Dental Malpractice Insurance for Dentists
Malpractice insurance for a dentist is a requirement unless other kinds of optional insurance policies. You may need this insurance coverage to become a licensed practicing dentist.
Your choice regarding malpractice insurance is not whether you get a policy, depending on where you practice. Instead, it’s opting for which provider and kind of coverage you need to safeguard yourself from possible legal action against you.
We suggest checking different factors that matter when choosing an insurance provider and other important information about malpractice insurance.
What is malpractice, and why do you need malpractice insurance for dentists?
According to Merriam-Webster, malpractice is “a dereliction of professional duty or failure to exercise an ordinary degree of professional skill or learning by one rendering professional services which result in injury, loss, or damage.” In easier terms, dental malpractice is a deviation from the basics of care that leads to patient injury and even death due to negligent treatment or failure to diagnose and treat. The patient may be able to sue for damages through the civil litigation process to compensate for his or her harm if they can prove that a particular dentist acted negligently to cause a patient such injury.
What is malpractice insurance for dentists?
Dental malpractice insurance is also professional liability or errors and omission insurance. Malpractice insurance protects licensed healthcare professionals from possible allegations of negligence while performing their professional duties.
This is protection against a malpractice claim. Suppose one of your clients files a lawsuit alleging that you didn’t perform your responsibilities well and were negligent. In that case, this insurance may help you cover the fees to protect yourself in a legal court and other policy-outlined provisions.
In most cases, oral surgeons have a high chance of having claims filed against them in the dental profession since they tend to perform more complicated procedures and frequently use anesthesia.
However, at the same time, orthodontists and general practitioners are also at high risk for claims. Dental malpractice insurance is a kind of professional liability insurance that safeguards most professionals in the dental industry.
Kinds of malpractice insurance for dentist
There are two kinds of dental malpractice insurance. These are the occurrence policies and claims-made policies.
These policies cover any claims against you for work done while the policy still takes place. You can still expect full coverage according to the terms of your policy as you file a claim after your policy expires.
Claims-made policies for malpractice insurance for dentist
This kind of dental malpractice insurance is less expensive than an occurrence policy. However, this coverage is based on when the claim is made against you. These insurance policies usually have a retroactive date of one to five years. You have a one-year claims-made policy if a patient files a lawsuit two years after you execute a procedure, so you will not be part of the coverage. Furthermore, this is different from occurrence policies. Claims-made policies will stop providing coverage once the policy terminates. If you wish to be safe from lawsuits after you retire from dental practice or end your policy, you may opt for another policy called tail coverage.
Dental malpractice coverage will cover any dental malpractice judgments or settlements. This will also cover any related court expenses and other legal fees. Most cases, your dental malpractice insurance companies will also provide you with lawyers.
Furthermore, this insurance coverage will cover any expenses of necessary legal fees and consultations if you receive a subpoena to appear as a witness or dental expert in a court case.
This may occur if your past or current patient sues another dentist for malpractice or if the other side of the legal court wishes to implement the proper protocol in specific dental clauses.
What is entity malpractice insurance for dentists, and how does it differ?
Entity malpractice coverage has similarities with basic malpractice insurance. However, this coverage includes your business entity. You need an entity policy to cover the fees with a portion of the claim to ensure that you are safeguarded once someone accuses you of malpractice.
This is essential coverage since you are not personally responsible for wrongdoing in a malpractice lawsuit. However, your practice can still stop and be also responsible for damages. You can choose entity coverage as part of your professional liability insurance policy or purchase separate coverage to protect your work.
Do dentists need professional liability?
Dental malpractice can be both actual or recognized. Out of the 5,588 dental malpractice claims reported to CNA over a 5-study time frame, about 35% were perceived to have no payment to the plaintiff. The case was either successfully defended at trial, the client dropped the complaint, or the court dismissed the case before the trial.
It can reach an average of $10,137 to defend even though there are no plaintiff payments in such cases. This is an essential part of professional liability insurance. You have to pay total legal expenses, such as attorney’s fees and court expenses, in addition to court settlements and judgments.
- Additional data from CNA’s 5-year study: The average dental malpractice claim, which includes payment and legal defense, can cost up to $107,915
- 0% of dental malpractice claims resulted in a payment of between $10,000 and $1 million
- Oral surgeons have the highest malpractice claim severity, with an average expense of $249,689
The most usual procedures that result in malpractice allegations are:
- Extractions (22%)
- Root canal therapy (19%)
- Implants (11%)
- Crowns (11%)
More About Professional Liability
Many dentists who are not in a lawsuit may think that a lawsuit won’t happen to them since only bad dentists get sued. Unfortunately, about 8,500 of your future workmates are defendants in malpractice lawsuits. The likelihood of a lawsuit can increase or decrease depending on your practice location, the kind of practice, and the procedures you perform. This averages to at most one claim in a typical dentist’s career.
The National Practitioner Data Bank, or the NPDB, said the average dental malpractice payout is about $68,000. This is limited to the actual indemnity payment to the person initiating the lawsuit. This does not include defense expenses that can be larger than that amount when defending a claim in a malpractice trial.
A lawsuit is not a tool that measures effective or non-effective dentistry. However, the end result of a malpractice claim can be traumatic, time-consuming, and expensive. This is regardless of the final verdict.
Are dentist licensing complaints covered?
Professional liability has several essential coverage extensions, including license protection. If you lose your license, you will lose your ability to practice. Something you post on social media can also lead to a license complaint with your state board, so we suggest being very careful.
- Anyone can file complaints against you. It could be a patient, family member, colleague, employer, or staff member.
- 29% of the professional liability claims in CNA’s 5-year study resulted from license complaints
- 23% of license complaints result from allegations of ‘general dissatisfaction.
- $4,435 is the average expense to hire an attorney to defend a license complaint
You will receive the same license protection limits that a professional liability has. This will allow you to get an attorney to help you respond to the allegation against you. Having an attorney with you to a board hearing will lead to a more successful outcome than appearing alone.
Types of Covered Risks in Dentistry/incidents with Dental Patients
Professional liability will cover you in all of the following hypothetical scenarios:
- A patient files a suit claiming they failed to diagnose oral cancer after a routine cleaning.
- Your state dental board is investigating a claim of false advertising against you.
- A patient claims you sexually harassed them.
- A neighbor asks for advice, later files suit against you and claims your advice resulted in an injury.
- A patient complains to your state board that you breached their HIPAA privacy rights.
- You dismiss a problem patient, and they file suit claiming abandonment.
Occurrence or claims made?
What is the difference between an occurrence and a claims-made policy in malpractice insurance for dentists?
We have two different kinds of professional liability coverage forms. These are occurrences and claims made. These two determine when malpractice claims are part of the coverage or not.
Occurrence policies offer coverage for claims while your insurance policy is still active. If the incident occurs while the policy is still active, the coverage is still available even though the policy expires or cancels.
Claims-made policies offer coverage for claims that happen while the policy is in place. The coverage expires once the policy also expires. Opting for a long-term reporting period endorsement or tail coverage is possible when a claims-made policy is canceled. This tail coverage lengthens the time. And they can report alleged incidents.
You may ask yourself why anyone would opt for this one considering that the claims-made policy is complicated. The answer is simple. It is the price.
Premiums are lower during the earlier years of a claims-made policy. The claims-made rate will slowly increase and become comparable to the occurrence policy rate.
Since claims-made coverage is triggered once a claim is filed, these insurance policies will not cover claims after the termination or cancellation of the policy. You will have to get an extended reporting endorsement or tail coverage to extend coverage after termination or cancellation of a claims-made policy, or else your new insurance company must cover your prior acts. Many dentists who purchase claims-made coverage think they will someday qualify for free tail coverage. However, this is different. Each year more than 50% of tail coverage that some insurance companies issue is not free but also purchased.
Typical circumstances that require you to purchase a tail coverage
You will likely have the coverage offered at no expense for your board exam as you prepare. Suppose this insurance policy is not an occurrence policy. In that case, you will need tail coverage after terminating your board exam coverage to cover any exposures during your board exam.
Externships & Moonlighting
Always remember that the kind of coverage you will get matters when entering these great learning opportunities. After you have completed your externship or stopped moonlighting, you have to pay for your tail coverage if you have opted for a claims-made policy during this time.
You will likely be part of the coverage of the university if you decide to return to school for a residency program. If this happens, you could cancel any coverage you have for your current practice. However, you must purchase tail coverage to cover any years spent in practice if you have insurance under a claims-made policy.
Leave of Absence
If you’re about to take a leave of absence from your practice, we suggest terminating your coverage. It may require obtaining tail coverage if you have insurance under a claims-made policy. Examples of leave of absence may include maternity leave, poor health, a religious-related concern, and medical mission trips.
Which policy is right for you?
The coverage taken by both policy forms is similar. The only difference is when you can report a claim. The occurrence form is more flexible, while the claims-made policy has a premium discount up front, which can be essential when starting your dental practice.
How can I reduce my dentist malpractice insurance premium?
The following qualify for money-saving discounts:
- AGD members, fellows, masters
- Dental school graduates
- ADA membership
- Part-time dentists
- Group practice
- Loss control procedures
- Operational controls
- Claim-free credits
- Disability or leave of absence
- Waiver of consent to settle
Why is malpractice insurance so important?
It Could Be A Requirement to Get a License
Having malpractice insurance is a needed requirement before you can become a licensed dentist.
It Protects Your Dental Career’s Future
Of course, you hope you will never have to use your malpractice insurance, but having it there can safeguard you against high fees and claim expenses associated with a malpractice lawsuit. It will also provide you with a legal professional to fight against invalid claims against you.
Malpractice suits are likely more common than you imagine
It surprises many people that malpractice suits are prevalent. According to Sara Charles, an MD Physician with the Litigation Stress Resource Center, there were 16,337 medical malpractice payments between 2006 to 2017 out of the 19,755 working dentists, meaning there is a high chance of you facing a malpractice lawsuit. Malpractice insurance is essential protection for you.
Litigation stress increasingly impacts dental professionals.
Litigation stress is a negative emotion and physical reaction when you have a lawsuit or fear ongoing lawsuits. Out of all the defendants, about 95% said they had some measurable physical or emotional reaction when a lawsuit was filed against them. Litigating stress can negatively affect you when you have to cope with regular events and communicate with others, and it also stops you from concentrating well. This can negatively impact your ability to do your job correctly.
Acquiring malpractice insurance as a form of protection may help calm these fears. This may help alleviate some of the stress and fear of dealing with someone trying to sue you for malpractice or ensure they won’t accuse you of wrongdoing. Having someone on your side can make all the difference in keeping litigation stress away from you.
What is and isn’t under malpractice insurance?
Your individual plan will be according to your specific needs and might differ depending on what is and is not part of the coverage. However, the following elements of a malpractice suit may be part of the coverage, at least in some kind form by your malpractice insurance:
- Damages if found liable for malpractice
- Expenses associated with either settling or defending malpractice suits
- Settlement costs
- Arbitration costs
- Medical damages
- Compensatory and punitive damages
The following are not under your malpractice insurance policy:
- Inappropriate alteration of medical records
- A criminal act of some sort
- Sexual misconduct
Digging Deeper into Malpractice Insurance Coverage Specifics
Of course, it is not the time to ask about malpractice insurance coverage in the middle of a lawsuit. By this point, there shouldn’t be any alterations to your insurance policy, and you have the coverage amounts and limits you currently have. Instead, you should have considered setting up your policy before the issue or after the incident through your policy review.
This is essential since you can review whether your insurance policy fits your current dental practice needs and is not based on factors that could be hugely different at the current time. It’s also a good idea to evaluate your insurance company occasionally to decide whether you genuinely have insurance from a company that suits your needs.
Kindly understand that you can be personally responsible for judgments above your policy limits. This further proves the importance of understanding your insurance policy and setting your coverage limits wisely. Please don’t fret, even though this is a scary proposition. Instead, we suggest reviewing your coverage limits and ensuring they are high enough to adequately protect you and your dental practice.
Malpractice insurance for dentist standard provisions
Dental malpractice insurance can be confusing to some. However, please remember that some standard provisions within most policies are less complicated. You may want to check those standards before purchasing a new malpractice insurance policy or reviewing your current policy.
Consent to Settle
You should, of course, have to know who determines if you should settle a claim. Do you have to decide? Is it up to the carrier? How much control do you have regarding settling? The consent to settle a provision is essential to decide before you face an actual claim. More details regarding this since some policies don’t give you the final word in a particular settlement.
What about Sedation Surcharges?
Some professional liability policies demand updates regarding the kinds of procedures you will use, among other elements such as your practice location. This could mean you have to pay a surcharge for using certain kinds of dental sedation during your procedures. Some kinds of sedation are not part of your coverage. So, asking your agent about the specific standard provisions for any new malpractice plan is essential.
Claims-Made Versus Occurrence Coverage
You also need to check if you want a claims-made or an occurrence policy, as these are the two main kinds of coverage available. Claims-made coverage is when a claim is made during a pre-decided coverage period. For occurrence coverage, this differs if the actions giving rise to the claim happened during your coverage period, even though the claim is after your policy term.
Occurrence coverage form
The occurrence coverage form includes many benefits.
● Unlimited time period to report claims – This is the occurrence policy that will pay for a covered professional incident that transpired during your insurance policy period. This is regardless of whether you report your claim. To compare, a claims-made insurance policy will only cover claims reported during your policy period.
● Cost savings – You don’t need to purchase Extended Report Period (ERP) coverage. The fees for this ERP coverage are usually negotiated when a claims-made policy is already terminated. In addition, this coverage is an essential and expensive option on a claims-made form. In some situations, changing carriers or retiring from your practice, you only have a minimal choice but to opt for ERP coverage to avoid coverage gaps.
● Flexibility – Going from one occurrence policy to another is easy if you change insurance companies. There are no hidden ERP premiums for you to pay, and you need prior acts or tail endorsement.
● Possibility of higher limits – You may have higher limits to get with occurrence policies. This is depending on when a claim transpires and when it is reported.
● Continuity of coverage terms and conditions – A claims-made policy is a yearlong contract that may change yearly, altering, reducing, or deleting essential coverage terms and conditions. These changes become retroactive at the very start of your claims-made policy. This can potentially reduce your coverage. With the help of an occurrence policy, the coverage terms and conditions can retroactively change and offer you peace of mind about your current insurance coverage.
Awards in Dental Malpractice Lawsuits Can Be Quite Large
- A lady was given $350,000 after a root canal resulted in nerve damage sometime in June 2013.
- A man received an $800,000 settlement after his own dentist did not refer him to a follow-check-up for a possible cancerous tumor under his tongue in June 2013.
- A patient was awarded $2.69 million after suffering nerve damage when a dental drill bit broke during his wisdom tooth extraction in May 2013.
- A patient received $297,000 after suffering bite problems after doing placement of a crown dental process in November 2012.
- A man received a $200,000 award since his dentures never fit properly in April 2012.
What are some risks dentists face so that you’ll need malpractice insurance for dentists?
There are many different reasons why a dentist may be sued for malpractice. Some of the following are common reasons for professional liability lawsuits:
- No informed consent from the patient or the patient’s legal guardian
- Non-referral of a patient to a specialist
- Inability to properly perform prosthodontics work, such as fitting crowns and bridges
- Removing the wrong tooth or not doing a tooth extraction properly or appropriately
- Missed to diagnose or even treat TMJ dysfunction, periodontal disease, or oral tumors and cancers
- Accidents such as slips and falls, burns, cuts, or other injuries suffered by patients while inside your dental clinic
- Compilations leading from the use of anesthesia during a dental operation
Other problems include adverse drug reactions, poor orthodontic work, and drill injuries. Awards can be a bit substantial depending on the extent of the injuries and problems your patients encounter.
What happens if a malpractice suit is filed against you?
- Your dental patient must show three obvious things before a lawsuit can be filed against you. A patient-and doctor-relationship should have already been made, and you had the duty to treat their dental request.
- Your patient must prove that you stayed away from your standard of care. This may include any treatment outside your scope of what a wise dental practitioner would do in the same situation.
- Your patient must also prove that there were damages because of your negligence. One great example is when your patient receives the wrong medication accidentally. However, the patient did not have any health issues due to it. There will be no damage, and the case will be stopped.
Your malpractice case will enter the discovery phase once the lawsuit is filed against you. You will have lawyers assigned to you by your insurance company, and the attorneys representing the other party will take depositions from both parties and expert witnesses.
You must keep well-organized patient notes to give this to the prosecution. You could run into more legal issues if you don’t have patient notes or if your records have been altered.
The lawyers will either agree to drop the lawsuit or will discuss a settlement once the discovery phase is complete in most cases. Only a few cases go to a juried trial.
Your Next Step:
Planning for the unpredictable
Having malpractice insurance is the very first step. You should also be careful in choosing which insurance company you should work with. Choosing a malpractice insurance policy backed by a long-standing company may be essential. This could show a history of understanding malpractice cases and offer protection when a malpractice suit is filed against you. Your malpractice coverage should be strong as the company providing said coverage.
You should, of course, consider planning for the unpredictable now even though you never plan to face a lawsuit, and I hope you never find yourself in such a difficult situation. We suggest preparing beforehand and immediately acquiring malpractice insurance or altering your current policy for complete protection, and don’t wait until you are already facing a full legal attack.
Ask us any questions.
Thank you for taking the time to read our articles. We hope our written article about malpractice insurance for dentists helps you. Should you need more help, please do not hesitate to contact us at Team AIS in Denver, CO, immediately. We will be waiting.