The relative merits of discretionary indemnity and insurance might not be top of your list of priorities. But with several new providers on the market, it’s important to know the differences so you can make an informed choice about protecting your career, reputation and finances. Here we drill down into those differences.
The types of organisation providing indemnity
Traditionally, most dentists in the UK were indemnified by mutual indemnity organisations – also known as dental defence organisations. Today, dental registrants also have the options of ‘claims-made’ and ‘claims-occurring’ insurance.
As part of MPS,[i] Dental Protection has remained a steady and trusted partner for many UK dentists and dental care professionals, with support and protection provided on a mutual discretionary indemnity basis. Members are part of a mutual organisation that they collectively own, paying subscriptions that go into a central pool. If a member faces a complaint, claim, regulatory investigation or any other matter, they have a right to request assistance and indemnity from this central pool.
As the organisation is owned by members, the default position is to see how any member facing a challenge can be helped. Once a request for help is approved, our experienced dentolegal team will provide support without being restricted by small print or financial caps.
This is different to insurance, where a contract specifies what protection the insurer will and will not provide, along with details of any exclusions, excesses and caps. The devil is in the detail. With insurance contracts, it’s vital to pay close attention to policy wording and schedules, to fully understand what is covered and what is not.
Reliability and responsiveness
Both discretionary indemnity and insurance can give you the protection you need. The question is, will the organisation you choose provide a quality service that you can depend on?
The first consideration is whether protection will be available when you need it. You might have heard that discretionary indemnity means organisations like Dental Protection will refuse or withdraw assistance on a whim. This is not true. Dental Protection acts in accordance with the voluntary Code of Practice which came into effect on 6 January 2025, as well as being governed by our Memorandum and Articles of Association. This means that members can be assured of fair and consistent support.
By way of contrast, an insurance contract clearly specifies when the insurance company will step in to support and when it won’t – and some professionals prefer to have that contractual certainty.
It is important to check the fine print of insurance policies to see if there are financial limits, or caps, imposed. Some insurance products have financial limits on legal costs, as well as imposing excesses. This might result in the policy holder having to fund some or all of their legal costs, or risk being unrepresented before the regulator.
Another important point to consider is whether assistance with all regulatory matters would be provided. The most obvious example here is GDC cases regarding personal conduct. Dental Protection members can request assistance for these cases and has also succeeded in judicial reviews against the GDC relating to a warning imposed for a driving offence. For professionals for whom the GDC regulates every aspect of life, that must be a consideration. If a GDC case arises, it’s not only expensive but also stressful to deal with without the robust support of an experienced indemnity provider.
Data released by the GDC shows that dental professionals who have representation before regulators obtain much better outcomes than those who don’t.[ii] This is why it’s so important to fully understand what your indemnity/insurance protects you for and how it works.
Another important thing to think about is whether your protection reflects your needs.
Discretionary indemnity has built-in flexibility, with the scope of support being much broader than the fixed policy wording of contractual insurance. Dentistry is a rapidly evolving field. Discretionary indemnity allows Dental Protection to respond to changes in the dentolegal environment and assist members with emerging risks that may not have existed when membership began.
Quality of service
You also need to be sure of the quality of the support you will receive. Dental Protection has a long history of providing excellent service to members, with experienced dentolegal consultants, case managers and award-winning lawyers working together to advise, guide and support members at the most difficult moments in their professional lives.
Dental Protection members can speak with a dentolegal consultant whenever they need to – and our team can help step in to resolve complaints before they escalate into something more serious, like a claim. Everything we do is geared towards resolving problems as quickly as possible, with the least upheaval and impact on your career and professional reputation.
In 2025, our defence team won In-house Legal Team of the Year at the British Legal Awards. Not all indemnity providers offer the same level of potentially career-saving expertise.
Financial strength and longevity
It goes without saying that you want your indemnifier to be a stable organisation in a strong financial position, so that it can protect you for as long as you need it.
As part of MPS, Dental Protection offers that strength, stability and longevity.[iii] In the last five years, over 16% of claims notified to Dental Protection involve treatment that commenced more than 10 years before the claim was made. Claims are increasingly being made for larger amounts, exceeding £100K. So, for an indemnifier, both financial security and longevity are vital considerations, ensuring we are able to fully support members no matter when the claim arises.
Who takes the risk – you or the indemnity provider?
Finally, you need to understand whether your protection is ‘occurrence-based’ or ‘claims-made’ – and what extra steps you might need to take if you opt for the latter.
Both the subscriptions charged by mutual organisations and the premiums charged by insurance companies are based on actuarial analysis and understanding of the risk to the mutual fund or reserves of the organisation concerned.
With occurrence-based indemnity, the responsibility for any future risk lies with the indemnity provider, which ensures that the subscriptions collected today will enable the organisation to be there to help members no matter when the assistance is required – even if that is in 10, 20, 30 years or more.
With claims-made insurance, the extent to which risk is carried into the future, and by whom, depends on whether the dental professional can secure ‘run-off’ or ‘tail’ cover when they end their policy or membership, retire, or leave the profession. Therefore, claims-made policies do not need this element of future risk priced into their premiums – which is why they can appear to be more affordable in the short term.
If you have a claims-made policy and are not offered, or are not able to buy, run-off cover when you want to leave or move to another provider, you won’t be protected if a claim later arises and the incident that gave rise to the claim wasn’t reported in accordance with the terms of the policy. You would only be covered if you were insured when the claim arose and was reported, and if you have separately bought another insurance policy with a retroactive date going back to when the clinical treatment which is the subject of the claim was done.
If you have occurrence-based indemnity, any incident that arises from the time you are with your indemnity provider – even if the complaint or claim is raised years later – is indemnified in perpetuity. This means there is no need to buy additional cover if you take an extended break in your practice, retire, or switch providers.
Claims against dentists are now arising 15, 20 or even more years after the clinical care was provided. A run-off period of any less than these timeframes will not protect you in the event of a clinical negligence claim or regulatory case being made many years into the future.
Another important aspect to consider in most, if not all, claims-made policies is the ‘incident reporting’ requirement. This provision requires reporting of complaints, claims, circumstances and adverse incidents that might give rise to a claim, within a defined time period, for the claim to be valid under the terms of the policy.
Final considerations
While some indemnity products may only help with clinical negligence claims and representation before the regulator, Dental Protection offers an extensive range of support – including dentolegal and ethical advice, patient complaints, disciplinary procedures, inquests, specialist media support, risk reduction training, counselling and wellbeing support.
Ultimately, the decision on whether to choose discretionary indemnity or insurance, occurrence-based or claims-made protection, depends on your individual circumstances. The indemnity provider or insurer that you opt for should be able to explain how they will protect you. We would be more than happy to answer any questions you might have.
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[i] Medical Protection Society