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Health insurers · staff · claims for payment
In a physiotherapy practice the conflict rarely comes from the patient and almost always from the health insurer checking your claims after the event.
Deze pagina in het Nederlands: Rechtsbijstandverzekering voor fysiotherapie.
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A premium indication, not personal advice. Prefer to talk it through? Call 072 - 509 24 56.
The practice works within contracts you do not draw up yourself. The health insurer sets the rate, the treatment index and the conditions, and checks afterwards through a substantive audit whether claims were properly made. If part is rejected, a recovery follows covering several years at once. That is a contractual dispute with a party much bigger than you, and it is the reason this cover exists.
There is also professional disciplinary law. A complaint about treatment first goes through the complaints officer and the disputes body, and can end in disciplinary proceedings. That is not a claim for compensation and therefore does not belong with your liability insurance. Legal expenses cover for disciplinary law is a separate section you have to include explicitly.
Not covered are: the amount repaid itself, a dispute about whether you are offered a contract, complaints already running when the policy started, and cases below the minimum interest or within the waiting period.
The structure of the cover in three parts, with an overview per situation below.
The disputes that arise from running a business itself.
What you add separately.
What the policy will not take on.
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.
Four points that make the difference between a policy that pays out and one that does not.
In an audit the health insurer requests files and checks whether the records, the indication and the treatment given match. If the supporting evidence is missing, the treatment is rejected regardless of whether it was good. Make sure a lawyer looks over your shoulder before you supply files and before you sign any proposal. What you acknowledge at that stage determines the size of the recovery across all the years audited.
A disciplinary complaint concerns your conduct as a care provider and not compensation. So your professional indemnity insurance (BAV) does not come into it, and many legal expenses policies exclude disciplinary law as standard. Ask for a separate section for a disciplinary defence and check whether it also applies to the stage before the complaints officer and the disputes body, where the case takes shape on the merits.
In an audit or a complaint, access to files is requested. You may not simply hand them over. Your professional confidentiality and the legal basis for processing limit what may leave the practice. If you supply too much, you breach the privacy of patients who have nothing to do with the case. Have it assessed per request which data are necessary and record that assessment in writing.
Physiotherapy practices work with employment, locum arrangements and self-employed professionals side by side. If a dispute arises about a non-competition clause, about the classification of an agreement or about leaving a partnership, those are three different modules. Employment law covers the employee, the contracts module the contractor, and disputes between partners are often excluded. Check that third category before you go into partnership.
Insurers weigh these details differently. That is where your saving is.
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.
This is what people ask us most.
No. Legal expenses insurance pays for the legal assistance in challenging the recovery, not the amount you have to repay. That distinction matters here, because an audit often covers several years at once. Bring in help at an early stage, because the size of the recovery is determined by what you supply and acknowledge during the audit yourself.
Only with a separate section for a disciplinary defence. Disciplinary proceedings are not about compensation, so your liability insurance does nothing there. Standard business legal expenses cover also often excludes disciplinary law. Ask expressly about this section when taking out the policy, and about whether the complaints stage falls under it as well.
Usually not. Whether a health insurer offers you a contract is a matter of freedom of contract and not a legal dispute within the meaning of the policy. What can be covered is a conflict about performance of a contract already in place: rates, agreements on volume or the way an audit was carried out.
That is your professional indemnity insurance, not your legal expenses insurance. Legal expenses cover runs conflicts in which you want to achieve something yourself or in which there is no claim for compensation. As soon as someone claims money from you for a treatment error, the liability insurer takes over the defence. So report a complaint to both insurers as soon as you receive it.
Request a quote without obligation. We will look at which insurer best matches your activities and your risk.
Prefer to call? 072 - 509 24 56, weekdays 09:00–17:00.
Claim on the road? Emergency line 06 - 55 20 40 72.
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.
This page was written and checked by an adviser at Finass Verzekert. Last updated on .
The information on this page is general in nature and is not personal advice.
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