Professional indemnity insurance (BAV) for an acupuncture practice
As soon as more than one practitioner works in the practice, the question shifts from your own conduct to who is liable and whose policy picks it up.
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In brief
A practice with several practitioners has two layers of liability. For employees on the payroll you are liable as the employer under Article 6:170 of the Dutch Civil Code: the patient holds the practice liable, not the individual acupuncturist. For hired-in self-employed practitioners and locums the position is different. They are liable themselves, but the patient has a treatment agreement with the practice and turns to the practice. Under Article 6:76 of the Dutch Civil Code you are then liable for the auxiliary you engage.
In practical terms that means two things. First: require every self-employed practitioner working under your name to show proof of own professional indemnity insurance (BAV), with a copy of the policy schedule on file. Second: make sure the practice policy also covers what someone else does in your practice, because otherwise you are caught between the patient and a colleague who has since left. For the individual practitioner there is a separate assessment, described on the page about the self-employed acupuncturist.
Alongside the needle risk, a practice also faces fit-out. An autoclave that does not sterilise properly, a treatment couch that collapses or a faulty electro-acupuncture device leads to injury for which you are liable under Article 6:77 of the Dutch Civil Code, even if the defect is not your fault. Loss that has nothing to do with the treatment, such as a fall in the waiting room, belongs on the public and employers' liability insurance.
This page deals with one situation. The full overview is on Compare professional indemnity insurance (BAV).
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Professional indemnity insurance (BAV)
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We report the claim and monitor how it is handled. In urgent cases you can reach us on the emergency line.
What to look out for
At a practice it is less about the technique and more about the organisation around it.
Who is covered by the policy
Check word for word who is named as an insured in the policy conditions: the practice, the partners, the staff, the locum during holidays, the trainee and the self-employed professional who rents a session. If a category is missing, a claim about that practitioner is declined while the patient still turns to you.
Hygiene and equipment are demonstrable or they are not
In an infection claim the first question is how you handle sterile needles, waste streams and cleaning. Keep a sterilisation log and record incidents. If that record is missing, the evidence on whether you met your duty of care runs against you, and the insurer will also look at compliance with the risk-prevention conditions on the policy schedule.
Transferring the practice calls for run-off cover
If you sell the practice, merge with another practice or stop altogether, treatments from the past will still lead to complaints for years. Without run-off cover your protection ends on the end date of the policy. Arrange it before you give notice: buying it afterwards is usually no longer possible.
What falls outside the policy
The following, among others, are outside the cover: fines and penalty payments imposed by the IGJ (the Dutch healthcare inspectorate) or the Autoriteit Persoonsgegevens (the Dutch data protection authority); loss or leakage of patient data, which on a cyber insurance is where that belongs; intent and wilful recklessness (Article 7:952 of the Dutch Civil Code); and damage to property in your keeping, such as hired equipment, through the care, custody and control exclusion.
What does your premium depend on?
- Number of practitioners: employees, partners and hired-in staff are counted separately
- Annual turnover of the practice: the usual basis for the sum insured
- Range of treatments: offering massage, cupping or dietary advice alongside acupuncture broadens the risk
- Locums and trainees: determines whether the class of insured persons must be extended
- Run-off period: especially important when a transfer is approaching
- Excess per claim: a higher contribution per complaint reduces the annual premium
Insurers weigh these details differently. That is where your saving is.
What is covered
| Situation | AVB | BAV |
|---|---|---|
| A patient becomes unwell during treatment and falls off the couch | No | Yes |
| A practitioner on the payroll continues treatment while the symptoms pointed to something else | No | Yes |
| An electro-acupuncture device delivers too high a current and the patient is left with symptoms | No | Yes |
| A patient slips on the wet floor of your toilet | Yes | No |
| A tap is left running in the practice room you rent and the floor below is ruined | Provided that | No |
| A patient asks for money back because a course of treatment did not help | No | No |
If the loss runs through the treatment, the practice policy is on the hook. If it runs through the building or the fittings, it is the public and employers' liability insurance.
Frequently asked questions
This is what people ask us most.
Our self-employed practitioners have their own policy. Do we still need one?
Yes. The patient enters into the treatment agreement with your practice and holds the practice liable. The fact that you have recourse against the self-employed practitioner internally changes nothing about your position towards the patient or about the cost of defending the claim. Do ask for their policy schedule each year, because lapsed cover at a hired-in practitioner becomes your problem as soon as he has left.
A trainee inserts a needle incorrectly. Who is liable?
The practice. A trainee works under your supervision and you are responsible for the tasks you allow him to carry out. Make sure trainees are named as insured persons on the policy and record which procedures they may perform independently. Procedures outside that agreement increase the chance that the insurer will look closely at your duty of care.
Does injury to a member of staff fall under this insurance?
No. Needlestick accidents or back problems affecting your own staff fall under employers' liability, and that is a section of the public and employers' liability insurance. Article 7:658 of the Dutch Civil Code imposes a duty of care on you for a safe workplace. If you cannot show that you met it, you are in principle liable for the employee's loss.
What is the difference between prior-acts cover and run-off cover?
Prior-acts cover determines how far back the policy looks: treatments given before the start date are covered only if a retroactive date has been agreed. Run-off cover determines how long the policy keeps working after it has ended. For a practice with a long patient history both matter, because a complaint rarely arrives in the same year as the treatment.
Every situation is different. For these situations we have a separate page.
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