For many years the Medical Defence Organisations (MDO’s) have provided the majority of dental professionals with protection against allegations of clinical negligence and support with disciplinary investigations. And for many years the membership rates charged by MDO’s have been consistently low.
There is no question that historically, the membership benefits offered by these organisations has been excellent and of course, many dentists want to be indemnified by a firm who employs dentists in claims advisory roles that can hold their hand should they be unfortunate enough to receive a patient complaint or the dreaded letter from the GDC. And to date, the insurance industry has been unable to offer the range of benefits for the same level of premium as the MDO’s.
Unfortunately, the claims culture over the last five years has changed dramatically and with the rise of the “no-win no-fee” solicitors and aggressive marketing of these services to patients the volume of claims being made has increased beyond recognition. Furthermore, claims costs, both in terms of compensation and legal fees, has also increased significantly over this time.
It would appear that the MDO’s are finding the current indemnity market very challenging indeed. Throughout the change in claims landscape they retained their low-cost membership subscription rates and comprehensive range of benefits. The knock-on effects of this are that many dentists are now being refused cover at renewal.
If members have had claims or been subjected to a GDC investigation often, they are being refused membership at renewal. We are also seeing members who have utilised the advice lines frequently yet have not had any claims or GDC investigations being refused membership at renewal. Of course, given the discretionary nature of the MDO’s indemnity the official letters issued to these unfortunate dentists is along the lines of “it is the discretion of council members whether to offer renewal and we are not obliged to provide a reason as to why you have been refused at this time”.
Surely it is unfair to treat customers this way? Insurance brokers would not be allowed to treat clients this way.
And it now also appears that the once lauded nature of the “discretionary indemnity” arrangement has also encountered significant problems. The Dental Law Partnership has recently published an article on a case where the MDO concerned point-blank refused to indemnify a member following a claim and you will be able to find this online. Their refusal to assist the member does not mean the member is not legally liable for compensation to the patients, or the legal costs incurred by those patients. Not to mention the dentist’s own legal costs in defending the allegations. Without the support of indemnity how is the dentist supposed to fund these costs and how are the patients going to be able to claim compensation if the courts rule that compensation is deserved?
We have also come across a case this week with a dentist who had a claim that was being dealt with by their MDO. At renewal, the MDO refused to offer renewal, but more shockingly once they refused to offer renewal they refused to continue dealing with the claim. This has left the dentist with an unexpected bill of around £8,000 (to date).
The discretionary nature of the MDO’s has always been controversial from the insurance industry’s perspective but as these recent cases highlight, it poses a significant risk to dentists and patients too. The GDC state that registered dental professionals must have “appropriate indemnity” that is right for the scope of practice of the individual involved so that deserving patients can be rightly compensated. It would be interesting to know how something that is purely discretionary can be deemed to meet this requirement, especially following these recent cases. These are not the first cases of dentists to be refused cover at the point of a claim either.
We are now in an age where the MDO’s have to increase membership rates significantly for those dentists they wish to retain and for the many that are being refused cover they have to search elsewhere for their indemnity.
Company Director at All Med Pro www.allmedpro.co.uk
Posted by Gemma