Under-insured, over-insured, but not properly insured: the structural liability-coverage gap in co-located robotic surgery and telesurgery

• Robotic-assisted and remote surgery distribute a single operative event across multiple independent actors, scattering liability accordingly.
• Existing insurance products are separately underwritten for single-actor domains, creating a patchwork that leaves co-located robotic surgery simultaneously over-insured and under-insured.
• Traditional risk-financing responses like excess layers or captives fail because the gap lies between the coverage towers rather than within any single tower.
• Telesurgery and teleintervention introduce novel legal exposures, including cross-jurisdictional licensing uncertainty, connectivity service-provider liability limitations, and standard-of-care ambiguities.
• The field requires an outward-facing, multi-domain integrated liability insurance product featuring a single coverage trigger and an accountable risk-bearing counterparty.

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