Manipulation · red flags · outside the Wet BIG
Professional indemnity insurance (BAV) for a self-employed osteopath
Osteopathy is not a protected profession under the Wet BIG, but you do fall under the Wkkgz and under ordinary liability law. A client left with symptoms after a manipulation brings a claim against you personally.
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Deze pagina in het Nederlands: Beroepsaansprakelijkheidsverzekering voor een zelfstandig osteopaat.
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
Because osteopathy falls outside the registers of the Wet BIG, there is no statutory disciplinary law testing your conduct. That does not make your position any lighter: the Wkkgz (the Dutch healthcare quality, complaints and disputes act) requires you, as a sole care provider, to have a complaints procedure and to be affiliated to a recognised disputes body, and that body can award compensation. Alongside that, the ordinary route runs through Article 6:162 of the Dutch Civil Code and the treatment agreement. Without registration under the Wet BIG, the assessment leans heavily on the guidelines and code of conduct of your own register.
The harm in this profession is almost always physical. A high-velocity, low-amplitude manipulation of the cervical spine is associated with dissection of a carotid artery; with osteoporosis or long-term corticosteroid use a rib or vertebral fracture can occur. A client with radiating symptoms turns out afterwards to have cauda equina syndrome or a malignancy and accuses you of not referring him on. Those are injury claims arising from the treatment itself. An ordinary public and employers' liability insurance covers the treatment couch that falls over, not the procedure you carry out on it. For that there is combined cover for care and welfare is meant.
If you treat at a health centre or stand in at a colleague's practice, check whether you are included there as an insured person. Usually you are not, and in the cooperation agreement you also accept an indemnity. Liability that would not exist without that clause is excluded. What a policy covers in general is set out on the hub page.
This page deals with one situation. The full overview is on Compare professional indemnity insurance (BAV).
Points to note in your policy
Four subjects that produce discussion in osteopathy more often than the level of the sum insured.
Your techniques must match your application
Insurers assess HVLA techniques on the neck, visceral techniques and cranial treatment separately. If you use a technique you have not declared, the insurer can rely on Articles 7:928 and 7:930 of the Dutch Civil Code and reduce or refuse payment. State honestly when you apply what you do, and report an extension of your range of treatments during the policy period.
Infants and young children
Treating babies for crying or feeding problems is socially sensitive and part of the market excluded or limited by a clauseit. Parents who believe afterwards that a condition was missed lodge both a complaint and a claim. If you work with this group, have it expressly stated on the policy schedule instead of assuming that it is included.
Screening for red flags and informed consent
The heart of your defence is that you asked about contraindications and informed the client about the possible reaction after a manipulation. Note for each treatment the history, the red flags found and the consent given. If the client does not follow your aftercare advice, contributory fault within the meaning of Article 6:101 of the Dutch Civil Code can reduce the compensation — but only if you can show that the advice was given.
Costs you bear yourself
Outside the cover are, among other things: the refunding treatment fees where a client is dissatisfied but not injured, fines and sanctions imposed by your professional association, and liability you accept by contract by promising a result. What you cause intentionally or with wilful recklessness also stays uninsured; Article 7:952 of the Dutch Civil Code keeps that outside the cover. Your own loss of income during proceedings is not an insured loss either.
What does your premium depend on?
- Annual turnover from treatments: the basis for the rate
- Manipulation techniques used: cervical HVLA weighs the most heavily
- Composition of your client group: infants and older people have their own injury patterns
- Registration with a recognised professional register: some insurers make that a condition
- Working at your own premises or at third parties': standing in calls for a separate arrangement
- Run-off period chosen: complaints are sometimes only reported months later
Insurers weigh these details differently. That is where your saving is.
What falls under which policy
| Situation | AVB | BAV |
|---|---|---|
| A rib fracture in a client with osteoporosis after a thoracic manipulation | No | Yes |
| A client with radiating symptoms whom you continued to treat while a disc herniation worsened | No | Yes |
| A client who slides off the treatment couch while you are briefly out of the room | Yes | No |
| Water damage to the treatment room you rent from a colleague by the half-day | Provided that | No |
| A coat that disappears from your waiting room during a treatment | No | No |
| The cost of defending proceedings before the disputes body you are affiliated to | No | Provided that |
The AVB covers what happens in the treatment room, the BAV what arises from the treatment itself; defence costs before a disputes body are not included on every policy.
Frequently asked questions
This is what people ask us most.
I am not registered under the Wet BIG. Can I still take out professional indemnity insurance?
Yes. Insurers look at your training, your registration with a recognised professional register and the techniques you use, not solely at the Wet BIG. Part of the market does make registration and continuing training a condition. If your registration status changes, report it, because it is a circumstance on which the underwriting is based.
A client is left with neurological symptoms after a neck treatment. What now?
First make sure the client is assessed medically and then report the matter to your insurer at once. Article 7:941 of the Dutch Civil Code requires you to report as soon as you are reasonably aware of the claim. Say nothing about fault and promise no compensation. The insurer conducts the defence and assesses whether you acted in line with the professional standard.
Do I have to be affiliated to a disputes body?
As a sole care provider the Wkkgz requires you to have a complaints officer and to be affiliated to a recognised disputes body. That body gives a binding decision and can award compensation. Report ongoing dispute proceedings to your insurer, because the outcome can lead to a payment under the policy.
What if client data leaks from my practice software?
That is not a treatment error but a data breach, and it belongs on a cyber insurance. That pays for investigation, recovery, notifying the data subjects and liability towards them. An administrative fine stays outside every liability cover, because it is a sanction and not compensation.
Read more
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