Every dental practitioner should be aware of the basic provisions of her professional liability insurance coverage. Often, however, the overriding considerations are the cost or premium and the limits of coverage. There are additional equally important considerations that are often overlooked. A broker can assist in evaluating the products, but the practitioner should also be able to ask intelligent questions. This column identifies some of the issues a practitioner should be aware of when evaluating various professional liability policies.
- What kind of history and expertise does the insurance company have in dental malpractice? Has the company handled dental claims for many years, or is it a new line of business? How long has the company practiced in the practitioner’s locale or venue? Does the company have dental practitioners involved in its claims process, or do practitioners have any ownership interest in the company? Companies that have more experience with the specialty and venue and more practitioner involvement at the claims and ownership level might be able to better analyze, evaluate, and handle claims. The financial stability of the company is critical.
- Is the policy an occurrence policy or a claims-made policy? A claims-made policy provides protection for claims that are reported in the policy period. An occurrence policy provides protection for acts that occur within the policy period. Generally, occurrence policies are more expensive and they might be difficult to obtain.
- If there is a switch to a new carrier, will there be continuous coverage? A practitioner never wants to have any gap in coverage and should clearly understand that all professional actions will be covered under some policy. If there are any issues about gaps, this should be closely evaluated, and options such as the purchase of supplemental coverage should be explored.
- Who will and will not be covered? Practitioners who hire associates, independent contractors, or others who participate in the practice must assure coverage if care is provided through their offices. Some independent contractors or part-time practitioners carry their own professional liability coverage. If they do this, the practitioner-owner must be assured that everyone is covered appropriately.
- What are the exclusions and requirements in the policy? Most policies do not cover intentional actions, such as battery. Some policies cover defense of disciplinary actions, and some do not. Other common provisions in professional liability policies require the practitioner to report the claim in a timely manner and cooperate with the carrier and assigned defense counsel.
Linda J. Hay, JD
Hay is a partner at Alholm Monahan Klauke Hay Oldenburg, LLC in Chicago. She graduated from The John Marshall Law School in 1986 and has defended dental professionals for more than 15 years. She may be reached at [email protected]
