In order to solve the contradiction between doctors and patients， disperse the risk of compensation in medical institutions， and build a harmonious doctor?patient relationship， China has implemented a medical liability insurance system based on the experience of other countries. Although the system has achieved certain results， the implementation of the system is still unsatisfactory due to the short time of implementation of medical liability insurance and the lack of corresponding legal regulations and supporting policy incentives. In the era of smart medical care， China should improve relevant legislation， ensure its effective implementation through administrative means， promote insurance companies to intervene in the mediation of medical disputes， construct multi?level medical risk burden mechanism， and fundamentally overcome the lack of market development in the operation of the medical liability insurance system. The lack of scientific design of insurance products has promoted the healthy development of medical and health services in China.