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FAQ & General Questions
An occurrence-based policy provides indemnity for treatments provided during that policy period. If an incident took place during the policy period, the insured will be covered irrespective of when the claim is made – which could be many years into the future.
A claims-made policy provides coverage for claims received during a specified period – which is usually the duration of the policy. Beyond that the cover ends. In order to maintain cover for potential new claims the policy will need to be renewed for as long as any potential new claims might be raised – the period for which is usually likely to be dictated by the Statutes of Limitations.
If you were previously with a Medical Defence Organisation (MDO), The MDO should respond to any claims that occurred during the period you were with them. For the most part the MDO’s offer “discretionary cover”. We are increasingly seeing the MDO’s use such discretionary powers to refuse claims or provide assistance to members.
If your MDO might not respond (or even no longer exist), you could potentially be left without cover for the period that you were with them. You have a couple of key considerations to make when deciding on cover going forward:
- Switch to an insurance backed claims occurrence policy. Many providers will only offer you a retroactive date of inception. This means the policy will only respond to any treatments provided from the inception date (start date of the new policy). In that case you are still of course relying on the discretionary cover provided previously.
The likes of All Med Pro can provide retrospective cover as far back as your graduation if required to cover the discretionary period. It also means no requirement for run off coverage as there is with claims made cover.
- Switch to a claim made policy. Again, many providers will offer you a retroactive date of inception and you will still have the reliance on discretionary cover for the period you were with the MDO.
The Likes of All Med Pro will be able to extend the retroactive period as far back as graduation. However, the downside to claims made is that you will require run off coverage. Run off cover is required on claims made cover in the event of retirement, permanent disability, moving abroad and death and the period the coverage extends to is limited.
When a patient makes a claim, it is increasingly likely that they may also pursue a company (or owners), as well as an individual dentist. The company is a legal entity and could face legal action itself. You will also find that NHS contracts may require such cover to be in place. You therefore need to ensure that your business has indemnity cover itself. This is also known as vicarious liability, entity cover, corporate indemnity, corporate medical malpractice or contingent liability.
Yes. Most providers will include nurses on the individual or business policy on request. This will cover the named nurses employed by you for negligence claims, complaints and GDC regulation.
Contrary to many other providers in our view the inclusion of dental nurses under the individual dentist or business policy is not in the best interest of the dentist, business owner or dental nurse for the following reasons:
- As additional Insured’s these persons would be bound by the policy conditions, breach of which by any individual could invalidate the entire policy,
- Should a claim be made against a dental nurse it could affect the dentist or business owner claims record, for which they could pay for many years following, including after the dental nurse has ceased working or left the establishment.
- If the individual has their own cover wherever and for whoever they work for, and the comfort of knowing that cover is in place even after they leave their employer/Insured. The Insured is also safe in the knowledge that should a claim be made against an individual it won’t affect their claims record, for which they could have to pay for many years following, including after that nurse has ceased working for the establishment.
- In the event of a dispute between the Insured and a dental nurse as to where the blame lies, both parties would be protected equally under the policy. The insurer would not simply be able to side with the entity because a joint Insured has equal rights. In a complex situation it could be expensive for the Insured to resolve this.
- If the Insured ultimately discovers that the individual was not up to their high standards and refused to continue to use him/her, they would be stuck with an unfortunate legacy if they had consented to cover him/her under their policy.
- All claims costs and payments, whether the fault of the Insured or the dental nurse solely, would count against the claims record and would be fully disclosable to all future Insurers (these claims statistics influence premium calculations).
For the above reasons we believe provide a separate standalone policy for the nurses or individual policies for the nurses as this advantageous for both the insured and dental nurse.
We understand the benefits of both ‘claims made’ and ‘claims occurrence’ coverage, and as one of the longest contract certain indemnity providers to dentists in the UK you can trust our advice.
The risk on a claim made basis is that your insurer refuses to renew your policy. The question is where you would stand in respect to the retrospective cover and run off coverage. With most insurance providers the trigger for the extended reporting period/run off cover must be received by the insurer prior to the end of the expiring period of insurance and generally this is only in respect of death, disablement of permanent death. It will not cover you if you were to move abroad, maternity/paternity or even take a carer break. If you have no intention to retire or if you were to die shortly after the expiry of the policy the retroactive cover would be lost unless you are your next of kin were fortunate enough for the arrange retroactive cover and/or run off cover with your new provider.
All Med Pro provide both ‘claims occurrence’ and ‘claims made’ coverage and ensure the policies we put in place match your requirements subject to underwriting criteria.
We believe in terms of cover choice All Med Pro provide more than any other indemnity provider. The medical indemnity insurance policy can be written on an occurrence-or claims made contractual basis and we can provide retrospective cover for the time you were with an insurance provider or MDO. Most provides only provide one basis of cover. Not every dental professional is the same!
Our policies are underwritten by a one of the largest global insurers who have been underwriting medical indemnity cover globally for decades. They understand how dentists work, they have the expertise to identify trends and they recognise the vital role of dentists supporting dentists.
All Med Pro provide claims occurrence and claim-made policies. St Paul was solely claims-made. St Paul coverage ended with the ending of the policy. Our insurers and All Med Pro are not chancing a hand in indemnity as it was suggested with St Paul. All Med Pro were one of the first insurance providers to offer insurance-based indemnity around ten years ago and as mentioned before our insurers have been underwriting indemnity globally for decades.
Run-off coverage protects you for a limited time even after you’ve left the dental field in case any claims are formulated against you by previous patients. In most situations, medical malpractice insurance ends when you exit the medical profession. Run-off coverage is used as a precautionary measure to provide you with extra peace of mind in the event a former action, event or patient alleges malpractice against you. This coverage is only applicable to claims made policies. You have no requirement for run off cover with claims occurrence policies.
If you have indemnity arrangements that are not an occurrence-based product – for example, claims made products – you will require run-off cover, unless the terms of your cover specify any defined circumstances where this would not be required.
Switching your indemnity provider
If you have had occurrence-based indemnity from an MDO up until now, you will still have a right to apply to them at any time in the future to request discretionary assistance and indemnity for any new matters that surface in the future.
If you are concerned about the discretionary nature of the MDO it is possible to cover that period with your new provider.
It is important to really understand the main difference between claims occurrence and claims made coverage when switching providers.
If you have a policy of claims-made insurance which provides cover up to the date of change it is important that any future insurer provides coverage relating to the previous policy period.