Professional indemnity insurance (BAV) for a dietetics practice
In a practice, a second layer is added to the treatment risk: contracts with health insurers, cooperation across the care chain and responsibility for colleagues.
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In brief
The treatment risk is familiar: advice that does not fit the client's medication or condition, resulting in harm to health. In a practice you are also liable for the dietitians you employ under Article 6:170 of the Dutch Civil Code, and the client concludes the treatment agreement with the practice, even if a locum carries out the consultation. Make sure the policy is a healthcare variant in which personal injury caused in the course of your profession is included, and that all practitioners are within the class of insured persons.
A risk often confused with liability is the billing risk. If a material review finds that services have been billed incorrectly, the health insurer reclaims the money. That is not a third party's loss caused by a professional error but a payment obligation of your own, and it is covered on no liability policy. The same applies to a discount or a clawback that follows from your contract with the health insurer.
The third layer is the chain. You work with the GP, the practice nurse, home care and sometimes an institution. Who carries which responsibility must be clear from the working arrangements. An unclear handover is a recurring cause of mistakes. For individual professional practice we set out the considerations under the self-employed dietitian.
This page deals with one situation. The full overview is on Compare professional indemnity insurance (BAV).
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What to look out for
Four points that arise in a practice with several practitioners.
Interns and locums in the policy
Nutrition and Dietetics students do placements and locums fill in during holidays. Both treat clients under your responsibility. Check whether they are included as insured persons and record which consultations they may carry out independently and when someone supervises. Working outside that arrangement increases the chance that the duty of care becomes an issue.
Records, systems and data
A practice works with electronic records, referrals and laboratory results. Under Article 7:454 of the Dutch Civil Code a retention period of twenty years applies. A data breach in that system is not a professional error but an information security incident: the costs and the liability towards clients belong on a cyber insurance.
Measuring equipment and materials
If you use a body composition analyser, weighing equipment or tube feeding materials, you are liable for loss caused by a defective device under Article 6:77 of the Dutch Civil Code, even where the defect lies with the manufacturer. Keep a record of maintenance and calibration. That is the first piece of evidence in any dispute.
What falls outside the policy
The following, among others, are outside the cover: clawbacks and discounts from health insurers; fines and penalty payments from regulators; injury and damage to property on the practice premises, which on a public and employers' liability insurance belong; and intent and wilful recklessness (Article 7:952 of the Dutch Civil Code).
What does your premium depend on?
- Number of dietitians: employees, partners and hired-in staff are counted separately
- Annual turnover of the practice: the basis for the premium and the sum insured
- Range of treatments: clinical dietetics and integrated care programmes weigh more heavily
- Locations: several sites or consultations in institutions broaden the risk
- Interns and locums: determines the size of the group of insured persons
- Retroactive and run-off periods: especially relevant when the practice is taken over or closed
Insurers weigh these details differently. That is where your saving is.
What is covered
| Situation | AVB | BAV |
|---|---|---|
| A dietitian on your payroll advises a diet that conflicts with the client's kidney function | No | Provided that |
| Your member of staff damages the client's kitchen fittings during a home visit | Yes | No |
| A GP holds you to account because no feedback was given and treatment was delayed as a result | No | Yes |
| A client demands a refund of his own contribution because the programme achieved nothing | No | No |
| An institution has to have its menu planning drawn up again after a mistake in your calculation | No | Yes |
| Your practice system is unreachable for days after an attack and the diary is at a standstill | No | No |
Injury caused by treatment and pure financial loss caused by advice must both be stated on the policy. The two are not automatically included together.
Frequently asked questions
This is what people ask us most.
A health insurer is reclaiming consultations we billed. Is that insured?
No. A clawback after a material review is a dispute about your own entitlement to payment, not about loss you have caused to someone else. Liability insurance does not cover it. For legal assistance in such a dispute, look at business legal expenses insurance; do check there whether disputes with health insurers fall within the cover.
Our locum makes a mistake. Who is liable?
The client has an agreement with the practice and brings the claim against the practice. If the locum works on a self-employed basis you can seek recovery internally, but that is a second step and does not solve your defence in the short term. Have every locum produce their own policy schedule and make sure locum work is stated as an insured activity in your own terms.
We are taking over a practice. Are earlier treatments covered?
Only with retroactive cover whose retroactive date falls before those treatments, and only if there are no known circumstances. When taking over, also settle what happens to the seller's run-off cover and who manages which records. Put the agreements in the purchase contract. Afterwards this is virtually impossible to put right.
Does injury to our own staff fall under this policy?
No. That is employer's liability, which sits as a section on public and employers' liability insurance. Article 7:658 of the Dutch Civil Code requires you to provide a safe workplace and demonstrable instruction. If you cannot show that, you are in principle liable for the employee's loss. For continued payment of salary during sickness, sickness absence insurance (verzuimverzekering) is the appropriate product.
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