Submitted by Simon Thackeray ~
The GDC presently recognizes arrangements provided by:
- Dental defence organizations.
- Professional indemnity insurance.
- NHS indemnity.
- Certain other forms of employer-provided indemnity such as ‘crown indemnity’provided by the Ministry of Defence.
- Registrants are required by the GDC to provide proof of cover if a complaint ismade to the GDC about fitness to practise. Proof of indemnity provision is also a requirement when applying to join a list to provide NHS dental services and as part of practice clinical governance procedures.
- Dental defence organizations
- In the UK there are three non-profitmaking, mutual organizations:
- Dental Protection Limited (DPL—part of Medical Protection Society).
- Medical and Dental Defence Union of Scotland (MDDUS).
- Dental Defence Union (DDU—part of Medical Defence Union).
As well as providing professional indemnity cover these organizations provide their members with advice, information, and support in proceedings involving professional matters, e.g. GDC fitness to practise hearings, NHS performance investigations, and various other situations. In addition, they also contribute significantly to the social life of medical and dental students.It is important to note that the support of these mutual organisations in a case may be discretionary and therefore not necessarily guaranteed, although this discretion is said by them to be rarely used. Since they are not regulated in the same way as insurance companies this can make it difficult to contest a decision not support a member, however rare that might be. On the other hand, insurance policies may have excesses that whilst they make the policy look cheaper than traditional indemnity, the cost to the dentist can still be high if they have to pay any excess.
Indemnity insurance
Provided by directly by commercial insurance companies and also through service providers, cover is subject to the terms, conditions, and any exclusions of the insurance policy. Some professional organizations, e.g. British Association of Dental Nurses, include some degree of indemnity insurance as part of their membership subscription. Insurance- based indemnity provides cover for claims arising during the period that the policy is in force. ‘Run-off’ cover may also need to be purchased to cover claims arising outside of the insurance term if changing indemnity provider or retiring. It is vitally important to check the insurance term if changing indemnity provider or retiring. It is vitally important to check the terms and conditions of any insurance, especially with regards to runoff cover to ensure you are fully covered at all times, and any excess that applies to the policy. Some policies may also include retroactive cover to pick up claims that the previous insurer or indemnifier may not. This is especially important if changing from one type of cover to another (such as from an Occurrence based policy to a claims made.
Some of the corporate bodies in dentistry also have their own products that are available to those who work within their organisation. It is also possible to access bespoke policies from the general insurance market, but this can be more complex.
Companies offering this type of policy include:
- Taylor Dental Services
- British Dental Association
- Professional Dental Indemnity/All Med Pro
- Densura
- Howdens
It is therefore vitally important to obtain the correct advice and look closely at the details of any policy or indemnity cover provided when deciding what type of indemnity is suitable for you. It is also important to look at whether a policy is Occurrence based or Claims based. An occurrence-based policy will cover the insured person for incidents which occur during the membership period of policy period, regardless of when the claim is made. For example, if a claim is made 5 years after you have left an occurrence-based provider, as long as the claim related to an incident that occurred during the time you were covered by the indemnifier, it should still be considered. This is not the same a claimsbased or claims made policy. A Claims made policy will provide cover only for incidents which occur during the period you are insured. If you leave the company and then subsequently have a claim, you will not be covered for any new claims reported. This is why it is important to read the small pint carefully as to what type of cover you have, especially if changing companies during your career. A claims made policy is likely to also then need a period of ‘Run off Cover’ to pick up the period of time between leaving one company and another so as to ensure continuity of indemnity cover. It is not for the BAPD to advise its members on what policy is suitable for them, but recommends that all members check their policies thoroughly to ensure they have continuous and appropriate cover so as not to leave them exposed in the case of a claim.
NHS indemnity
Crown/NHS indemnity provides cover relating to acts or omissions of doctors and dentists working in NHS hospitals and Salaried Primary Care. Crown/NHS indemnity covers work undertaken within the NHS contract; it does not provide assistance for private treatment, regulatory issues (GDC/GMC), fatal accident enquiries, or coroner’s inquest. It is recommended that additional professional indemnity is taken out to cover involvement in such situations.It is important to ensure that indemnity cover is sufficient to cover all aspects of work being undertaken, e.g. implants, maxillofacial surgery, cosmetic procedures. In addition, it is important that any changes in working hours are notified to indemnifiers to ensure the relevant cover is in place as an increase in hours can often mean the policy will need to change to cover this.
Parts of this have been reproduced with permission from chapter 17 ‘Law and Ethics’ of the Oxford Handbook of Clinical Dentistry (7th edition) https://global.oup.com/academic/product/oxford-handbook-of-clinical-dentistry-9780198832171?cc=gb&lang=en&
