Andry Saarm, CEO of Howden Kindlustusmaakler OÜ, explained why the UK-based insurance group Howden decided to enter the Estonian market: "Several clinics and other healthcare providers approached us with concerns that only one company in Estonia was offering liability insurance, and prices were high."

Howden offers liability insurance through a syndicate solution, meaning the risk is shared by multiple insurers rather than just one company. Currently, Howden is working quickly to establish the service, as the patient insurance law takes effect on November 1, and by December 1, all Estonian healthcare providers must have contracts in place.

Local insurance companies in Estonia were hesitant to offer patient liability insurance, partly because the number of potential claims is unknown. However, Howden is large enough to consider any potential losses from the Estonian market as minor. "Howden Insurance Brokers handles £3 billion in annual insurance premiums, and its most recent profit was £1 billion (€1.2 billion)," Saarm noted.

According to Saarm, local insurers are likely waiting for larger international players to take on the initial risks, which will make it safer for smaller companies to start offering coverage later. "My speculation is that in about six months, local insurers will also enter the market," Saarm said.

Another company entering Estonia's patient insurance market is Northern1, which currently provides clinical trial insurance in Estonia and the Nordic countries, as well as dental and health insurance in Poland and Denmark. Through Northern1, liability insurance for Estonian healthcare providers will be offered by Newline Insurance, a British-rooted corporation operating in 80 countries. Northern1 has previously worked with Newline on clinical trial insurance.

Vandeni Kindlustusmaaklerid is the third company to begin offering patient liability insurance.

To compensate patients for medical errors, all hospitals, clinics and doctors must sign mandatory liability insurance contracts. However, in the final stages of this long-planned reform, PZU was initially the only insurance company willing to offer this coverage. BTA and Seesam backed out at the last moment, with Seesam citing the difficulty of predicting what might happen as the reason for its decision.

By December 1, around 1,600 healthcare providers must have liability insurance in place. Healthcare facilities without such coverage risk losing their operating licenses.

Recent statistics show that the most frequent complaints have been about dental care. In 2021, there were 42 such complaints, accounting for a quarter of all complaints that year, although their share has been smaller in other years.

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