Confidence in a country’s health care system requires indemnification and deterrence systems that adequately cover liability, provide fair compensation for injury, and deter medical malpractices.  Over the last years, in many OECD countries, these systems have experienced difficulties resulting in high-risk specialty physicians and surgeons leaving the practice and the development of expensive and useless—if not risky—defensive medicine.  This publication surveys and assesses various types of mechanisms and reforms that best limit and indemnify medical accidents. Reasons for difficulties faced by some compensation and prevention regimes, given the specificities of national circumstances and in particular of health care systems, are examined. The study offers a series of unique and focused policy options for establishing more efficient indemnification and deterrence systems to cope with medical accidents.