Why Bangladesh Needs Malpractice Insurance

Raj Kiron Das: Bangladesh is witnessing a steady rise in complaints related to medical negligence, exposing serious gaps in patient protection, accountability and financial safeguards in the healthcare system. As concerns grow, experts are increasingly pointing to medical malpractice insurance as a necessary step to improve accountability and restore public confidence in healthcare services.

Recent findings from the Bangladesh Bureau of Statistics highlight the scale of the issue. A 2025 survey found that nearly 38 percent of patients reported experiencing negligence or incorrect treatment while receiving hospital care. The situation appears more severe in urban areas, where the figure rises to 44 percent, while 36 percent of rural patients expressed dissatisfaction with the quality of care. These figures reflect a widening trust gap, as complaints increase but access to timely remedies remains limited.

One of the key challenges lies in the absence of a dedicated legal framework for medical negligence. Bangladesh does not yet have a specific law governing malpractice, forcing victims to rely on scattered provisions under existing laws. These include the Consumer Rights Protection Act, 2009 and Section 304A of the Penal Code, 1860, which deals with deaths caused by negligence. Although constitutional remedies are available through writ petitions under Article 102, the process is often lengthy, costly and difficult for ordinary patients to navigate.

Available data also suggest that the problem is long-standing. Various reports indicate that hundreds of serious medical negligence cases have been recorded over the past decades, many of which remain unresolved for years. This delay in justice leaves affected families financially and emotionally strained, and further weakens trust in the system.

Against this backdrop, medical malpractice insurance is being viewed as a practical and effective solution. Also known as professional liability insurance, it helps protect healthcare providers from the financial consequences of errors, omissions or negligence in their professional duties. These policies typically cover compensation claims made by patients, along with legal expenses such as lawyer fees and court costs.

At the same time, malpractice insurance can create a more structured and predictable pathway for compensation. Instead of relying solely on prolonged legal battles, patients may have a clearer route to financial recovery when negligence is established. This can reduce conflict and promote a more balanced system of accountability.

In Bangladesh, a few insurers, including Green Delta Insurance, Sadharan Bima Corporation, Dhaka Insurance and Reliance Insurance, already offer professional liability-related products. However, malpractice insurance is not mandatory, and awareness among healthcare providers remains limited. As a result, many hospitals and practitioners continue to operate without adequate financial protection against negligence claims.

Some healthcare professionals express concern that making such insurance mandatory could lead to an increase in litigation or higher treatment costs. However, experts argue that a properly regulated framework would likely have the opposite effect. Clear guidelines on claims, compensation limits and professional standards can reduce unnecessary disputes while ensuring fairness for both patients and providers.

The need for reform is further strengthened by broader structural weaknesses in the healthcare system. Bangladesh relies heavily on out-of-pocket spending, with patients covering between 69 and 73 percent of total healthcare costs. According to the World Health Organisation, such high direct expenses significantly increase the risk of financial hardship for families. Government spending on health also remains relatively low, accounting for just over five percent of the national budget and less than one percent of GDP, far below global recommendations.

In addition, shortages in healthcare workforce and infrastructure continue to place pressure on the system. The number of doctors per 10,000 people remains well below international standards, while the nurse-to-doctor ratio and hospital bed availability are also inadequate. These constraints increase the likelihood of service gaps and medical errors, making risk management even more important.

Experts suggest that Bangladesh could consider a phased introduction of malpractice insurance, starting with hospitals, diagnostic centres and high-risk medical specialties. The Insurance Development and Regulatory Authority, in coordination with the health ministry and professional medical bodies, could play a key role in designing policy standards, claim procedures and fair premium structures.

Medical malpractice insurance will not solve all the challenges facing Bangladesh’s healthcare system. It cannot replace ethical medical practice, stronger regulation or improved infrastructure. However, it can play a crucial role in strengthening accountability and financial protection.

As medical care directly affects human life, ensuring patient safety and fair compensation is no longer optional. For Bangladesh, introducing a well-structured malpractice insurance framework could mark an important step toward a more transparent, accountable and trusted healthcare system.