By Travis Christy, White Coat Insurance
Dental malpractice insurance is a critical protection for dentists, offering coverage for claims of negligence, errors, or harm that may occur during patient care. Even the best professionals can face unexpected lawsuits, and without proper coverage, the financial and reputational consequences can be devastating. Unfortunately, sometimes bad things happen to good doctors and dentists, and being prepared is essential.
Consider a 2019 dental malpractice lawsuit in California, in which a dentist performed a wisdom tooth extraction that resulted in permanent nerve damage for the patient. The patient experienced ongoing pain and numbness, significantly impacting her quality of life. The lawsuit concluded with a $500,000 jury verdict against the dentist. In such cases, dental malpractice insurance financially shields practitioners from the burden of legal claims and associated costs.
This insurance covers dentists’ legal defense expenses, settlements, or judgments, allowing more of a focus on patients and dental practices without unnecessary worry if something goes wrong. For WCI followers, securing dental malpractice insurance is an essential step toward protecting the career and financial stability you’ve worked so hard to build.
How Does Dental Malpractice Insurance Work?
To understand how malpractice insurance works, it’s important to distinguish between the two primary types of policies: claims-based policies and occurrence-based policies.
Claims-Based Policies
Coverage is triggered only if both the incident and the claim occur while the policy is active. If the policy lapses or you switch insurers, you’ll need to purchase tail coverage to extend protection for claims filed after your coverage period ends.
Tail coverage is an additional insurance option that extends the protection of a claims-based malpractice policy after it has expired or has been canceled. Since claims-based policies only cover incidents that are reported while the policy is active, tail coverage ensures that any claims filed after the policy period for events that occurred during the policy’s term are still covered. This is especially important when switching insurers, retiring, or closing a practice, as it prevents gaps in liability protection.
How Long to Maintain Tail Coverage
The duration for which a retired dentist or a dentist who switches insurers needs to maintain tail coverage depends on the statute of limitations for malpractice claims in their state and the type of dental services provided.
Generally, most states have a statute of limitations for malpractice claims ranging from 1-5 years. However, some states have exceptions that allow claims to be filed years later, especially for minors or under “discovery” rules (when the injury is discovered much later). Many dentists choose to maintain tail coverage for 5-10 years after retirement or a policy switch to align with these legal timelines. Some opt for “unlimited tail coverage,” which covers any claims indefinitely.
Is Tail Coverage a One-Time Fee?
Yes, tail coverage is typically a one-time fee. The cost is usually calculated as a percentage of the last year's policy premium—commonly 200%-300% of that amount. For example, if your annual premium is $5,000, tail coverage could cost $10,000-$15,000 for unlimited protection. However, some insurers offer options to reduce or waive the cost of tail coverage. That might include:
- Free tail coverage for retirement: Available if the dentist meets age and tenure requirements with the insurer.
- Prior acts coverage: If the new insurer offers prior acts coverage, it could replace the need for a separate tail policy.
Don’t Skip Tail Coverage
In 2013, a dentist in Arizona faced a malpractice lawsuit after a patient alleged that a root canal procedure performed in 2010 led to ongoing pain and complications. At the time of the procedure, the dentist had a claims-made liability insurance policy. However, in 2012, the dentist switched to a new insurer and did not purchase tail coverage from the previous policy.
When the lawsuit was filed in 2013, the new insurer denied coverage since the incident occurred before its policy period, and the previous insurer also denied the claim because the policy had lapsed. As a result, the dentist was left personally responsible for all legal defense costs and any potential settlement or judgment.
Occurrence-Based Policies
The second type of malpractice insurance is occurrence-based malpractice insurance, and it provides lifetime coverage for any incidents that happen while the policy is active, no matter when the claim is filed. It could even be years later. As long as the event occurred during the policy period, you’re covered—even if the policy has since expired or been canceled.
While occurrence-based policies are typically more expensive than claims-based options, they eliminate the need for tail coverage. This makes them an attractive choice for dentists who want comprehensive, long-term protection without the worry of purchasing additional coverage if they switch insurers or retire.
Which Should You Buy: Claims-Based or Occurence-Based Policies and Why?
In the dental malpractice insurance market, claims-made policies are more commonly sold than occurrence-based policies. The reasons for this include several factors:
- Cost-effectiveness: Claims-made policies often have lower initial premiums, making them more attractive to dental professionals, especially those starting their careers.
- Market availability: Many insurance carriers prefer offering claims-made policies due to their ability to manage long-term liabilities more effectively.
- Flexibility: Claims-made policies can be tailored with options like tail coverage, providing extended protection even after the policy period ends.
While occurrence-based policies offer the advantage of covering procedures that occur during the policy period regardless of when a claim is filed, their higher cost and limited availability make them less prevalent in the dental malpractice insurance market.
It's important for dental professionals to assess their individual needs and consult with one of the WCI-vetted insurance experts to determine the most suitable coverage option.
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What Happens When a Claim Is Filed?
If a patient alleges negligence or harm, it’s imperative to notify the insurer as soon as possible. Prompt reporting allows the insurance company to start investigating, collect relevant information, and manage the situation effectively. Delaying reporting could complicate the process or even jeopardize coverage.
Defense Coverage
Once the claim is reported, the insurance company steps in to provide legal support, including:
- Attorney fees: Lawyers who specialize in malpractice defense.
- Expert witnesses: Costs for dental experts to support a case.
- Case management: Many insurers offer resources to navigate the complexities of the legal process, from gathering evidence to preparing depositions.
Settlements or Judgments
If the case results in a settlement or court judgment, the policy will cover these costs up to liability limits. This means:
- Settlements: Negotiated agreements to resolve the case outside of court.
- Judgments: Court-ordered financial awards if the case proceeds to trial.
Malpractice insurance absorbs all these financial burdens allowing a busy dentist to maintain their practice and care for patients.
The Emotional Toll of a Malpractice Lawsuit and How to Handle It
Facing a malpractice lawsuit can feel deeply personal, but as one experienced physician shared in the WCI Forum:
“Early in my career, I was named in a lawsuit alongside several colleagues. While the case eventually shifted to the hospital and settled, it dragged on for years and took a significant emotional toll. I was fortunate to have excellent support throughout the process, but even with that, I questioned my decisions and briefly considered leaving the profession altogether. The experience didn’t affect my employment or reputation, but it was a reminder of how important it is to have the right support system in place. My advice: make changes in your practice and life to feel more secure, lean on the support available to you, and trust that you can get through it.”
This perspective shows the importance of viewing lawsuits as a professional challenge, not a personal failure. By maintaining comprehensive malpractice insurance, dentists and other healthcare providers can navigate the financial strain and focus on other things, including work.
More information here:
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Are Dental Hygienists Covered Under the Dentist’s Malpractice Insurance?
Dental hygienists may or may not need their own malpractice insurance protection depending on their work situation and the coverage provided by the dentist or employer. Here are key considerations:
When Dental Hygienists May Not Need Separate Coverage
- Covered by employer’s policy: Many dentists’ malpractice insurance policies automatically include coverage for their supervised employees, including hygienists. However, it’s important to confirm this with the employer or the insurance provider.
- Limited scope of practice: If a hygienist works strictly under the supervision of a dentist and within the scope of their assigned duties, the employer’s policy might be sufficient. Check with an employer to find out the policy provisions.
When Dental Hygienists Should Consider Their Own Coverage
- Working across multiple offices: If a hygienist provides services in different practices, the employer’s coverage might not extend to those settings.
- Independent practice: Some states allow hygienists to work independently or provide certain services outside the supervision of a dentist, which typically requires separate malpractice insurance.
- Gaps in employer coverage: Not all employer policies fully protect employees, or the coverage limits may be insufficient for a serious claim.
- Personal peace of mind: Having their own policy gives hygienists direct control over their legal representation and coverage limits rather than relying on their employer’s policy.
Is Dental Malpractice Insurance Required?
As of this writing, the requirement for dentists to carry malpractice liability insurance varies significantly across the United States. Students in dental school are covered by their programs. However, practicing dentists and dental specialists will need to seek an individual plan. It is highly recommended to protect against potential claims of negligence or harm.
Here are some key points:
- State requirements: Some states require dentists to maintain malpractice insurance. For instance, Colorado, Connecticut, Kansas, Massachusetts, New Jersey, Rhode Island, and Wisconsin have specific mandates for physicians, which may extend to dental professionals.
- Proof of coverage: Even in states where malpractice insurance is required, proof of coverage may not be necessary for licensure or renewal. This means that while the requirement exists, enforcement may vary.
- Coverage for dental hygienists: Dentist malpractice insurance policies may not automatically cover dental hygienists. Some policies include clauses that exclude coverage for hygienists unless the dentist is also named in the claim. Additionally, certain policies might allow the insurance company to seek reimbursement from the hygienist for settlement costs.
- Coverage limitations: Even comprehensive liability insurance plans have monetary limits. If a settlement exceeds these limits, the dentist or dental hygienist could be responsible for the remaining costs, including court and defense fees.
Here's our recommendation. Given these variables, it's crucial for both dentists and dental hygienists to thoroughly review their malpractice insurance policies. Understanding the extent of coverage, including any exclusions or limitations, is essential to ensure adequate protection against potential legal claims.
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Costs and Choosing the Best Dental Malpractice Insurance
How Much Does It Cost?
The annual premium for dental malpractice insurance varies based on factors such as experience, specialty, and location. For instance, a general dentist in Massachusetts with six years of practice can expect to pay approximately $2,100 per year for an occurrence policy. In contrast, a periodontist in the same state may face premiums of around $3,465 annually.
Some tips to save include bundling policies, increasing deductibles, maintaining a clean record, and comparing quotes from multiple providers.
Finding and Choosing the Right Coverage
WCI-vetted agents work with reputable insurers who understand dentists’ unique needs. Key features to evaluate include:
- Policy type: Occurrence-based (long-term protection) vs. claims-made (affordable upfront, needs tail coverage).
- Coverage limits and exclusions: Ensure your policy aligns with your risks and practice needs.
- Claims support: Look for strong legal defense and responsive customer service.
How Fast Can You Get Covered?
Policies can often be secured within a few days, and WCI agents can expedite the process for faster protection.
The Bottom Line
Dental malpractice insurance is a key part of protection in addition to personal umbrella, disability, and life insurance. All protect a practice and the wealth and stability a dentist has worked so hard to achieve. At The White Coat Investor, we believe in empowering dentists with the knowledge and tools to make smart financial decisions, and securing the right coverage is an essential step in that journey.
Obtain a malpractice quote from one of our vetted agents!
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