GOOD FAITH AS A BASIS OF THE CONTRACT.

   It is warranted that the statements made and documents submitted in support of this insurance form the basis of this contract and that any concealment or misrepresentation of any material fact renders this policy void or voidable at the option of the Company.

   
   

   PART 2: DUTIES OF THE INSURED
   1. NOTICE OF POTENTIAL CLAIM.

      As soon as the insured shall become aware of any claim or any event likely to give rise to a claim, notice thereof shall immediately be given to the Company. As soon as practicable, full details of such claim or event shall be forwarded to the Company.

      
      

   2. NOTICE OF ACTUAL CLAIM.

      Without any admission of liability, the insured hereby agrees to forward to the Company immediately upon receipt any demand, notice, summons, complaint or any other documents received in connection with the claim or intended claim. Further, it is warranted that no admission, offer, promise or payment shall be made or given by or on behalf of the insured without the Company’s written consent.

      
      

      Further if indemnity is sought under this policy by any fraudulent means;

      1. All benefit in respect of such claim shall be forfeited;

      2. The Company may cancel the policy with immediate effect by notice in writing to the last known address of the insured.

         
         

   3. CLAIMS COOPERATION.

      It is a condition of this policy that the insured shall cooperate with the Company in all aspects relating to any claims that may be submitted under this policy.

      
      

   4. CHANGES IN PRACTICE AND OTHER PARTICULARS.

      It is a condition of this insurance that the insured shall notify the Company of any material changes as soon as the changes occur. In particular, the insured shall communicate any changes relating to the nature of practice, location, suspension, revocation or restriction of license, and any others that are material to the insured’s medical practice.

      
      

   5. POLICY CHANGES.

      The insured shall, in writing, notify the Company of any changes that may be required to the policy herein, it being a condition that any such changes shall not be effective until a suitable endorsement has been issued by the Company.

      
      

      If the limit of liability is increased during the period of insurance, the liability of the Company in respect of claims made against the insured or for circumstances notified, or which should have been notified, to the Company prior to such increase, shall not exceed the limit of liability applicable prior to such increase.

   6. DECLARATION CLAUSE

      The first and all renewal premiums that may be accepted are to be regulated by the annual fees received during each period of insurance. The insured shall supply the Company with a correct figure of such fees during any period of insurance. If the declaration shall differ from the figures of which the premium has been paid, the difference in premium shall be met by a further proportionate payment to the Company or by a refund by the Company.

      
      

      Should the Insured fail to supply such a declaration within one month of the expiry of the period of insurance, the Company shall assume that there is no change in the declared values and the previous period figures provided to be adopted for the current renewal period. In the event of a claim and the insured declared higher values, or it is discovered that the values were underdeclared, then the average clause shall apply.

      
      

      If the schedule of the insured annual fees differs from the actual annual fees and the insured has not declared the actual annual fees and paid the additional premium the company shall have the right to prorate any payable claim in proportion the rate of under-insurance.

      
      

      The Company will not be bound by any premium receipt unless given on their printed official receipt form. Where this Policy is void or the benefit hereunder is forfeited the premium paid in respect hereof will be retained by the Company.

      The Insured shall supply a fresh declaration of annual fees at the commencement of each Period of Insurance

      
      

   7. PAYMENT OF PREMIUM.

The premium is payable annually in advance. The renewal premium must be paid to the Company on or before the expiry of the preceding policy period.

It is a condition of this insurance that the insured shall maintain accurate records of all professional services undertaken and that such records shall be made available to the Company or their duly appointed representatives at all times.

It is a condition of this policy that no action of whatever nature shall be instituted against the Company unless the insured has first compiled fully with all the terms and conditions of this policy.

This policy is not assignable whether in part or in whole without the Company’s prior written consent.

If there be any other insurance(s) covering the insured’s legal liability for acts or omissions arising out of the rendering of professional services, this policy shall only be liable for any amount that may be payable over and above that which is recoverable from such other insurance(s).

The insured and any other person(or party) acting on his behalf must at all times take all the appropriate and necessary measures to safeguard all the rights and remedies that may be available from third parties following payment of any claim under this policy.

The Company may cancel this policy by sending seven days notice by registered letter to the insured at his last known address and in such event will return to the insured the premium paid less the pro-rata portion thereof for the period the policy has been in force or the policy may be cancelled at any time by the insured (provided no claim has arisen during the current period of insurance) and the insured shall be entitled to a premium refund, less the premium payable for the period of cover, calculated at the company’s short period rate.

If any dispute shall arise as to the amount to be paid under this policy (liability being otherwise admitted) such dispute shall be referred to the decision of an arbitrator in accordance with the statutory provisions of the Arbitration act Cap 49 of the laws of Kenya.

This policy shall be governed by and construed in accordance with the laws of the republic of Kenya.

Notices and other communication must be in writing and shall be deemed to have been fully given or made when

delivered by registered mail; fax or electronic mail to the other party’s specified last known address.

It is hereby declared and agreed that the policy is issues on a claims made basis. For the purposes of this clause, claims made policy means the policy issued by the Company to the insured to indemnify the insured against claims arising from his rendering or failure to render professional service(s) which the insured first becomes aware of during the policy period and notifies the Company during the same period.

The Policy and the schedule shall be read together as one contract and any word or expression to which a specific meaning has been attached in any part of this policy or schedule shall bear such meaning wherever it may appear.

“The [Insurer] shall not be deemed to provide cover and the [Insurer]shall not be liable to pay any claim or provide any benefit under this policy to the extent that the provision of such coverage, payment of such claim or provision of such benefit would expose the [Insurer], its parent, subsidiary or affiliate entities and organizations, including any director, officer, employee, or agent to any sanction, prohibition or restriction implemented pursuant to resolutions of the United Nations or the trade and economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.”

Warranted that the company shall not be liable for any loss and/or claim arising out of failure by the insured to implement any risk improvement recommendations or survey recommendations within the stipulated timelines

Insured shall notify the company of all claims promptly and not later than six (6) months whichever the earlier from the date of loss. Any claim brought and notified to the company upon expiry of the set period herein above shall not be admissible and the company shall not be under any compulsion and/or obligation under this policy to admit liability.

This clause shall be read alongside the notification clause and does not extinguish the notification clause/condition