Professional indemnity insurance (BAV) for an occupational therapist
An occupational therapist advises on aids and adaptations that are then used for years. A wrong assessment leads to a fall, or to building work that has to be done again.
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In brief
Your work produces two kinds of loss, and that is unusual. On the one hand injury: a client falls from a hoist or from a wrongly adjusted wheelchair, a transfer technique you taught turns out not to be suitable, a splint causes pressure injury. On the other hand pure financial loss: a home adaptation carried out on your advice turns out not to be usable, and the local authority or the client has to have the work done again. Your policy has to be able to carry both.
You are judged against the standard of a good care provider in Article 7:453 of the Dutch Civil Code and, where you advise on the instructions of a local authority or an employer, against the care of a reasonably competent contractor in Article 7:401 of the Dutch Civil Code. In advice under the Wmo (the Dutch social support act) or advice on adapting a workplace, your client is not the user. That triangle makes it important for your report to set out what you observed, which assumptions you used and which alternatives you weighed up.
Working in clients' homes also brings damage to property with it: a damaged window frame while taking measurements, a stain on a floor, a cupboard knocked over. That is not a professional error and belongs on a public and employers' liability insurance. If you work in a practice with colleagues, further questions arise. Those are covered under the occupational therapy practice.
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 make the difference in advice on aids and adaptations.
Advising is not the same as supplying
As long as you advise, your mistake falls under professional liability. If you supply, fit or adjust aids yourself, liability for the product and its installation is added, and that is excluded as standard. Describe in your quotation exactly where your role ends and who places and adjusts the aid.
Defective aids
If you use an aid during treatment that turns out to be defective, you can be liable for it under Article 6:77 of the Dutch Civil Code, even if you did not know of the defect. Check equipment you bring with you and record what you leave behind with a client, including the instructions given.
Aids in your keeping
Demonstration models, equipment on loan from a supplier or an institution's equipment are someone else's property that you manage temporarily. Damage to them falls under the care, custody and control exclusion and is not insured on ordinary liability cover. Ask for separate care, custody and control or goods cover if you regularly drive around with loan equipment.
What falls outside the policy
The following, among others, are outside the cover: the cost of the adaptation itself in so far as that amounts to redoing your own advice; fines and penalty payments; intent and wilful recklessness (Article 7:952 of the Dutch Civil Code); and contractual penalties or performance guarantees from a tender, which go beyond your liability in law.
What does your premium depend on?
- Annual turnover: the usual basis for practising independently
- Type of assignments: treatment at home, Wmo advice and work-related advice weigh differently
- Type of client: local authorities and employers set their own contractual requirements
- Supply or installation of aids: determines whether product cover has to be added
- Sum insured: a home adaptation that goes wrong sets the lower limit
- Retroactive and run-off periods: adaptations are used for years before a defect becomes apparent
Insurers weigh these details differently. That is where your saving is.
What is covered
| Situation | AVB | BAV |
|---|---|---|
| A client falls because you adjusted the wheelchair incorrectly | No | Provided that |
| You damage a door frame while taking measurements at the client's home | Yes | No |
| A stairlift is installed on your advice and turns out to be unusable for this client | No | Yes |
| An employer adapts the workplace on your advice and the employee's symptoms persist | No | Yes |
| A client demands your fee back because he does not find the advice suitable | No | No |
| You are unable to work for several weeks after a complaint and lose income | No | No |
Your profession produces both injury and pure financial loss. Only a policy that carries both covers your work in full.
Frequently asked questions
This is what people ask us most.
A client falls from a hoist I advised on. Who is liable?
That depends on the cause. If the advice was suitable but the hoist defective, attention turns to the supplier and the manufacturer. If the aid did not fit the client's situation, or instructions were lacking, that is a professional error on your part. Report the claim to your insurer at once, record the situation and admit no liability before the cause is established.
The local authority requires liability insurance with a minimum sum insured.
That is usual in Wmo engagements. Ask your insurer for a statement confirming the amount, and note the distinction between the limit per claim and the maximum per insurance year. Contractual penalties and guaranteed lead times set out in the specification are not insurable; assess those clauses before you tender.
I advise an employer on workplace adaptations. What is the risk there?
That your advice is used in a return-to-work programme. If capacity for work turns out to have been assessed wrongly and absence or a sanction follows, the question arises whether you advised carefully. Support your conclusions with what you observed and measured, name the limitations of your assessment and record which information you received from the employer.
How long am I at risk after an adaptation?
An adaptation lasts for years and a defect often only shows up when use changes or the client's condition deteriorates. Under a claims-made policy the moment of notification counts, so arrange sufficient run-off cover if you stop and retroactive cover if you switch. Also report circumstances you already know about as soon as you know them; Article 7:941 of the Dutch Civil Code requires prompt notification.
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