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Professional Indemnity Insurance for Dental Practitioners in India

Article in Journal of Health Sciences & Research · December 2018

DOI: 10.5005/jp-journals-10042-1067

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Kedarnath N Seshappa et al. 10.5005/jp-journals-10042-1067

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Professional Indemnity Insurance for Dental Practitioners

in India
1
Kedarnath N Seshappa, 2Shruthi Rangaswamy, 3Arun K Puttegowda

ABSTRACT INDEMNITY
Dental practitioners are at high risk of facing medical negligence The word indemnity means security or protection against
cases because of the nature of the work and high costs involved
a loss or other financial burden.2 A person who offers
in the treatment. Professional indemnity insurance protects the
doctors from the medical negligence claims and legal liabilities service based on an expert knowledge is a professional,
and thus provides financial security. The purpose of this paper and an indemnity policy or insurance that is made to suit
is to highlight the importance of professional indemnity insur- a particular profession is called professional indemnity
ance and to understand various terminologies in choosing the
right policy. insurance.
In case of proven medical negligence, the insurance
Keyword: Dentist, Indemnity policy, Professional liability.
company will pay for the compensation awarded to the
How to cite this article: Seshappa KN, Shruthi R, Puttegowda Dentist and also gives a sense of mental security. Hence
AK. Professional Indemnity Insurance for Dental Practitioners
in India. J Health Sci Res 2018;9(2):38-40. it is prudent for every dentist to have the professional
indemnity insurance cover.
Source of support: Nil
A professional indemnity policy protects the doctors
Conflict of interest: None against:
• Injury or death caused by negligence and claims
INTRODUCTION
made against such errors.
The Indian society has observed a lot of changes after
• The liability which may include defending advocate
1986 with the introduction of consumer protection act,
charges, costs of investigation, representation.
especially in the medical profession. Earlier a Doctor
treating a patient was seen as a noble service and is now How to Choose an Insurance Policy for
reduced to consumer and service provider. Professional Indemnity
The essence of the doctor-patient relationship is
Insurance policy varies across insurance companies and
disappearing resulting in lawsuits against the doctors,
insurer. The professional choosing such insurance cover
and there has been a steady increase in the number of
such cases/suits in the recent years.1 The entry of corpo- has to go through the document in detail. Professional/
rate companies into healthcare has also influenced the the doctor-insurer should be thorough with many termi-
dynamics of this change. Dental practitioners because nologies mentioned in the policy and consider various
of the nature of the work and the high costs involved factors that best suits his/her practice before finalizing
in such treatments are at high risk of facing a medical one such policy.
negligence case suit. Some of the terminologies to be understood are listed
A single case of medical negligence can cost heavily in Table 1.
to the dentist, professionally and financially as well.
Professional Services
Reputation is an integral part of the medical profession
and maintaining the same is very critical. The need of the Professional services provided will be clearly described
hour, in the present litigious world, is to secure professional in the document, and the professional has to ensure that
practice by way of professional indemnity insurance. the policy adequately covers the requirements.

Table 1: Terminologies
1,2
Professor, 3Reader
Professional services Limit of claim
1-3
Department of Oral and Maxillofacial Surgery, RajaRajeswari Anyone accident and anyone Claims made policy
Dental College and Hospital, Bengaluru, Karnataka, India
year limit
Corresponding Author: Kedarnath N Seshappa, Professor, Occurrence policy Extended reporting period
Department of Oral and Maxillofacial Surgery, RajaRajeswari
Dental College and Hospital, Bengaluru, Karnataka, India, e-mail: Anyone claim policy Aggregate policy
[email protected] Runoff cover

38
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Professional Indemnity Insurance for Dental Practitioners in India

Limit of Indemnity Basis of Cover

Limit of indemnity means the sum insured in the policy The process of indemnity cover varies from company to
that can be claimed. This should be based on the losses company depending on the treatment services provided
that might arise in inadvertent circumstances. Most of at the place. There can be a variation to the sum insured
the indemnity insurance cover starts around one lakh, in policy depending on whether the policy is anyone
and the limit of indemnity can be tailored to the needs claim or aggregate policy.
of the individual or the group or institution. In ‘anyone claim’ policy, coverage for each individual
While choosing the limit of indemnity, one should claim during active policy period can be up to the full
consider the following factors: limit of the insurance made, but in an ‘aggregate’ policy,
• The nature of the profession like diagnostic, surgical, coverage includes a full limit for all the claims that were
cosmetic procedures.
raised in the active period of the policy.
• The size and extent of the service provided in a small
For example, if two ` 75,000/– claims are made against
clinic or big hospital.
` 1,00,000/–, in ‘anyone claim’ policy the company would
• The extent of the risks involved in surgical proce-
dures, general, and sedation. cover the expenses of both claims since both are below
• Type of patients seeking the service: Children, medically the ` 1,00,000/– limit.
compromised patients, and elderly patients. If two ` 75,000/– claims are made against rupees
• The place where services are offered: Rural, semi-urban, 1,00,000/– in an ‘aggregate policy’, the company will
urban, major city, metro city and cover expenses only up to the ` 1,00,000/– limit.
• Claims made against those in the same profession. As the claims total ` 1,50,000/–, the remaining money
The sum insured is fixed per accident and per policy the company will not cover ` 50,000/- which is excess of
period also called anyone accident (AOA) limit and any ` 1,00,000/– limit.
one year (AOY) limit respectively.3,4
In general, ‘anyone claim’ is considered to be more
Duration of Coverage comprehensive policy and the process of insurance cover-
age can vary from company to company depending on
One should explore the policy for details on the period
of insurance cover related to renewal and non-renewal of the services provided.7-9
policy, as there can be variation in file suits of negligence
on a doctor from nil to many at a point of time. Extended Reporting Period or Runoff Cover
There can be different types of indemnity cover like: Period of limitation in the law allows the grieved patients
• Claims made coverage to file a case up to 3 years after the treatment. In this
• Occurrence coverage
regard, the extended reporting period becomes important
The differences between occurrence coverage and
if the doctor plans to close the clinic or hospital. Even
claims made coverage are5,6 (Table 2):
though the doctor has stopped providing the services, he
Table 2: Difference between occurrence coverage is still liable for the services provided up to 3 years after
and claims made coverage
the closure of the clinic or hospital.
Occurrence coverage Claims made coverage The costs may be high in purchasing an extended
Protects against Policy covers any claims defined
incidents which occurred when both the incident and the
policy or tail coverage, but it is still beneficial compared
during policy period, claim occurred during the active to the risks involved.10,11
does not consider the policy period.
time of claim
Offers permanent Provides coverage from the time Exclusions of Professional Indemnity
coverage of first policy and continued active
policies by renewals. One has to carefully look for the exclusions mentioned
Once premiums stop the in the policy before buying the policy. Acts committed
coverage stops
under influence of alcohol/drugs, any criminal acts,
The company will An insurance company will not
respond to claims even provide the claims made after the personal damages, loss of goodwill, any penalties, and
after termination of the policy periods, even if the incident also any medical treatments given for, weight reduction,
policy. happens during the policy period. cosmetic/plastic surgery procedures, and any condition
No need for extended The policy will cover claims even
associated with human immune virus (HIV)/acquired
coverage. after the original policy coverage
period only when the insured had immune deficiency syndrome (AIDS) and non compli-
purchased the "tail" coverage or ance with statutory provisions are not covered by the
extended period insurance.
insurance policy.12
Journal of Health Sciences & Research, July-December 2018;9(2):38-40 39
Kedarnath N Seshappa et al.

HOW TO CLAIM The need for professional indemnity cover is more

relevant than ever in today’s litigious world.
In any case of untoward incidents, the information has
to be rendered to the insurance company as soon as pos- REFERENCES
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