Professional indemnity insurance (BAV) for a speech therapy practice
In speech and language therapy a mistake rarely leads to wasted money alone. A missed warning sign or wrong advice on swallowing affects the patient's health, and that calls for a different form of policy from the standard advisory variant.
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In brief
The most serious claims in this profession concern swallowing disorders. Advice on food and drink consistency that does not match the findings, a swallowing test on a patient after a stroke not carried out in line with the protocol, or advice not revised after the situation deteriorated, can lead to choking and aspiration pneumonia. There is also the risk of missing a red flag: persistent hoarseness not referred to an ENT specialist, or a child receiving speech therapy for months when a hearing problem is the underlying cause.
That makes the form of policy decisive. Your mistake leads to damage to health and not solely to financial detriment. So choose professional indemnity insurance with a healthcare variant in which personal injury arising from the practice of your profession is included. The legal standard is that of the good care provider in Article 7:453 of the Dutch Civil Code. Speech and language therapist is an Article 34 profession under the Wet BIG: a protected qualification title without a disciplinary tribunal of its own, so complaints go through the Wkkgz (the Dutch healthcare quality, complaints and disputes act) route and the civil courts.
As a practice you also carry the risk of others. If you work with speech and language therapists on the payroll, you are liable for mistakes by your employees under Article 6:170 of the Dutch Civil Code; with locums and self-employed professionals the patient has contracted with your practice and the complaint comes to you as well. For the individual practitioner the considerations are set out under the self-employed speech and language therapist. How the cover works in outline is described on the hub page on the BAV.
This page deals with one situation. The full overview is on Compare professional indemnity insurance (BAV).
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Help with claims
We report the claim and monitor how it is handled. In urgent cases you can reach us on the emergency line.
What to look out for
Four subjects that lead to a claim at a speech and language therapy practice more often than the treatment itself.
Referring on and spotting the signs
With direct access, some of your patients come in without a referral. The screening for red flags is then down to you: swallowing complaints with weight loss, one-sided hoarseness that persists, sudden loss of function. Record the screening and the referral advice in the file. When a claim arises, this is almost always the first point examined.
Who falls under the policy
Check whether, alongside the practice, staff, locums, trainee speech and language therapists and interns are treated as insured persons. Ask hired-in self-employed professionals for their policy schedule each year and record the division of responsibility in writing, including who keeps the file and who has the treatment relationship.
Working outside the practice premises
If you treat at schools, in childcare centres, nursing homes or in people's homes, report that when you apply. Pre-verbal therapy for infants and treatment of frail older people are also assessed separately. Work that has not been reported can, under Articles 7:928 and 7:930 of the Dutch Civil Code, have consequences for the cover, even years after the policy was taken out.
What falls outside the policy
Excluded are, among others: clawback of treatments billed after a material review by a health insurer, because that is a dispute about your invoices; fines and penalty payments; intent and wilful recklessness (Article 7:952 of the Dutch Civil Code); and the running through your own course of treatment again without charge.
What does your premium depend on?
- Annual turnover of the practice: the usual basis for healthcare practices
- Number of practitioners: employees, locums and self-employed professionals count separately
- Patient groups: dysphagia and neurological rehabilitation weigh more heavily than children's speech work
- Treatment locations: institutions, schools and home visits broaden the risk profile
- Sum insured: set it by injury claims, not by your average treatment invoice
- Retroactive period: important because harm to children comes to light late
Insurers weigh these details differently. That is where your saving is.
What is covered
| Situation | AVB | BAV |
|---|---|---|
| A patient chokes on food of the consistency you advised and is admitted with pneumonia | No | Provided that |
| A child receives two years of speech therapy when an unnoticed hearing problem turned out to be the cause | No | Yes |
| A parent claims back travel costs and the excess for treatments that were pointless because of your mistake | No | Provided that |
| A locum of yours damages a patient's hearing aid during an exercise | Yes | No |
| A child pulls over a cupboard in your waiting room and is hurt | Yes | No |
| The health insurer reclaims a year of billing because the referral was not in order | No | No |
Refunding your own fees is a dispute about the invoice and not a loss that a liability policy pays.
Frequently asked questions
This is what people ask us most.
Is harm caused by choking covered?
Only if your policy covers injury arising from professional practice. Many standard forms are written for advisory professions and are limited to financial detriment. So ask for the healthcare variant and check it on the policy schedule. An AVB is not an alternative here. That policy is intended for injury and damage to property outside the treatment.
We have a complaints procedure through the professional association. Is that enough?
No. The Wkkgz requires you to have a complaints officer and to be affiliated to a disputes body, and that body can award compensation. That arranges the handling of the complaint, not the payment of the loss. For that you need insurance. So also report a complaint to your insurer as soon as you receive it.
When do we have to report a claim?
Do not wait until a lawyer's notice of liability arrives. Article 7:941 of the Dutch Civil Code requires prompt notification, and most policies are claims-made: the moment of notification determines which insurance year the matter falls in. Also report a circumstance that is not yet a claim, for instance an angry parent or a complaint that has been announced. Admit no liability before the insurer has looked at it.
How long can we be held to account for treating a child?
A long time. You keep the file for twenty years under Article 7:454 of the Dutch Civil Code, and for minors the period for bringing a claim only starts to run when they reach adulthood. If you transfer the practice or close it, agree run-off cover before you cancel, otherwise you face the late claims yourself.
Every situation is different. For these situations we have a separate page.
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