There are two types of case where, as a broker, I see legal disputes stall at the very first step: suspected medical malpractice and defective building work. In both, the layperson feels that something did not happen as it should have, but only an expert can confirm this in substance – and the expert costs money before anyone has even started a lawsuit. The question is therefore not whether legal protection insurance pays the litigation costs, but whether it pays for a private expert before litigation, up to what amount and on what terms. The article on the cost map listed the cost elements of a legal dispute; this article is about a single element, the expert, and about how the course of a malpractice or construction case builds on it.
- Malpractice and construction disputes are decided by the expert opinion, so the fee of a private expert before litigation is the first real cost of the dispute – and most cases get stuck here.
- Legal protection policy conditions typically reimburse an out-of-court expert separately, with a per-event cap – up to EUR 600 + VAT according to a 2025 Hungarian product information sheet – while the fee of an expert appointed by the court in litigation is paid within the cover limit.
- In a malpractice case the first step is not the expert but requesting the medical records under Section 24 of the Health Care Act (Eütv.); it is advisable to engage the expert with the insurer's prior approval, otherwise the fee may stay with the client.
Why does the expert decide these disputes?
Section 244 (2) of Act CLIV of 1997 on Health Care (Eütv.) requires the rules of the Hungarian Civil Code (Ptk.) on liability for damage caused outside a contract to be applied accordingly to damages claims arising in connection with healthcare services, while for defective construction work the Ptk.'s rules on defective performance and warranty for defects (kellékszavatosság) apply. In a malpractice case the patient has to prove the damage and that it arose in connection with the care, and the provider is released from liability if it proves that it acted with the due care required under Section 77 (3) of the Eütv., in compliance with professional rules; in a construction dispute the customer has to prove defective performance. In neither case can the patient or the person having the building work done prove or disprove by their own word whether the provider departed from the rules of the profession – which is why the expert decides. The Code of Civil Procedure in force since 2018 recognises a private expert opinion commissioned by a party as one form of expert evidence, and in disputed cases the court appoints a forensic expert; in malpractice cases the opinion of the forensic expert panel of the Medical Research Council (Egészségügyi Tudományos Tanács) carries great weight in practice. The role of the private expert before litigation is therefore twofold: they say whether the claim has any basis at all – which is also the key to assessing the prospects of success – and they lay the groundwork for the letter of demand with which many cases end in a settlement without litigation.
In malpractice cases the first step: the records, not the expert
An expert does not work without documentation, so a malpractice case typically starts with requesting the medical records. Under Section 24 of the Eütv., the patient is entitled to know their data contained in the medical records kept on them, to inspect the records and to receive a copy of them – at their own expense; if the patient has died, the legal representative, a close relative and the heir may, on written request, learn the data related to the cause of death or to the medical treatment preceding death, and may receive a copy. It is advisable to submit the request in writing to the head of the institution and to ask, in addition to the discharge summary, for the complete records: the operation report, temperature chart, nursing records, consent forms and imaging results. A parallel route is the patients' rights representative and a complaint to the institution – this is not compensation, but it can help clarify the facts. With the records in hand, the next step is the expert opinion, which usually comes from a forensic medical expert or a doctor in the relevant specialty; its fee varies greatly by case and by specialty, and someone has to pay this fee before litigation.
What does legal protection pay before litigation – and up to what amount?
Here it is worth reading the policy conditions word for word. Hungarian legal protection policy conditions cover the fee of an expert appointed by the court in litigation as a regular part of the cost cover, within the cover limit; an expert engaged by the client before litigation, however, is typically treated as a separate service with a per-event cap, and some policy conditions also limit the number of occasions. A concrete example: LegitiMo's 2025 product information sheet (TIV 2025/1) defines out-of-court expert cost reimbursement as follows: in connection with the insured areas of legal protection, an expert may be used out of court for up to EUR 600 + VAT per insured event, while for the contract as a whole a sum insured of HUF 12 or 15 million can be chosen per event and per year. The difference between the two figures shows the essence: litigation itself is well covered, gathering evidence before litigation far more narrowly. Other insurers' policy conditions use different amounts and a different structure – it differs from insurer to insurer, and not all of them provide a separate item for out-of-court experts. Two further conditions are common almost everywhere: engaging the expert requires the insurer's prior approval – the fee for an opinion ordered on your own initiative is not necessarily reimbursed afterwards, as I described in the article on notifying the insurer after the fact – and the insurer may examine the prospects of success, which means that if the opinion finds no professional error, it may refuse to cover further costs. A malpractice claim typically belongs to the damages claims module, but some policy conditions treat claims connected with health care separately or exclude them – it is worth checking this in the module description before taking out the policy.
The course of the case step by step
With suspected malpractice, the typical sequence is as follows. First, reporting the legal case on the insurer's own line, even before the expert is engaged. Second, requesting the records under Section 24 of the Eütv. Third, the expert opinion with the insurer's approval, from the out-of-court allowance under the policy conditions; if the fee exceeds the allowance, the difference remains with the client unless the policy conditions provide otherwise. Fourth, the letter of demand: healthcare providers are required by law to have liability insurance, so in practice the claim is addressed to the institution and its liability insurer, who checks the allegation with its own expert. Fifth, settlement or litigation – I described the difference between the two routes, without lecturing, in the article on settlements; in litigation the court appoints a forensic expert, whose fee is then charged against the cover limit. Time must not be forgotten either: under the general rule of the Ptk., a claim for damages becomes time-barred after five years, but obtaining the records and the expert opinion can take months, so it is not advisable to delay reporting the case.
Defective building work: the same logic, a different expert
In a construction dispute, the expert is a forensic expert in construction or an engineer of the trade concerned, and the documentation is the construction contract, the construction log, the plans and the handover report. Two things differ from malpractice. One is preserving the evidence: anyone who has the defect repaired before the expert inspection loses their evidence, so the order is photos, a written defect notice to the contractor, inspection, and only then repair – except for work needed to mitigate the damage. The other is the deadline: under the Ptk., warranty-for-defects claims become time-barred within a short period – two years for consumer contracts, otherwise one year – and a separate government decree (Government Decree 181/2003) prescribes a compulsory warranty period (jótállás) for residential construction, so the timing of the expert opinion is even tighter here. Legal protection policy conditions typically handle construction disputes in the contractual legal protection module, with its own waiting period, and the out-of-court expert allowance works with a per-event cap here too – a full structural survey of a house rarely fits into it, determining the cause of water ingress more often does. From 2025, the law requires a specified group of contractors to have liability insurance, so increasingly a damages claim also has an insurer to be addressed to.
What should you do if you are facing such a dispute?
First, look at your own policy conditions: is there an item for out-of-court experts, how high is the per-event cap, and which module does this type of case fall under? Second, report the legal case on the insurer's line, and engage the expert only after approval. Third, collect the documentation – for malpractice the complete medical records, for construction work the contract, the log and the photos – because the expert works from this, and the insurer assesses the prospects of success from it. If the expert's fee exceeds the allowance, ask the insurer whether the difference can be counted towards the cost cover once litigation has started – this depends on the policy conditions. The insurer pays only for what is an insured event under your contract, and neither the expert nor the insurer makes any promise about the outcome of the legal dispute. If a case gets stuck or is disputed, I help where I can; the legal handling of the case is carried out, within the legal protection cover, by the lawyer paid by the insurer.
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Sources
- Act CLIV of 1997 on Health Care (Eütv.) – Section 24 (the right to access medical records)
- Act V of 2013 on the Civil Code (Hungarian Civil Code, Ptk.) – warranty for defects, limitation
- Act CXXX of 2016 on the Code of Civil Procedure (Pp.) – expert evidence, private expert opinion
- LegitiMo Jogvédelmi Biztosító: Legal protection insurance product information sheet TIV 2025/1 (out-of-court expert cost reimbursement)
- ESzCsM Decree 34/2003 (VI. 7.) on the Medical Research Council (ETT) – Section 1(2), Section 5/A (the ETT's forensic expert panel)
- Government Decree 181/2003 (XI. 5.) on compulsory warranty (jótállás) in residential construction – scope: residential buildings, flats, certain structures
