Managing run-off risk: A critical issue for sports medicine doctors, solved by Howden.

At the recent BASEM conference, our discussions with industry peers surfaced a critical issue in sports medicine: the risks associated with run-off exposure when doctors’ contracts with professional clubs come to an end. The terms run-off, tail and extended reporting period are often used interchangeably so we’ll stick to the phrase run-off throughout this piece.

Why run-off exposure exists

Run-off risks arise because indemnity policies for sports doctors can be claims-made. Under a claims-made policy, protection applies only if the policy is active when the claim is filed, or incident is reported by the policy holder and not when the incident occurred. Without run-off cover, financial responsibility for any claim made after your policy expires would fall squarely on the doctor’s shoulders.

Run-off (extended reporting endorsement) is the solution when someone retires from private practice.

The scale of the problem

• Medical negligence claims can surface years later. While the primary limitation period is three years, secondary periods and exceptions mean claims can arise years after the incident.
• In regulated professions, run-off premiums often range from 100% to 350% of the annual premium, creating a sudden and substantial financial burden if not anticipated.
• A recent UK indemnity survey found that over 30% of healthcare professionals lacked clarity on their run-off obligations, exposing them to unexpected liabilities. [iffresearch.com]

When does it become an issue?

Run-off exposure becomes critical when:

• You leave a club and move back to non-sports related private work
• You stop private practice entirely and continue to work in the NHS only
• You take a sabbatical or parental leave
• You emigrate from the UK
• You retire, die or become disabled

In sports medicine, where contracts are often short-term, these scenarios can be quite common.

As we were told at BASEM by many doctors, the examples above are common and their insurers will not give them a run-off cover without the doctor paying for it. This is an unexpected cost as the club isn’t paying for the run-off and could mean the doctor has to find 100% to 350% of the original premium, they paid to get a run-off policy!   

The Howden advantage

At Howden, we specialise in contract-certain indemnity solutions, not discretionary schemes, offering clarity and security to our clients.

Our policies include:

• 21 years of run-off cover for long-term protection in the event of death, disability or retirement, but also in the event of permanent cessation of private practice. As we understand this is the policy difference.
• Retroactive cover and seamless switching between sports, non-sports and sabbatical / parental leave to avoid gaps and flex with you as your portfolio career evolves.
• Expert medico-legal support and risk management advice.

By engaging with Howden early, you could avoid costly surprises and safeguard your professional reputation. Run-off exposure is not a niche issue—it’s a structural risk in claims-made indemnity. For sports medicine doctors, proactive planning and expert guidance are non-negotiable. We are well equipped ready to help you navigate these complexities with confidence.