Dr Yvonne Shaw, Head of Underwriting at Dental Protection, explains why when it comes to a defence organisation, you need to be thinking 25 years ahead.
In 2018, 40% of claims costs related to treatment that started 10 or more years before the claim was made
Predicting the future cost of claims is difficult, but it’s an important
part of what we do. We are in the business of understanding and managing
clinical negligence risk and after 125 years we understand exactly what it
takes to protect your reputation, careers and finances.
Late reported claims
In recent years we’ve seen a damaging trend in UK dental claims.
Increasingly we see claims being brought against clinicians for treatment
that they provided many years earlier. In fact only 35% of UK dental claims
are actually reported within the first two years after the incident date.
Of the 100 largest UK dental claims we received in 2018, 60 of them related
to claims where the treatment started ten years or more before the claim
was reported. In some cases, the dentists involved may have moved practice,
retired or even passed away.
The majority of these late reported claims involve allegations relating to
the management of periodontal disease, but can extend to include
allegations about management of caries over many years. It’s now not
uncommon to see claims that include allegations spanning decades of care,
and claims reported to us more than 25 years after the patient’s first
attendance at a practice.
Why has this happened?
The challenge we all face is that the increase in periodontal and late
reported claims is not necessarily related to changes in the standard of
dental care. If anything, we know that education and training in the area
of screening, diagnosis and management of periodontal disease and caries
has advanced significantly. Coupled with increased understanding of the
importance of record keeping, patient care should now be very different to
that provided several decades ago.
However there are other factors at play, including increased public
awareness of periodontal disease
and changes in patients’ expectations; with patients more willing to
challenge clinicians about any unexpected outcomes. We have also seen
claimant law firms switch to actively targeting periodontal claims and
long-term care, as these cases are likely to be more lucrative in terms of
I’ve only recently qualified, so do I need to worry about these claims?
The trend, unfortunately, does not seem to show signs of stopping.
Periodontal and long tail cases often involve all clinicians who treat a
patient within a practice, up to the point the patient has been made aware
of the true extent and nature of their dental problems. It is not uncommon
that these claims now involve multiple clinicians, some of whom may have
been involved in a patient’s care for only one or two appointments.
Whist allegations relating to the first treating clinician usually relate
to the initial assessment and diagnosis, subsequent clinicians usually face
similar allegations including not undertaking an adequate assessment and
not intervening when oral health was continuing to deteriorate. These
allegations are often linked to not taking appropriate radiographs, failing
to act on radiograph findings and not providing clear information to
patients about treatment needs.
Where multiple clinicians are involved over time, it makes the cases even
more involved and protracted as we work with other indemnity organisations
to review and assess shared liability.
Am I protected for these claims?
Dental Protection membership is designed to give you peace of
mind. We offer occurrence-based membership. This means we collect a
subscription each membership year and you can then request assistance for
any claim that arises from your professional practice during that year
regardless of when it is reported - even if it is years later, you are no
longer a member, or you have ceased practising.
With occurrence-based protection, the responsibility of future risk lies
with the indemnifier (us). The money we collect today needs to ensure that
we are here for you in 10, 15 or 25 years should you be unfortunate to be
drawn into a claim.
Occurrence-based protection may not be the cheapest option but members tell
us that they value the long-term peace of mind that it offers, because they
do not need to make any further financial arrangements to ensure they have
protection after they leave membership or cease practice.
So what do I need to do?
Firstly, there are some key things you can do to reduce your risk. We have
some useful resources below that highlight the common risks and pitfalls
associated with periodontal disease.
Secondly, you need to ask yourself; can I trust my indemnifier to still be
here for me in 10, 20, or even 30 years? At Dental Protection we can
confidently say we were built to last. Our subscription rates reflect the
cost of our long-term commitment to protecting you to the highest standard
long into the future, not a short-term requirement to generate profits.
We have seen new entrants come into this market seeking to generate profits
and many will underestimate the impact of late reported claims. If they
exit the market it can leave practitioners vulnerable to the financial
consequences of a claim brought many years later. Failure to have adequate
and appropriate indemnity can also leave dental registrants open to a
challenge by the regulator.
Our financial strength gives us confidence that we can continue to be there
for members in the years ahead, in the same way that we have always been.
We have the largest reserves of any defence organisation in the UK.
Continue your learning and earn CPD…
Webinar: Key insights into periodontal claims
Join Dr Yvonne Shaw, Head of Underwriting Policy, and Andrew Walker, Dentolegal Consultant and Periodontal Specialist, as they share insights into the nature of periodontal claims and what can be done to reduce the risk of a claim. Book your place here.
To learn more about managing the risks of periodontal disease, log in to Prism, our e-learning platform. A 45 minute interactive module is available to all members that will highlight the common risks and pitfalls associated with periodontal disease and suggest ways of managing these areas of risk.