Proof of dental insurance legal by 2013

The General Dental Council (GDC) is promising dental patients that proof of insurance will soon become a condition of being registered to practise as a dentist.

The GDC’s reassurance came as the Dental Law Partnership (DLP), a claimant dental negligence solicitors, stepped up its ‘Bridge the Gap’ campaign, calling for a ‘change of attitude’ among insurers.

The DLP said in a press statement this week: ‘A culture of non-cooperation by dental insurers is a greater long-term risk to patient protection than the current absence of mandatory insurance cover for dentists.

‘Even if the legal loophole relating to indemnity is closed, patients and their representatives will still find it difficult to get redress because insurers are not obliged to co-operate with the legal process.’

The DLP’s managing director, Chris Dean, said: ‘The attitude of insurance companies is designed to prevent pay out not facilitate it.

‘We want to make people aware that, even if their dentist is insured, there is no guarantee that his insurance firm will co-operate with enquiries.’

Under current terms of operation, insurers are not obliged to reveal whether the dentist in question is insured with them because of the Data Protection Act.

The DLP claims that this ‘immediately releases them from any obligation to get involved in the investigations associated with a claim, however solid it is’.

But Kevin Lewis, dental director with Dental Protection, the mutual (not-for-profit) organisation, challenged the firm of solicitors’ campaign.

He said: ‘The ‘Bridge the Gap’ campaign criticises the use of contractual “small print” by insurance companies in order to avoid paying out on otherwise apparently valid claims. We feel obliged to reassure Dental Protection members, to eliminate any ambiguity, that this organisation is not the subject of that criticism since the unlimited, discretionary basis of the indemnity arrangements we offer means that we have no contractual “small print” to hide behind in the first place.’

‘Commercial insurers, in common with discretionary mutual organisations like Dental Protection, do have the option of offering an ex gratia payment to an injured patient, which is something that Dental Protection has done on numerous occasions and continues to do in appropriate circumstances. If, as suggested by the DLP, insurance companies are electing not to offer such compensation, that is a matter for them and in some situations there may even be a perfectly good reason for their decision (for example, there may be no evidence that the patient in question has ever been treated by the dentist against whom the claim is being brought, and the dentist is no longer in the country or otherwise contactable to confirm the position either way).’

Mr Lewis also argued the need for professional indemnity to remain in the hands of not-for-profit organisations such as Dental Protection.

He said: ‘Contracts of insurance exist to protect and limit the exposure of the insurance provider, and when that provider is profit-seeking it should come as no surprise that the interests of patients will sometimes come last in the queue. This is one of many reasons why we believe that professional indemnity should remain in the hands of not-for-profit organisations that are owned by the profession itself (and consequently have a direct interest in its reputation) and also free from unhelpful commercial pressures.

‘The systems of redress in this country were of course never intended nor designed to make it quicker and easier for claimant law firms to maximise the success fees that they can legitimately claim under Conditional Fee Arrangements (‘No win – no fee’), and the proposals in the ‘Bridge the Gap’ campaign primarily seek to remove some of these obstacles, although this may not be immediately obvious to all observers.

 ‘We agree that indemnity providers should not unreasonably seek to impede a patient’s access to compensation that is properly due to them, but we must also act within the law and the climate of trust that must necessarily exist between an organisation like Dental Protection and its members.

‘We make no apology for the fact that we cannot and would not reveal any personal details that have been provided to us in confidence by a member, and we would be surprised if the DLP would be prepared to reveal equivalent personal details about the clients they represent and nor would we expect them to.’

In discussion
He added that Dental Protection is in discussions with the GDC and plans are afoot to streamline the present processes both within the law as it stands, and as it might look in the future.

He said: ‘That dialogue will continue and there is no lack of will within Dental Protection to play its part by helping the profession to discharge its responsibilities to any patients who are avoidably harmed as a result of dental care and treatment they have received.’

The GDC already has measures in place requiring dentists to have adequate insurance to ensure patients can claim compensation if something goes wrong but a spokesperson confirmed possible changes in the situation regarding insurance for dentists.

She said: ‘In addition to current requirements, we check the insurance arrangements whenever we investigate complaints about dentists, whether or not the complaint relates to insurance and dentists face being struck off for not having insurance.

‘Meanwhile, we propose to amend our current requirements to ensure dentists co-operate with insurers when a patient makes a claim and they must have appropriate cover in place.

‘We are working to increase the current, substantial protections for patients, by seeking powers to require proof of insurance as a condition of being registered to practise as a dentist.  We expect to have these powers by October 2013.’

The GDC continually reminds dentists of their duty to have adequate insurance in place and, say it has sent out tens of thousands of copies of its patient leaflet that urges patients to ask their dentists about insurance cover.

But DLP’s Chris Dean does not believe the plans go far enough.

He said: ‘We want insurance cover to be adequate in all cases and co-operation to be mandatory for insurance companies in the event of a good solid claim. Otherwise the legislation on indemnity is pointless.’

A spokesperson for the Dental Defence Union declined to comment on the DLP’s claims.

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