How Much Do You Know About Your Malpractice Insurance?

Previously, we discussed the importance of getting familiar with the basics of your malpractice insurance coverage. Now, we'll address a few of the other points that can help assure not only that your coverage remains intact, but you get the most out of your policy.

Get familiar with your policy's supplementary coverage.

Once you buy a policy, read through it. Though you don't need to memorize it, you should be aware of all the coverages available and any changes that may affect coverage. Be sure to notify AAOIC of any changes—including your plans to retire—to help keep you fully protected.

You should also be aware of supplementary coverages. For example, did you know AAOIC will assist with the defense of regulatory complaints? Or that it provides first aid coverage for a patient's injury resulting from an orthodontic incident? To take full advantage of the benefits available, become familiar with the policy's supplementary payments and exclusions.

Know the conditions of your policy's coverage.

The policy also contains pertinent information about who is covered and when, as well as claim reporting requirements, time deadlines, and conditions that must be met. If you're unaware of these requirements, you could easily overlook something and create a coverage problem when you report a claim. AAOIC wants to provide coverage when there's a claim. Knowing the requirements and limitations of your policy can help avoid a denial. 

Notify the company of any changes that could affect coverage.

You're required to notify the company if you have changes, including:

• If you're retiring: if you have claims-made coverage, you'll need to have the extended reporting (tail) coverage endorsement to report a claim that may develop after you've stopped practicing.
• If you're changing from a claims-made policy to an occurrence policy: you'll also need the supplemental extended reporting (tail) coverage endorsement. Don't worry! Tail coverage is free with AAOIC if you are at least 50 years old and have been insured for at least four consecutive years.
• If you're adding or subtracting locations: you're covered no matter where you practice in the United States; however, to ensure your premium is calculated accurately, the underwriter will need to know each location and the total hours practiced per week at each location.

Be aware of other needed endorsements for coverage.

Always let the underwriters know changes you're making that may affect coverage, so your policy can be properly endorsed. Consider the following situations:

• If you need a substitute orthodontist to cover your practice in the event of absence: you may request insurance coverage for the substitute doctor with a locum tenens endorsement. Remember, the doctor who will be temporarily out of the office is the one who purchases the endorsement. Locum tenens coverage precludes the substitute doctor from exposing his/her own coverage to liability that arises out of the orthodontics services that he/she will be providing to your patients while in your office.
• If you are contractually obligated to provide vicarious liability coverage for another entity: you'll need to discuss an additional insured endorsement for your policy. This is likely to be a requirement in the contract for an employed orthodontist or an independent contractor. Know what your contract says. If litigation is filed against you and the doctor or corporation for which you work, AAOIC will likely be able to defend that doctor or corporation if the lawsuit arises out of your work.
• If you have ownership interest in a professional corporation or partnership: you'll need individual and corporate entity coverage. If you're sued for an orthodontic incident, your corporation will probably be sued as well. AAOIC will not defend the entity(ties) unless that professional corporation or partnership is a named insured on the policy.

Contact your claims department as soon as a claim is suspected.

If a patient or parent expresses any dissatisfaction, call your claims department immediately. The malpractice insurance policy requires you to report potential claims as soon as you know about them.

Even if you're not sure a patient will make a claim, call and report the details. The first level of information intake in a claims department is called an incident, which is defined as any office situation with a patient that could develop into a claim. If the company establishes an incident, it will not attach it to a policy. However, it serves as the claim report date if one is filed later.

If you do have an incident, the claims staff may be able to assist you. They have significant experience with patient problems and can usually make suggestions that will help prevent a claim or regulatory complaint from being filed. 

AAOIC serves as your first line of defense, and your malpractice insurance policy can help assure you're protected against claims. Make sure you know what's included in your policy and how it could change so that you're fully protected. If you have any questions, call 1.800.622.0344.