Complaints · disciplinary law · claims for payment
Legal expenses insurance (rechtsbijstandverzekering) for dentists
A dental practice is challenged through three channels at once: the complaints regime under the Wkkgz, the disciplinary regime under the Individual Healthcare Professions Act (Wet BIG) and the contractual line with the health insurer.
The calculator and the quote form below are in Dutch. Prefer to do this in English? Email info@finassverzekert. nl or call 072 - 509 24 56 and we will take it from there.
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A premium indication, not personal advice. Prefer to talk it through? Call 072 - 509 24 56.
In brief
For a dentist the heaviest procedure is rarely a civil one. A complaint first goes to the complaints officer and then to the disputes body required by the Wkkgz. A disciplinary complaint goes past you to the regional disciplinary court and affects your BIG registration. A third line is the health insurer recovering payments after a substantive audit. Each of these three procedures has its own deadlines and its own way of building a file.
That makes selecting modules more important here than in an average SME. On many business legal expenses policies, disciplinary and complaints proceedings are not a standard section, precisely because there is no opponent with a claim against you. Ask about it explicitly and have it recorded whether assistance before the disciplinary court is included or whether you are only covered for the civil aftermath.
Legal expenses insurance reimburses the cost of legal assistance. Compensation claimed by a patient for a treatment error does not run through this policy, but through your professional indemnity cover. We set those two policies side by side so that you do not find both insurers pointing at each other. You can read more about the basic form at business legal expenses insurance.
What does legal expenses insurance for dentists cover?
The structure of the cover in three parts, with an overview per situation below.
Basic
Business operations
The disputes that arise from running a business itself.
Contracts and deliveries
Collecting your invoices
A dispute with a supplier
Extension
Separate modules
What you add separately.
Employment law and staff
Rent of the business premises
Tax and social security
Limits
What falls outside it
What the policy will not take on.
A dispute dating from before the start date
Below the threshold
During the waiting period
What is covered
Situation
Basic module
With extension
Dispute with a client about work delivered
Yes
Yes
Collection of an unpaid invoice
Provided that
Yes
Employment dispute with an employee
No
Yes
Dispute with the landlord of your business premises
No
Yes
Tax dispute with the Belastingdienst (the Dutch tax authority)
No
Provided that
A dispute that was already running before the start date
No
No
Business legal expenses insurance has a waiting period and a threshold: a case is not taken on below a certain financial interest. Employment law, tenancy law and tax law are usually in separate modules. In legal proceedings you have a free choice of lawyer. A dispute whose cause already existed when the policy was taken out is excluded.
This overview is general in nature and is not personal advice. What is actually covered, including exclusions, limits and the excess, is set out in the policy conditions and the insurance card (verzekeringskaart) of the insurer; you receive both before you take out cover. Taking out cover without advice? Then read what execution only means for you.
Where things go wrong in practice
Four points that make the difference between a policy that pays out and one that does not.
Disciplinary law affects your registration, not your wallet
A disciplinary complaint is lodged with the regional disciplinary court and can end in a warning, a reprimand or removal from the register. There is nothing to collect and nothing to pay, and that is precisely why insurers often do not treat these proceedings as a dispute within the meaning of the policy. If you want assistance here, it has to be on the policy schedule as a separate module or clause. Check that before a complaint arrives.
The Wkkgz complaints regime runs ahead of disciplinary law
Every practice has to have a complaints officer and be affiliated to a recognised disputes body. That body can give a binding ruling and award compensation. This process starts informally and escalates quickly. What you write in your first letter to the patient is on the table later. So report a complaint to your insurer as soon as it comes in, even if you think you can resolve it yourself.
Substantive audits and recovery of payments
Health insurers check afterwards whether treatments were rightly claimed and under the correct performance codes. If your records differ, a recovery follows covering a series of years. This is a contractual dispute and falls under the contracts module, not under debt collection. The insurance pays for the assistance. The amount you have to repay stays at your expense, even if you lose the case.
Practice takeovers, goodwill and the partnership
On a takeover or on leaving, things go wrong over the valuation of goodwill, a non-competition clause or the division of hidden reserves. Many policies exclude disputes about the acquisition or disposal of a business, and disputes between partners or shareholders fall outside them almost without exception. Arrange this before the transaction through your notary or adviser. The policy will not catch it afterwards.
What does your premium depend on?
Number of chairs and practice structure. A sole practice, a partnership and a chain with several locations are rated differently.
Wage bill and staffing. Assistants, dental hygienists and prevention assistants determine how heavily the employment law module counts.
Modules chosen. Disciplinary law, administrative law, contracts, debt collection and employment law can be chosen separately and each adds to the premium.
Own premises or rented practice space. If you rent the space, the property module is needed for disputes with the landlord.
Limit on external costs per case. The maximum for an external lawyer in proceedings where free choice of lawyer applies differs per insurer.
Claims history and files under way. Earlier cases and a conflict already known at the start count towards acceptance and pricing.
Insurers weigh these details differently. That is where your saving is.
How we arrange it
You request a quoteWe take stock of your situation, your risk and your wishes.
We compareseveral insurers, on premium as well as conditions.
You receive a proposalWith an explanation of the differences and the exclusions.
We arrange the switchIncluding cancellation, so there is no gap in cover.
Customers rate our service on four aspects: personal service, service delivery, availability and the outcome. The reviews are collected and published by NH1816 and come from customers who have actually taken out a policy with Finass Advies B.V. or reported a claim.
Will I get assistance with a disciplinary complaint?
Only if disciplinary law is stated in so many words on your policy schedule. As standard, business legal expenses insurance is aimed at disputes with an opponent, and a disciplinary court is not one. When taking out the policy, ask whether proceedings before the regional disciplinary court are included and up to what amount, and whether an appeal to the central disciplinary court is covered as well.
Who pays the compensation to a patient?
Not this insurance. Legal expenses insurance reimburses only the cost of legal assistance. If a patient claims compensation for a treatment error, that is a claim on your professional indemnity cover. So always report a complaint to both policies, because the duty to report in Article 7:941 of the Dutch Civil Code applies to each policy separately.
Is a dispute with the health insurer covered?
With the contracts module, yes. A recovery after a substantive audit is a contractual dispute about performance of the care agreement. Watch the exclusion of tax disputes, because on many policies it is drafted widely and can extend to additional assessments connected with your claims flow.
Is there a waiting period?
Yes, usually three months after the start date. A complaint or dispute already running on the start date, or whose cause you already knew of then, is excluded, even after the waiting period has passed and even if you switch from another insurer. So take out this cover in a period when nothing is going on.
Finass Verzekert is a trading name of Finass Advies B.V. We advise on and arrange non-life insurance on the basis of an objective analysis of several insurers, and receive commission for this from the insurer, which is included in the premium. You pay no separate advice fee. Before you take out cover, we establish your wishes and needs.
You will find our licence, KvK and Kifid details and our complaints procedure at the foot of every page.
