Your questions answered

Policyholders, please call us on 020 7535 5858 or email indemnity@bda.org.

Your Coronavirus questions

I want to treat a patient face-to-face. Will BDA Indemnity cover me?

In the last eight weeks of the pandemic of strictly limited dental activity BDA Indemnity policyholders have been increasingly concerned about the extent of their cover for a range of work either in the practice providing telephone triage or at urgent dental centres treating patients in pain.

During this time we have spoken to members who had specific patients for whom they wished to provide urgent care as they had not been able to access this through urgent dental care centres.

We advised them to do a risk assessment. If they felt, having gone through that risk assessment that managing that patient face-to-face with interventive dental treatment was in the patient's best interest, then they could be assured of cover under the policy.

Good clinical records are required and the template has been made available to all BDA Indemnity members. This advice has been consistent to all policyholders throughout this time whether they were working under NHS or private contractual arrangements.

Policyholders who work under private contractual arrangements have requested reassurance about the extent of their cover at a time that there are perceived and actual restrictions on the extent of treatment allowed by NHS contractual arrangements in the four devolved nations.

Dental services is defined deliberately widely in the BDA Indemnity policy. If a policyholder is providing dental services to patients they can be assured of cover.

In the event of a challenge from a patient, regulator or any other body, the quality and success of a policyholder's defence will always be determined by the factual matrix of what happened at the particular incident time, what the allegations are and what the dentist did or did not do at the time or afterwards, and the contemporaneous clinical records. It will also depend on the prevailing context of the guidance, laws and directives that were in force at the time.

You can be assured that under your contractual insurance cover we are not able to exercise our discretion not to cover you. You can therefore confidently look to us to be by your side through these challenging times as you provide dental services in the coming weeks and months whether under NHS or private contractual arrangements.

I have been told I will be working as a dentist much less than my normal four days. How do I calculate how much this will cost?

We recommend you reduce your hours to the minimum which is 400 hours – the equivalent of one day per week. Please put this request in an email to indemnity@bda.org and in the subject line enter your GDC number and title it “Mid Year Adjustment”. We will be in touch as soon as possible.

We would, by default keep your policy at the lowest level for three months unless we hear from you. You can of course (and must) amend it if your hours increase before the three month period ends. It is important you maintain your indemnity to ensure cover in the event of a complaint, claim, GDC enquiry or the wide range of cover provided by your unique BDA Indemnity policy.

I am not working at all, even on the emergency clinics set up. Should I just cancel my BDA Indemnity and then reapply later?

We understand the financial pressures many dentists are facing at this difficult time. We have advised policyholders to reduce the payments to the lowest rate which is 400 hours (the equivalent of one day a week) for the next three months. As this is an occurrence-based policy, any claims that are notified to you after you stopped working but relate to when you are working will be covered. Keeping your policy active means that you will have cover for any GDC investigations for example which could relate to your personal or professional conduct. Maintaining your policy means there will be no delay in you returning straight back to work when the situation changes.

If however, having carefully considered all these important factors you still wish to cancel your policy, you may do this by giving us 30 days’ notice in an email addressed to indemnity@bda.org.

I don’t know how long I will be working for. How much notice do I need to make a change in my hours?

Once you know how you have your work arrangement set up please contact us as above in point 1.

I am not going to be placing any implants as they are an aerosol generating procedure. Can I stop my implant cover till the guidance with regards to COVID-19 changes?

If you are still managing patients with implants for example restoring, refitting/re-cementing abutments even under emergency/urgent arrangements in the practice, you will need to remain in the implant category.

My practice is closed and I will not be working as a dentist for the foreseeable future. Should I just stop my policy ?

We would advise you keep your cover running (especially for any possible regulatory investigations) and reduce your cover to the minimum 400 hours per year. This ensures that in addition to any enquiry from the GDC, CQC or other regulator you will also have cover for HMRC and other areas of your professional life which are listed as part of our cover features. You will need to contact us as soon as possible when you return to your normal working hours. It’s likely that dentists will be asked to redeploy into the wider NHS workforce.

The practice has laid off all employed staff and I am working in another clinical capacity as a nurse and hygienist. Should I stop my policy?

As a registered dentist doing clinical work within your scope of practice you are legally required to have professional indemnity. Stopping your policy means that if any complaint or investigation arising from something that happens after you stopped the policy you would not be covered for legal assistance and advice including GDC investigations.

The practice circumstances are changing all the time. How many changes can I make to my policy?

Once you know for sure what the weekly arrangements are going to be, let us know. You can make three adjustments during the policy year including a change back to your original policy when things go back to normal.

I have stopped doing aerosol generating procedures (AGPs). Can I reduce my insurance premiums?

The policy covers dentistry in its widest definition and the cost is not based on the provision of particular treatments except for implants. A complaint or claim can arise from a wide variety of situations ranging from examinations and advice to complex restorative care. AGPs have been restricted but may still be used in particular circumstances in defined situations.

About the policy

What does ‘occurrence-based’ mean?

With occurrence-based cover, as long as you are paying the right subscription rate at the time the incident occurred that later gave rise to a claim, you will be covered in perpetuity. This means that if you did something negligent but retired the next day and stopped your payments, even if the complaint and legal claim is made against you three years later, your policy will respond.

I’ve heard that some cover is discretionary. What does this really mean?

Ours is insurance-based indemnity which operates on the same basis as other forms of insurance. The policy wording specifies what is covered by this agreement as well as being transparent about the term, conditions and policy exclusions. If you are declined cover, you can complain to the BDA in the first instance. If you are not satisfied with the final response from BDA, you can then refer your complaint to the Financial Ombudsman Service (FOS). That same legal protection does not exist with discretionary cover: the organisation can exercise its absolute discretion not to assist you, even if you are in the right subscription category, have paid the correct fees and the matter is within the scope of cover – and there is no independent source of adjudication. Whilst it rarely happens, as a mutual fund, a refusal to assist an individual member can be argued to be justified on the basis that incurring the costs of the case would not be in the interests of other members.

What's covered?

It's a unique policy designed for dentists and dentistry. It's specifically designed for UK dentists and the wide range of work they do. The cover is for all the things that dentists generally do, including tooth whitening and dental implants (including sinus lifts and bone grafts), the dental specialty of oral surgery and the use of cosmetic injectable procedures throughout the face.

What's not covered?

Because this is a policy for dentists who are delivering dentistry, the medical specialty of oral and maxillofacial surgery is not covered. Procedures in the neck or other parts of the body are not included, and certain types of specialised cosmetic facial procedures (even when used in the face) are similarly excluded. See our flowchart to assess whether or not the surgical procedures you carry out are covered.

Is my business covered?

When a patient makes a claim, they may pursue a company (or owners), as well as an individual dentist. A Limited Company (or PLC/LLP) is a legal entity in its own right and could face legal action itself. In addition, NHS contracts may require such cover to be in place. You therefore need to ensure that your business has indemnity cover itself. This is referred to by different providers as entity cover, corporate indemnity, corporate medical malpractice or contingent liability. Find out more including arranging entity cover with Lloyd & Whyte, the BDA’s financial services partner.

Are my nurses covered?

Yes, if you purchase the policy as an Expert member practice owner, any nurses employed by you are indemnified for negligence claims, compliant with GDC regulation. You can download a letter for your nurses to provide as evidence.

Would a member who only does a few implants each year be less of a risk than one who does more?

Dental implants are now a recognised element of the range of clinical options. But by their nature the complexity of the risks involved and the costs of putting things right is of a different order to non-implant dentistry. There are two ways of looking at this: do more, become more proficient, present less risk. Or, do fewer, present fewer opportunities for things to go wrong, present less risk. Our view is that it is difficult to call and so we believe the fairest way is to price both ends of the spectrum the same.

How is this different to what's already out there?

In developing this product, we have achieved a number of components that buck the trend in the wider market. The indemnity insurance policy is written on an occurrence-based contractual basis. This means that members will be offered the best of the insurance element (contractual certainty) together with what has been the best of the MDO world (protection in perpetuity). Even more remarkably we have achieved the same terms for the legal expenses cover (we believe that this is the only one of its kind to offer occurrence-based cover).

Eligibility

Who can apply?

Any GDC-registered UK dentist can get a quote and we'd encourage you to do so. Members can apply after receiving the quote.

What happens if I join or upgrade my membership and then my indemnity application is unsuccessful?

If you join the BDA to take advantage of the indemnity cover but your application is unsuccessful, we will refund your membership fee. If you upgrade from one package to another to be eligible to purchase the cover then we will refund the difference and revert your membership to the original package.

Pricing and payments

The cover has been arranged putting members at the heart of it. It's unique to dentistry and we've worked hard to price it so it's fair and accessible. There will be members for whom our price isn't cheaper than their current provider, but hopefully the combined package of membership plus indemnity over is worth more than the sum of its parts. Remember, not all policies and scope of cover are the same.

If you offer discounts on the indemnity product for part time dentists, can you do the same for membership?

Our membership rates are driven solely by providing the availability of advisers and the materials they produce. Indemnity is different in that the more time you are chairside the greater the chance that you will perform a clinical intervention that may need designated time and expenditure on their behalf.

I've recently qualified. How am I catered for?

We might not be competitive on price - we'll be clear about that from the beginning. Other traditional providers discount heavily for recently qualified members to incentivise them to join but this has to mean that others are subsidising them. Ours is a fair product that's not subsidised by others, including maxillofacial surgeons, doctors and dental members from other countries.

We think that as a professional your risk is your own and shouldn't be subsidised by anyone else's.

We have managed to offer some special prices which rise incrementally the longer you are qualified to get to the full standard rate.

Will I have one subscription or two?

There will be two separate subscriptions: one for the traditional membership and one for indemnity cover.

Are there any special discounts for BDA Good Practice members?

Not at the moment. One of the benefits of our integrated offering is that over time we will get better and better claims experience data. In time we may be able to reflect that in the different rates we charge.

How about partners who jointly own their practice. Will we pay for two memberships to access two indemnity packages?

Professional liability insurance, otherwise known as indemnity cover, is personal protection from claims. The Dentists Act 1984 (Amendment order) 2005 introduced the need for all registrants to have adequate and appropriate professional indemnity. This became a legal requirement with the 2015 Rules, reducing the likelihood of a dentist being uninsured and unable to pay compensation. Part of the reason RSA was keen to work with us is because membership enables members to mitigate risk by taking advice when they need it. That philosophy meant the premiums could be fairly priced. BDA membership is for individuals and not to be shared.

Why are you not including these services under membership?

The protection and cover provided is different. Indemnity cover is a legal and regulatory requirement. We've built in additional dentist-led legal protection to bolster the professional liability insurance so that members get complete end-to-end cover. We respect each member’s right to choose their indemnity provider, and it’s only fair to price the two elements separately. That way, we avoid cross-subsidies between those members who choose BDA Indemnity, and those who do not.

Think of Extra and Expert membership as the prevention - advice for business matters and to avoid issues day-to-day. Indemnity is the 'cure' when there is the possibility that the practice of dentistry may have gone wrong.

How will you balance the needs of the insurance providers and the best interests of members?

The reason for choosing Royal and Sun Alliance Insurance is because they listened to us about dentistry and appreciate how it's unique. They understand how dentists work and they recognise the central importance of dentists supporting dentists. They are very supportive of our first point of contact role in making things right for our members.

You're asking members to upgrade their membership to save money on indemnity. What's the rationale behind that?

Part of the reason the insurer was keen to work with us is because Extra and Expert membership enables members to mitigate risk by taking advice when they need it. That philosophy meant the premiums could be fairly priced.

Why does it matter which part of the UK a member works in?

The claims experience and value is lower in Scotland so members working there get cheaper indemnity.

The Background

Our indemnity offer represents yet another piece in the jigsaw designed to make sure members are properly equipped to thrive in today’s professional environment.

Members told us they are concerned about indemnity and what’s happening in the market, so we responded.

The combination of this new offer together with our vast knowledge base provides a powerful solution for members when things go wrong.

We’ve built in additional dentist-led support to bolster the professional liability insurance so that members get complete end-to-end cover. It’s unique to dentistry and we’ve worked hard to price it so it’s fair and accessible.

Why now?

Until a few years ago, professional indemnity had been a fairly non-contentious area in the lives of UK dentists. More recently the BDA has received many comments and questions from members about their experiences in this area. The comments have related to price, fairness, treatment of members and transparency of action and reliability. The strength of feeling went on to fuel debate across BDA committees, including at the General Dental Practice Committee and motions at the national conference of Local Dental Committees.

Our routine surveying of member views reinforced the fact that something in the world had changed and that members expected the BDA to do something about it. We committed to a workstream in our three-year strategy to explore this area just as the Government announced major changes to the way general medical practitioners were to be indemnified. Just afterwards the Government announced its own concerns about the way indemnity is delivered and launched a public consultation into the subject. So, it’s not just dentists who are concerned.

Our offering has been designed in such a way that the criticisms and concerns of members in relation to the current arrangements have been addressed. In addition, we have taken on board the comments in the Government consultation paper and have addressed the concerns that are described there. So, our offering will represent the best-of-breed for current circumstances and will also be future proofed against any changes that come about as the consultation.

If you have a question not answered here, please email indemnity@bda.org.