2018 Dental Renewal FAQ

The claim types that we use in calculating the no claims bonus are:

• Professional indemnity claims, including a written or verbal demand for compensation from a third party
• Statutory board inquiries or investigations

Health fund audits are not included in your total claims experience.

Having two or more professional indemnity claims and/or having any finalised statutory board inquiries in the last five years will affect your no claims bonus.

Your no claims bonus is calculated based on the number of claims made in the preceding five year period.

A notification is not considered to be a claim.

A claim arises only when costs are incurred resulting from a third party demand or legal support is provided for a statutory board inquiry or investigation.

Some notifications, due to their complexity, the nature of the patient’s demands, or resistance to resolution, have a heightened risk of escalating into a claim against you. In these cases, a Community Relations Officer, after seeking your approval to take the matter further may request legal assistance to attempt to avoid an escalation occurring. In such situations this legal advice will incur a cost against your policy.

If you believe that a notification has unfairly impacted your eligibility for the no claims bonus, please call Guild Insurance on 1800 810 213 and request an independent review of your individual circumstances.

The partnership between ADA VIC and Guild results in the Community Relations Officer acting on behalf of Guild. This means that the Community Relations Officer can act as an agent of Guild to assist in the management of your matter. As such, although you may only be interacting with the Community Relations Officer in the first instance, after seeking your approval to take the matter further, they may seek legal advice.

If you have any concerns about your eligibility for the no claims bonus, please call Guild Insurance on 1800 810 213 and request an independent review of your individual circumstances.

When a matter is notified due to its complexity, the nature of the patient’s demands, or resistance to resolution, the Community Relations Officer, after seeking your approval to take the matter further, may request legal assistance to prevent a complaint resulting in a claim. This legal advice incurs a cost that can trigger a claim.

As a recent graduate, not only have premiums at each year post graduation not increased from last year, it includes a significant discount to help you establish your career. You will continue to receive a discounted premium until your fifth year of practice, giving you access to up to ten years of free or discounted insurance.

Table shows premium relativity of graduate pricing compared to average premium for practitioners with no claims bonus applied.

As an ADA VIC member, you will always be rewarded with an exclusive member discount. This is in part a reflection of your access to the extensive CPD program available to members, including the free CPD material available on Guild's DentalRiskHQ. Not only will you continue to benefit from this member discount for as long as you remain a member, but by making the most of the CPD and risk material available to you, you will be able to increase your understanding of the risks you face, and work to minimise and avoid them. In turn you can maintain the benefit of your no claims bonus while building your clinical experience and Guild loyalty discounts.

Experience is only one part of the calculations that make up your individual premium. As you are starting to build your professional experience, you will be keen to stay up to date with your profession. As such, ADA VIC members have always been rewarded with an exclusive member premium. This is in part due to recognising your commitment to your profession, and the extensive CPD program available to members, including the free CPD material available on Guild's DentalRiskHQ. Maintaining your ADA VIC membership will continue to qualify you for this additional exclusive member benefit. By making the most of the CPD and risk material available to you, you will be able to increase your understanding of the risks you face, and work to minimise and avoid them. In turn you can maintain the benefit of your no claims bonus while building towards your clinical experience and Guild loyalty discounts.

Experience is only one part of the calculations that make up your individual premium. The ADA VIC Guild Professional Indemnity insurance policy is on a ‘claims made’ basis, providing cover for professionals in relation to claims made against them and reported to ADA VIC or Guild during the period of cover. These claims can arise long after the professional service which gives rise to the claim was conducted.

Our claims data has shown there is an increased incidence of claims for those who have been practicing for this length of time. These claims do not necessarily come from clinical errors.  An example of a claims trend that is unique to practitioners in this group is when it comes to practitioners who are retiring or selling their practice. There is an increasing incidence of the incoming practitioner discussing their predecessor’s treatment plans and highlighting procedures that they believe require further work, sometimes encouraging the patient to lodge a claim or complaint, or do so themselves under mandatory notification procedures.

In calculating your years of clinical experience, we relied upon AHPRA’s registration data. In a small number of cases, the AHPRA data may have been incorrect or missing.

If you need to update your year of registration, you can call Guild on 1800 810 213, email [email protected]  or visit Policy Hub. We also recommend that you correct this information with AHPRA as this is publically available information. You can call AHPRA on 1300 419 495.

We define orthodontics as any procedures defined by The Australian Schedule of Dental Services as orthodontics (items 811-881), costing $1,500 or above per treatment plan, no matter the number of procedures completed. If as a General Dental Practitioner you intend to perform these procedures in the next 12 months, you should select 'yes' to undertaking this defined procedure.

We define endosseous implants as the surgical insertion of an implant made of biocompatible material in the bone of the maxilla or mandible, not including restorative work. If as a General Dental Practitioner, you intend to perform this procedure in the next 12 months, you should select 'yes' to undertaking this defined procedure.

If you nominate cover for defined procedures, we will include this as a factor in the calculations of your total premium. Unlike previous years, there is no fixed dollar amount that is charged in addition to your standard premium.

Our claims analysis has identified that endosseous implant insertion and GP orthodontic treatments lead to significantly more claims than other treatment types. Not necessarily because the treatment is poorly performed, but the nature of the treatment is such that complications can arise and become costly to rectify. Our claims data shows that claims for these defined procedures have increased in both frequency and severity in recent years, which is reflected in the premium calculation for practitioners who undertake them.

Entity cover is available for practitioners who own all or part of an incorporated entity (Pty Ltd) so it protects your dental practice in the event proceedings are brought against your dental practice rather than against you personally as a dental practitioner.

A claim could be made against the dental practice (entity) for:

• Civil claims for compensation arising from injuries sustained during treatment
• Loss of patient records
• Privacy breaches
• Disciplinary proceedings arising from consumer complaints which can now be brought directly against the entity.

We offer entity cover for a proprietor dentists who as the owner of an incorporated (Pty Ltd) dental practice wish to protect their business from liabilities arising against the dental practice because of the proprietor’s own actions, or from the vicarious liability arising from the actions of the employees, consultants, agents or other principals of the dental practice.

It’s important to note that the entity cover does not provide direct cover to AHPRA registered employees, principals or other staff. The intent is to ensure we provide cover to the individual dental practitioner who is listed on the policy schedule and to extend the protection to their own dental practice.

If you choose to include cover for your entity, then the entity premium is charged in addition to your individual premium if your entity has more than one registered practitioner engaged in your business other than yourself. We provide premium relief to proprietors that are part owners in the business. This cover is optional.

If you chose to take entity cover, work part time and employ any registered practitioners, a minimum premium will apply if you want to insure your entity. This is on the basis your practice is open even when you are not working, and therefore is still exposed to risk. If your practice is also only open part time, you can contact us to review your premium.

If your entity name was previously listed on the schedule then your entity was provided cover. We have now introduced a premium for this cover.

In an unincorporated entity (e.g. an entity that has an ABN but is not a Pty. Ltd.) there is no separation of liability between the entity and it's principal. The common law principle of vicarious liability means that a principal entity, such as an employer, will be held liable for the tortious acts of its employees. This means that if the principal entity is unincorporated then the practitioner principal will be personally held liable for adverse outcomes arising from treatment provided by others. The practitioner principal requires cover for this liability.

Practitioners that are sole traders or in partnerships are personally liable for all aspects associated with their business. As such these owners require cover to be extended for their vicarious liability for the actions of any employees because in an unincorporated business there is no separation of liability between the business and the owner – liability passes straight through to the practitioner principal. All owners of unincorporated businesses are automatically given Vicarious Liability cover.

The Vicarious Liability premium is charged in addition to your individual premium if your entity has more than one registered practitioner engaged in your business other than yourself. We provide premium relief to proprietors that are part owners in the business

If you work part time and employ any registered practitioners, a minimum premium will automatically apply. This is on the basis your practice is open even when you are not working. If your practice is also only open part time, you can contact us to review your premium.  

Online Risk Management Solution is a voluntary online education module available to members to manage their risk exposure. This year the module is targeting General Practitioners who provide orthodontic treatment. Practitioners that complete ORMS will receive a discount on their defined procedure.

1. 1. For renewing General practitioner dentists that have Orthodontic treatment as a defined procedure
   2. For renewing General practitioner dentists that will be adding Defined procedure – Orthodontic treatment for the first time
   3. New policy holders that add defined procedures – Orthodontic treatment

1. For renewing GPs that have the orthodontic treatment defined procedure, they will receive a link to complete ORMS on policy hub
2. For renewing GPs that wish to include orthodontic treatment defined procedure for the first time, you can login into Policy Hub and update your policy to include Defined procedures. You will receive a new schedule with links to access the ORMS
3. When you are joining Guild for the 1^st time and include defined procedures Orthodontic treatment. When we send you your new business schedule, we will send you the ORMS package to complete

ORMS will be available on Policy hub until Wednesday 7 August 2019 unless you pay in full before completing the package.

Practitioners who pay by the month will have until Wednesday 7 August 2019 to complete the package, if you have had an initial direct debit for the new policy term then the discount will apply to the remaining instalments for the year.

We can send you a copy of the ORMS package for you to complete and apply a discount. Please contact us on 1800 810 213

If you exit the ORMS package before completing the module, the discount will not apply to your policy.

Please allow up to 30 minutes to complete the full package

No, the ORMS package is a self-paced online module designed to increase your risk management knowledge. We can send you a hard copy version if you are unable to access the package online.

The GP Orthodontic treatment ORMS module is designed to educate general dentists performing orthodontic treatment on risk management as our claims data shows that they face slightly different risks compared to a specialist orthodontist. If you are interested in learning more about risk management, you can visit RiskHQ

By accepting your participation to ORMS, we encourage you to make use of the risk information available in the module into your clinical practice. We understand that even with the best measures in place, claims can still arise, and we don’t ask you to prove that you have completed the module.

Undertaking the ORMS package can count towards your required CPD hours. It’s expected that completing the CPD package will take you approximately 30 mins for reading and reflection; this means that during and after reading the package you’re expected to reflect on your practice and consider what changes you might implement based on what you’ve learnt.

To find out more about how Guild Insurance can provide free CPD activity, visit RiskHQ now.