Delegation of tasks · infection control · transferring the practice
Professional indemnity – Dental practice
In a practice it is not only the dentist who treats. The dental hygienist, prevention assistant and locum work under the same name, and the patient claims against the practice.
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Deze pagina in het Nederlands: Beroepsaansprakelijkheid – Tandartspraktijk.
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- We compare the offerings of several insurers
- An adviser checks whether the cover suits your activities
- We arrange the switch, including cancellation
A premium indication, not personal advice. Prefer to talk it through? Call 072 - 509 24 56.
In brief
The treatment agreement is concluded with the practice, even where the procedure is carried out by someone else. For staff on the payroll you are liable under Article 6:170 of the Dutch Civil Code, for auxiliaries you engage through Article 6:76 of the Dutch Civil Code. The practical heart of the matter is delegation of tasks: the Wet BIG allows a prevention assistant or dental hygienist to carry out reserved procedures, but only on instruction, with demonstrable competence and with supervision and the ability to intervene as Articles 35 and 38 require.
There are also risks that are not treatment errors but still land with the practice. A defective treatment chair, a laser or an X-ray unit that does not do what it should, falls under Article 6:77 of the Dutch Civil Code: towards the patient you are liable for the unsuitable auxiliary item, even where the cause turns out to lie with the manufacturer. The same applies to inadequate infection control, where sterilisation records and the water quality of the unit are the first things requested.
Keep the limits of the policy clearly in view. Injury to a patient who falls in the waiting room belongs on the public and employers' liability insurance, a breach in the patient system containing X-ray images on a cyber insurance. The individual side of the work is described under the self-employed dentist.
This page deals with one situation. The full overview is on Compare professional indemnity insurance (BAV).
What goes wrong in a practice
Four subjects that arise specifically as soon as more than one practitioner works there.
Put delegation of tasks in writing
Record for each member of staff which procedures she may carry out independently, on the basis of which training, and when the dentist has to supervise. In a claim about an anaesthetic given incorrectly or a tooth damaged during cleaning, everything turns on whether the instruction was clear and competence was established. Working instructions without a date and a signature do not help there.
Locums and self-employed practitioners
A self-employed dentist or freelance dental hygienist is not automatically covered by your policy, while the patient does write to the practice. Ask each year for a copy of their policy schedule and agree who conducts the defence. Do not include an indemnity in the cooperation agreement that goes beyond liability in law, because such a clause falls outside your own cover.
Equipment, sterilisation and radiation
Keep records of maintenance, calibration and sterilisation cycles, including the flushing protocols for the unit's water lines. For X-ray equipment there are separate requirements on supervision and expertise. When a claim arises, these records are evidence, not administration: if they are missing, it is assumed that the procedure was not carried out.
What the policy does not pay out
Outside the cover are: warranties on the lifespan of crown and implant work and replacing it free of charge; fines and penalty payments from regulators; damage to property in your keeping, such as a denture damaged during a repair at the practice; and intent or wilful recklessness under Article 7:952 of the Dutch Civil Code.
What does your premium depend on?
- Number of chairs and practitioners: dentists, dental hygienists and assistants each count
- Annual turnover of the practice: the basis for the premium and the sum insured
- Range of treatments: implantology, surgery and orthodontics make the risk profile heavier
- Extent of delegation of tasks: how many procedures are carried out by assistants
- Number of branches: several sites call for uniform protocols
- Retroactive date: decisive when taking over an existing practice
Insurers weigh these details differently. That is where your saving is.
What is covered
| Situation | AVB | BAV |
|---|---|---|
| An X-ray of another patient leads to a healthy tooth being extracted | No | Yes |
| An allergy noted in the file is missed when an antibiotic is prescribed | No | Yes |
| A locum dentist makes a mistake and the patient writes to your practice | No | Provided that |
| A patient falls over a loose mat in the waiting room | Yes | No |
| The compressor fails and you have to cancel a day of appointments | No | No |
| A patient leaves the bill unpaid after complaining about his crown | No | No |
Equipment failure and unpaid invoices are business risks, not liability. For those, look at business interruption cover and debt collection.
Frequently asked questions
This is what people ask us most.
Our dental hygienist works on a self-employed basis. Does she need her own insurance?
Yes, and that is in your interest too. She is directly answerable for her own conduct and cannot rely on the protection an employee has. Without her own policy a claim still reaches you, because the patient writes to the practice and you have to conduct the defence. Set out the insurance obligation in the cooperation agreement.
A patient's denture breaks while it is with us for repair.
That is damage to property you have in your keeping and it falls under the care, custody and control exclusion. It is not on the professional indemnity insurance in any event, because it is not a mistake in the treatment. If you want to cover this, ask expressly for care, custody and control cover on the public and employers' liability insurance and report which items you have in your keeping.
A patient demands the cost of a failed treatment back.
Split the claim. Refunding your own fee and carrying out the same treatment again are not covered. The cost of remedial work elsewhere, of follow-up treatment and of any injury are, provided there is an identifiable professional error. Respond in writing, make no admission of liability and report the claim to your insurer.
A dentist is leaving us. What happens to his earlier treatments?
As long as the practice policy remains in force and he was named on it as an insured person, claims about that period in principle remain covered. Do check this policy by policy and record in writing on departure who reports which claims and who manages the files. If the practice itself closes, run-off cover is necessary to have later claims covered.
Read more
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