Handing over or administering · transfers · care, custody and control
Professional indemnity – Care worker
A care worker works close to the client's body and in the client's home. The allegations are accordingly about two things: a fall or the wrong dose, and belongings that get broken.
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Deze pagina in het Nederlands: Beroepsaansprakelijkheid – Verzorgende.
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In brief
As a care worker in individual health care (verzorgende IG) you are not in the BIG register and you do not fall under the disciplinary law of Article 47 of the Wet BIG. That does not mean you run less risk: you are simply liable in Article 6:162 of the Dutch Civil Code and, as a contractor, bound by the care of a good contractor under Article 7:401 of the Dutch Civil Code. Complaints follow the route prescribed by the Wkkgz (the Dutch care quality and complaints act) and can still turn into a liability claim afterwards.
The sharpest line in your work is the one between handing over and administering. Preparing and handing over medication is allowed; injecting and catheterising are reserved procedures that may only be carried out on instruction and with demonstrable competence (Articles 35 and 36 of the Wet BIG). If you regularly carry out nursing procedures, state that when you apply, because a policy for care work does not cover them as a matter of course.
Besides that, things simply get broken in a household from time to time: a garment in the wash, a pair of glasses, a hearing aid, a scratch in the floor from the hoist. That is not a professional error but damage to property and belongs on the public and employers' liability insurance. This is where it often runs aground on the care, custody and control exclusion, because these are precisely the items that were in your care at the time.
This page deals with one situation. The full overview is on Compare professional indemnity insurance (BAV).
What to look out for
Four points that decide who bears the loss in care work at home.
The line between handing over and administering
If you come across a client who needs insulin or has a feeding tube, ask for a written instruction and a statement of competence, or hand the procedure back to the district nursing team. Carrying out a procedure for which you are not authorised and not demonstrably competent undermines your defence completely, however reasonable the situation seemed at the time.
Falls and transfer incidents
Most injury claims in care work arise when helping someone to stand, showering and using a hoist. Work with the lifting protocol that applies to the client, check the sling and its attachment beforehand, and do not work alone where the protocol requires two people. Afterwards, note down factually what happened; a reconstruction from memory after the event convinces no insurer.
The client's belongings that are in your care
Clothing in the washing machine, glasses on the bedside table, jewellery during washing: damage to items in your care is excluded on virtually every liability policy. Report that you do this work and ask whether limited care, custody and control cover is possible. Without that extension you pay for damage of this kind yourself or through an amicable settlement.
What falls outside the cover
Excluded are, among others: allegations of theft or misappropriation, because intent is excluded (Article 7:952 of the Dutch Civil Code); fines from whichever body; work you have not disclosed, with the consequences of Articles 7:928 and 7:930 of the Dutch Civil Code; and redoing or repaying your own hours.
What does your premium depend on?
- Annual turnover from care hours: the common basis for the premium
- Description of the work: personal care weighs differently from nursing procedures
- Client groups: dementia, palliative care and severe loss of mobility increase the risk of falls
- Working alone or with a colleague: important for transfers and lifting
- Care, custody and control cover included: for the client's belongings that are in your care
- Sum insured and excess: per claim and per insurance year
Insurers weigh these details differently. That is where your saving is.
What is covered
| Situation | AVB | BAV |
|---|---|---|
| A client suffers burns because the temperature of the bath water was not checked | No | Yes |
| You leave one client's weekly pill box with another and a hospital admission follows | No | Yes |
| The washing machine empties out because the hose was not connected properly and the carpet is lost | Yes | No |
| You drive the client's car to the pharmacy and cause a collision | No | No |
| You fall down a client's cellar stairs yourself and cannot work for weeks | No | No |
| A client wrongly administers the insulin you handed over and their levels go out of control | No | Provided that |
Injury to yourself and loss arising in traffic follow their own route and belong on neither policy.
Frequently asked questions
This is what people ask us most.
I am not in the BIG register. Do I still need insurance?
Yes. Registration determines whether you fall under disciplinary law, not whether you can be liable. A client or their surviving relatives can bring an ordinary civil claim against you for injury or damage to health, and as a self-employed professional there is no employer in between to absorb it. The defence costs alone are a reason not to carry this yourself.
My client's glasses have fallen and broken. What now?
That is property damage and not a professional error, so this policy does nothing. On a public and employers' liability policy there is a real chance that the care, custody and control exclusion applies, because the glasses were in your care at the time. Report it anyway, because the assessment depends on the exact circumstances, and tell the client yourself before the complaint comes in through a family member.
May I inject insulin when the district nurse is not there?
Only with an instruction from the doctor and if you are demonstrably competent; injecting is a reserved procedure within the meaning of Article 36 of the Wet BIG. If either is missing, you are acting outside your authority. That makes you liable if the client's levels go out of control and it also puts the cover under pressure if that procedure is not described on your policy.
A client falls while I am helping him to stand. Am I liable?
Not automatically. The question is whether you acted as a reasonably competent care worker would in that situation: the right aid, the agreed number of people and a safe environment. If you can show that, there is no error, however serious the injury. Report the incident to your insurer at once and make no statement about fault.
Read more
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