Referral policy · eye pressure · pupil dilation
Professional indemnity insurance (BAV) for a self-employed optometrist
As an optometrist you assess whether someone needs to see an ophthalmologist. The most serious claim in this profession is therefore not about a wrong measurement, but about a referral that came too late.
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Deze pagina in het Nederlands: Beroepsaansprakelijkheidsverzekering voor een zelfstandig optometrist.
The calculator and the quote form below are in Dutch. Prefer to do this in English? Email info@finassverzekert. nl or call 072 - 509 24 56 and we will take it from there.
Work out for yourself what it would cost.
Enter your details; you will receive a proposal within one working day.
- 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
Optometry is an an Article 34 profession under the Wet BIG: a protected qualification title with a defined field of expertise. Within that field you carry out examinations that have consequences for someone's sight — measuring eye pressure, slit lamp examination, fundoscopy, visual field testing — and you then take a decision: monitor yourself, review, or refer on. If things go wrong, the discussion is about that decision. Raised eye pressure you kept under review when there was already visual field loss, an optic disc not assessed, diabetic retinopathy missed in a screening round: that leads to permanent harm and therefore to an injury claim arising from professional practice.
A policy that only covers pure financial loss is too narrow for this profession, while an ordinary public and employers' liability insurance specifically excludes loss arising from the examination itself. You need cover that includes both, as described under the liability insurance for care and welfare. Because you carry out a medical procedure, the standard in Article 7:453 of the Dutch Civil Codeapplies: the care of a good care provider in line with the professional standard, with the profession's guidelines as the yardstick.
If you work under a contract for services at an optician's, a chain location or an outpatient clinic, do not assume that you are covered by that organisation's policy. Usually you are not an insured person there and you also sign an indemnity in which you take on the client's loss. Liability that only arises through such a clause is excluded on virtually every policy. See also the points to note for self-employed professionals.
This page deals with one situation. The full overview is on Compare professional indemnity insurance (BAV).
Risks of this profession
Four points on which a self-employed optometrist comes unstuck in practice.
The moment of referral is your burden of proof
Where a diagnosis is missed or delayed, the insurer looks at your records: which values you measured, which images you took, what you advised and when. Images without a conclusion do not help you. Note for each consultation the finding, the referral advice and whether the patient acted on it. Without that, showing that you acted in line with the guideline is virtually impossible.
Dilating drops and the journey home
After tropicamide a person is temporarily sensitive to light and unable to focus properly. If the patient then drives and an accident occurs, the question arises whether you gave the warning. Article 7:448 of the Dutch Civil Code requires you to inform patients about consequences and risks; give those instructions in writing. Also bear in mind the rare but serious risk of an acute angle-closure glaucoma attack where the anterior chamber angle is narrow.
Staying within your field of expertise
Procedures falling outside the Article 34 field of expertise, or reserved procedures without a valid instruction within the meaning of Articles 35 and 36 of the Wet BIG, can lead to a dispute about cover. Insurers accept the risk on the basis of the activities you declared. If you expand into, for instance, therapeutic pharmaceuticals or contact lens care, report it; Articles 7:928 and 7:930 of the Dutch Civil Code attach consequences to an incorrect or incomplete declaration.
What falls outside the cover
What is not insured includes: disciplinary measures and fines, refunding your own fee where a patient is dissatisfied, loss caused by intent or wilful recklessness (Article 7:952 of the Dutch Civil Code), and claims arising from circumstances you already knew about when you took out the policy. A disciplinary complaint does not produce compensation, so in principle the policy does not come into play there. For assistance, look at business legal expenses insurance.
What does your premium depend on?
- Annual turnover from consultations: the basis on which the rate is set
- Examinations you carry out yourself: fundoscopy and visual field testing weigh differently from refraction
- Use of diagnostic pharmaceuticals: using drops brings a risk profile of its own
- Way of working: your own practice, secondment or individual engagements per location
- Taking part in chain screening: large patient numbers per round increase the exposure
- Length of the run-off period: damage to sight is sometimes only noticed years later
Insurers weigh these details differently. That is where your saving is.
What falls under which policy
| Situation | AVB | BAV |
|---|---|---|
| A visual field test you did not repeat, so that glaucoma damage progressed | No | Yes |
| Damage to the cornea after fitting a contact lens that was too tight | No | Yes |
| A patient trips over the footrest of your slit lamp and breaks a wrist | Yes | No |
| A fundus camera belonging to the practice where you work that you drop while transporting it | Provided that | No |
| The cost of defending yourself against a patient alleging a late referral | No | Yes |
| Your own loss of income because you carry out fewer consultations while a claim is being handled | No | No |
The AVB covers injury and damage to property in and around the examination room, the BAV the harm arising from the examination itself. Your own business interruption falls outside both.
Frequently asked questions
This is what people ask us most.
I work for a chain. Am I covered through their policy?
Only if you are named there as an insured person. A company policy covers the organisation and its staff. A self-employed professional with their own contract for services generally falls outside it. Ask for written confirmation or take out your own policy. Also look in the contract at the minimum sum insured the client requires.
A patient accuses me of discovering glaucoma too late. What should I do?
Report it to your insurer at once and admit no liability; virtually every policy prohibits promises of compensation. Gather the measurements, images and file notes from all the consultations and set out which guideline you followed. The insurer assesses whether your conduct met the professional standard, not whether the outcome was unfortunate.
Does the cover continue if I close my practice?
Only with a run-off period. Most policies are claims-made: what counts is the moment the claim is notified, not when you carried out the examination. Because damage to sight develops slowly, run-off cover for several years is sensible in this profession. Arrange it before the termination date, because buying it afterwards is usually not possible.
If I am off work through illness, does this policy pay out?
No. This insurance pays a third party who holds you liable and not you yourself. For your own income during illness or injury, look at disability insurance. Self-employed professionals in healthcare often combine that with liability and legal expenses cover in one package.
Read more
Within Beroepsaansprakelijkheidsverzekering
- Beroepsaansprakelijkheidsverzekeringthe main page
- Beroepsaansprakelijkheidsverzekering fysiotherapeut zzp
- Beroepsaansprakelijkheidsverzekering poh zzp
- Beroepsaansprakelijkheidsverzekering huisarts zzp
- Beroepsaansprakelijkheidsverzekering psycholoog zzp
- Beroepsaansprakelijkheidsverzekering huidtherapeut zzp
- Beroepsaansprakelijkheidsverzekering tandarts zzp
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