Dental Malpractice Insurance: How Does It Work and What Does It Cover?

Your reasons for needing (or wanting) dental malpractice insurance might vary. Certain licensing authorities will require you to purchase a policy. And if you want to join an existing dental team, you might be asked to buy your own policy before you start. Or, even if the practice has insurance, you might prefer to purchase your own policy so that if you’re ever named in a claim, you will have access to your own lawyers and funds for legal expenses and any necessary settlements.

No matter the path you’re on, this guide helps dig into what dental malpractice insurance protects, how it works, and when you can lean on it. Here’s all your dental malpractice insurance questions answered in one place.

What Is Dental Malpractice Insurance?

Dental malpractice insurance is a type of professional liability insurance specifically designed for dental professionals. If a patient alleges that a dental professional made a medical error, a dental malpractice policy can cover the costs associated with the claim or lawsuit. It can pay legal fees to defend you if an individual, group, or board files an action against you — even if the claim is frivolous and lacks evidence or a valid legal argument — and can pay a judgment or settlement if required to resolve the case.

Types of Dental Malpractice Insurance

• Claims-made policy: Covers incidents only if they happened and the claims were filed during the policy period. (See below for an example of a claims – made policy in “How Does Dental Malpractice Work”)
• Occurrence policy: Covers incidents that happened during the policy period, even if the claim is filed after the policy expired. Learn more about claims made policies vs. occurrence policies
• Tail coverage: Extends the coverage of a claims-made policy after it ends. You would likely buy tail coverage if you were leaving a job and had a claims-made policy with that employer.
  

  Learn more about tail insurance

What You Need to Know About Malpractice Insurance

Dental malpractice falls within the medical malpractice insurance family, so you are likely to see the following terms referenced in the policy or promotional materials. Along with occurrence vs claims-made policies, the following terms are critical to sorting out what you want in a dental malpractice policy. Here’s a quick breakdown of some of the most common malpractice insurance vocabulary words you might come across:

• Certificate of insurance (COI): A document issued by the insurance company describing coverage and summarizing the most important details of a policy, including the effective dates. Some employers will ask to see your COI before you start working.
• Defense costs: This includes fees and expenses paid to your lawyer, to the court, and to expert witnesses as part of your defense. This is separate from any money paid to a successful claimant/plaintiff, whether as a settlement or court judgment.
• Hammer or forced arbitration clause: Also called a settlement cap provision or consent to settlement provision. If the lawyers provided by your insurance company recommend you settle your case, but you insist on going to trial, a hammer clause would make you responsible for paying the plaintiff out of pocket if the judgment is more than what your case could have settled for.
• Limits of liability: The cap on what the insurance company will pay. Limits of liability have two components — how much the policy will cover per claim (or per occurrence) and the maximum it will cover during the policy period (known as the aggregate limit).
  You also might hear limits of liability mentioned when discussing whether defense costs are “inside the limits” or “outside the limits” of the policy. If defense costs are inside the limits of liability, the money paid to the lawyers will reduce the amount available to pay a settlement or judgment. But a policy where limits are “outside the limits” will not deduct legal defense costs from the policy’s limits.

Why Do Dentists Need Malpractice Insurance?

As with any medical profession, dentistry is inherently risky. The National Practitioner Data Bank (NPDB) reports 31,685 dental malpractice payments and 29,211 adverse actions between 2001 and 2021. If a dentist doesn’t have proper insurance, they could be personally on the hook for their defense costs and any money paid to the injured patient. (Learn more about the dental professionals who need medical malpractice.)

The Most Common Types of Claims Made Against Dental Professionals

According to the American Dental Association (ADA), the most common claims made against dentists are:

• Improper crown/bridge placement
• Prescribing incorrect drugs or dosages
• Improper tooth extractions
• Endodontic procedures
• Orthodontic treatment complications
• Improper treatment after procedures
• Failure to diagnose oral health issues
• Dental anesthesia complications

The National Institute of Health (NIH) also reports common allegations are pain and distress, worsening of existing periodontal disease, tooth loss, and “violation of autonomy” (when healthcare providers act without a patient’s consent).

How Does Dental Malpractice Insurance Work?

“Malpractice insurance covers licensed professionals who are operating under the authority of a board or agency that determines the standard of care for their practice,” explains Irnise F. Williams, Esq., a nurse and lawyer specializing in risk and compliance for healthcare practices.

For example, suppose Lisa is a dentist and has a certificate of insurance showing a claims – made policy with $1,000,000/$3,000,000 limits of liability. This is an “inside the limits” policy that provides $1 million of coverage per occurrence (or per claim) and has a $3 million cap on coverage per year.

If a patient of Lisa’s feels they suffered complications relating a treatment she provided, they may file a malpractice lawsuit against her. According to Lisa’s certificate of insurance, she has up to $1 million in protection against this claim.

One of the first things Lisa should do when she learns of the claim, or potential claim, against her is to notify her malpractice insurance company. According to Williams, a dental professional should contact their insurer any time a patient has a complaint or a bad outcome. Even if the incident does not develop into a claim or full – blown lawsuit, alerting the insurer early on is always a good idea.

The insurer will likely assign a claims professional to help her manage the process. In Lisa’s case, since there is a lawsuit filed, she will also be provided with an attorney to defend her.

Assuming the total cost of defense and settlement of this case is $1 million, she will then have $2 million remaining to handle any other claims that year (up to $1 million each).

Now say a patient files a claim against Lisa for something that happened during the policy period, but does not actually make the claim until after her policy expires. Because Lisa had a claims – made policy, the claim would be outside the policy’s coverage. However, if she had purchased an occurrence policy, the claim would still be considered for coverage. Or, if she had a claims – made policy and purchased tail coverage when it ended, she would have extended the coverage of the policy and now have coverage for this claim.

How Much Does Dental Malpractice Insurance Cost?

The most significant factors that influence your policy premiums include your specialty, the dental practice’s size and location, and your personal claims history.

Dental malpractice insurance costs can range anywhere from $100 to $400 per year for a recent dental school graduate’s first-year occurrence policy (less for claims-made policies). This cost will typically go up each year for the next 5 years before they max out.

To get a sense of what dentists, hygienists and periodontists would pay for dental malpractice insurance at Berxi, we created this list. Note that the prices reflect occurrence policies for dental professionals working full-time in the state of Massachusetts. Your rate may differ based on various factors including, state, years of experience, number of working hours, dental specialty, etc.:

• $100 for first-year dentists
• $2,100 for dentists 6 years out
• $101 for hygienists
• $3,465 for periodontists

Get your own quote from Berxi

When it comes to dental malpractice insurance, what does “value” mean to you? Affordability? Quality of service? Trust in your provider? At Berxi, we’re committed to providing a “no regrets” experience for dental professionals – and that means ensuring that the value we provide is always greater than the cost.

What Does Dental Malpractice Insurance Cover?

Dental malpractice insurance covers claims against dental professionals including individual dentists, entire practices, hygienists, and dental specialists like endodontists and periodontists. However, the protection varies from policy to policy. Policies typically cover:

• Attorneys’ fees
• Arbitration costs
• Expert testimony fees
• Court costs
• Settlement costs (reimbursement to injured party for hurt, loss or damage)
• License protection if the licensing authority launches an investigation

A dental malpractice policy won’t cover everything, however. Common claims that are not covered (called “exclusions”) are for sexual misconduct and criminal acts. If a claim against you alleged that you committed one of these acts, you might have to find representation outside of your insurance provider. Or, if your insurance provider represented you, it might require reimbursement if you are found guilty.

Is Dental Malpractice Insurance Worth It?

Most dentists don’t have the resources to pay the potentially high costs of court fees, settlement awards, and indemnity claims out of their own pockets. Between 2001 and 2021, most dental claims were less than $50,000 — but many were above that amount, costing up to $2 million or more, according to the NPDB.

A malpractice policy’s key features can protect you against financial ruin. That sounds extreme, but the goal of having insurance is to prevent you from having to dip into your savings if a claim is filed against you. And, if it’s a large settlement with large legal fees, it might not only deplete a savings account but also put you at risk of bankruptcy.

Compared to the amount of protection you would likely get from your malpractice policy, the premiums can be worth the cost. However, it’s best to speak with a licensed attorney or insurance professional to determine whether carrying your own liability coverage is the right option for your situation.

Reasons to Consider Having Dental Malpractice Insurance

While you trust the quality of your work, the reality is that board complaints or malpractice claims do happen, whether mistakes were made or not. You should consider a policy if you want to:

• Operate your own practice
• Supplement your employer’s coverage
• Work as an independent contractor
• Start student clinicals

What to Look for in a Dental Malpractice Insurance Provider

Not all malpractice insurance providers are created equal. When choosing an insurer, consider whether it offers:

• Special rates for recent grads 1-5 years out
• Legal defense costs outside the limits of liability
• Availability of both occurrence and claims – made coverage
• Limits of liability options
• No deductible
• Knowledgeable claims professionals who specialize in dental and medical claims
• Consent to settle
• Convenient payment plans and options
• Online access to manage your policy
• Coverage extensions for dental hygienists and dental assistants who work in your practice.
• Financial strength ratings that prove its ability to pay future claims (A++ ratings are ideal)
• Easy-to-reach, knowledgeable customer support
• Educational materials
• Happy customer testimonials
• Discounts for members of dental organizations
• Discounts for taking risk management courses

Ultimately, you want to look for a “provider who actively helps you mitigate lawsuits and provides education and a hotline to answer questions,” says Williams.

Final Thoughts

Unfortunately, a dental malpractice claim is often not a case of “if” one will happen, but “when” one will. If shopping for dental malpractice insurance for yourself or for your team, you’ll want an insurance provider who removes the stress from claims processing, offers outstanding financial stability, and provides exceptional customer service as part of its core business practices.

Berxi checks all of the boxes, plus applying is fast and easy. Get your quote today!

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Last updated on Nov 25, 2024.
Originally published on Jul 14, 2022.

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• Dental
• Risk Management

The views expressed in this article are those of the author and do not necessarily reflect those of Berxi™ or Berkshire Hathaway Specialty Insurance Company. This article (subject to change without notice) is for informational purposes only, and does not constitute professional advice. Click here to read our full disclaimer