Malpractice Insurance in the Kingdom of Saudi Arabia: Registered Nurses' Perceptions and Willingness to Pay

Abstract

Background: In accordance with the healthcare transformation programs of the Saudi Vision 2030, the Kingdom of Saudi Arabia (KSA) established a mandatory malpractice insurance to improve the quality of patient care and the conditions of service delivery. Malpractice litigation has been an issue affecting nurses based on changing healthcare transparency and transformation of services. Professional liability insurance shields them despite the differences exist between perception and the willingness to pay the insurance. Objective: this study assessed nurses’ perceptions of nursing malpractice insurance in the KSA, and their willingness to pay for such insurance. Moreover, examined the sociodemographic, professional, and contextual factors that predict these outcomes. Methods: A descriptive, cross-sectional, correlational study conducted an online survey of 720 registered nurses from governmental and private hospitals in 13 regions across the KSA between September and November 2025. Results: Among the 720 nurses, 92.5% perceived malpractice insurance to be required, and 79.2% indicated a willingness to pay. It was significantly correlated that perception had a positive relationship with age, income, and price and a negative relationship with nationality. While the price, insurance status, perception, and training were positively related to willingness to pay. Conclusions: Different predictors influence perception and willingness and that interventions could be designed differently based on perception considering cultural background, experience, and medico-legal education; whereas willingness could be done with price, affordability, training, and insurance facilitation to increase insurance uptake.