Channels of appeal and compensation
If you are not satisfied with the everyday conditions of medical institutions or the health workers level of communication, you should always first bring this to the attention of the management of that medical institution. Health care providers are required, in their place of activity, to inform about the patient's right to receive contact details and make a complaint to the health service provider's management, the Estonian Health Insurance Fund or the Health Board concerning the provision of health service.
The Estonian Health Insurance Fund can monitor the quality and availability of health care services provided by its contract partners. The list of EHIF’s contract partners can be found here. You can report about quality and availability issues concerning health care services to info [at] tervisekassa.ee (info[at]tervisekassa[dot]ee)
Starting November 1, 2024, mandatory liability insurance for healthcare providers, also known as patient insurance, will apply in Estonia. For patients, the new system provides the right to claim compensation from the insurer if an avoidable real health injury occurs due to an error during the medical process after the law takes effect.
Patients who have suffered avoidable harm during the medical process can apply for compensation either through the healthcare provider or the insurer that provides coverage to the specific healthcare provider. The insurer will handle the case and decide on the compensation. If the patient disagrees with the insurer's decision, they may appeal to the Conciliation Committee, which will review the decision.
Patient insurance does not cover situations involving suspected intentional harm. In such cases, patients must contact law enforcement authorities.
If a patient is dissatisfied with the compensation decision made by the insurer, they have the option to turn to the Conciliation Committee, which will operate under the Health Board.
The Conciliation Committee is a permanent, independent pre-court body for resolving liability insurance disputes. It operates based on the Conciliation Act unless otherwise stipulated in the Mandatory Liability Insurance for Healthcare Providers Act. For more detailed information on how to approach the Conciliation Committee, click here.
Please note! If you used health care services outside Estonia and you were not satisfied with the quality of the treatment provided there, you must, when making your complaint, follow the legislation of the country where the treatment was provided to you.
More information: The role of health care providers in quality assurance
Compensation
If it is determined that the patient was harmed during the provision of health care service, it is possible to appeal for compensation:
- to the health care provider or their insurer;
- to civil court.
