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Taylor Defence Services (TDS) has been introducing professional liability insurance (dental indemnity) for a decade along with a unique legally binding service agreement for all dentists and DCPs in the UK.
Here, Neil Taylor, Head of TDS Services, tells us more about what they offer and why they’re introducing a new type of cover this month. He also shares his thoughts on the Government’s consultation paper into healthcare workers’ indemnity and the outcome of the recently reported preliminary issues raised by a retired dentist for treatment carried out by his associates…
TDS has been providing services to dentists for 10 years, can you tell us about what you offer to the profession?
TDS was set up in March 2012 after a period of about two years analysing what the profession was receiving with respect to indemnity. TDS is the largest introducer of insurance-based indemnity to dentists and DCPs in the UK.
We were founded on a drive to provide a service that is second-to-none, with employed advisers who care equally about the profession at large and the individuals that they are representing.
The TDS team of advisers, who are either practising dentists or recently retired dentists, are extremely knowledgeable and employed rather than consultants. That’s important because it means that it keeps the standard of advice high and that calls the dentists make are answered in the moment rather than waiting for a consultant to be available.
The standard cover has no clinical exclusions, and the only additional costs are for those dentists providing sinus lifts and block grafts.
This month, June 2021, sees you launching cover that is claims-occurring and includes inbuilt past cover. Can you explain more about what that means and why it’s important for dentists?
The cover is an amalgamation of the best parts of a claims-made policy, i.e., the past cover, along with the best part of a claims-occurring policy, i.e., cover in perpetuity. This means in simple terms that dentists now have past, present and future cover.
There’s no need to discuss run-off cover, retroactive cover or any need to worry about terminology type. Dentists also do not need to rely on the capital reserves of their previous provider. If a dentists’ previous provider is, for whatever reason, unwilling or unable to cover them, they will be protected and always have been.
About 70% of dentists currently have Medical Defence Organisation (MDO) membership. If you have previously been covered by an MDO and they can’t or won’t represent you in a case, the policy will trigger to represent and cover you.
That was always the case with the previous claims-made policies we introduced, we have simply added cover in perpetuity – a simple sounding change but one that can have a big difference and will help dentists to feel more secure.
It’s important for dentists as it means they don’t have to rely on their previous provider to pick up the case or their capital reserves. The cover is there for always in the future and, most importantly, it’s still there for the past as well. This is achieved with a prior acts clause as an endorsement which is unique, and endorsed on all polices, as standard at no extra cost.
You say this new product is unique to the market, in what other ways does TDS differ to the other indemnifiers in the market?
Very importantly TDS acts on behalf of the dentist or DCP, rather than the insurer. This means that the dentist or DCP is always represented with what is in their best interests rather than the interests of the whole membership or in the interests of someone acting for insurers.
As we are separated from the insurers, clients can call TDS as many times as they require without fear of increasing costs.
We operate a bordereau system. This means that 90% of the cases we see are dealt with in-house rather than requiring the need to contact consultants or the insurers in order to progress defending or dealing with the issue.
Dentists have the security of being able to tap into the TDS team’s knowledge with a number of years’ experience in the indemnity sector and the exceptional reputation that we have built over that time. That is something we pride ourselves on.
The Government is in the process of considering moving all dental professional indemnity cover to insurance-based. How likely do you think that is to happen and what would be the consequences for dentists and indemnifiers?
In my view, that’s very likely.
The Government set out their consultation paper in December 2018, in which their preferred option is to have all healthcare workers covered by insurance-based policies.
If that happens the impact for TDS clients is none, as we already introduce an insurance-based policy. That having been said, when the profession understands the transition, we do expect a lot of interest to be transferred to us, especially with the launch of the new product we talked about above.
It’s not clear what affect the proposed changes will have on other indemnifiers. The MDOs will presumably become introducers of an insurance-based policy.
The most interesting question is whether the MDOs will introduce claims-made policies to cover the past treatments or if their past liabilities will run off under the current discretionary membership arrangements?
The main role for TDS is to educate dentists that they can obtain both the service level we offer along with the new product which means that they ultimately end up with the certainty of cover for past, present and future and a fantastic service.
If the move to insurance-based indemnity does go ahead, there will be a transition period which is an unknown period of time right now.
There’s been much discussion recently about the Breakingbury v Croad case in which a dentist was successfully sued for treatment carried out by his associates. What are your thoughts on this and the implications for dentists?
The issue in this case is not new law and is not really about vicarious liability, albeit the judge does go on to consider vicarious liability. The case doesn’t really alter the risk to principal dentists, who have associates, as that risk has been there for some considerable time. It just takes time for the profession to be alerted to the issue. This is not new at all; I was lecturing on this eight years ago.
Certain law firms will, as a standard, send out a letters of claim to principal dentists with or without the associates named as defendants. That has been happening for quite a while already. The profession becomes alerted to something when those involved don’t have the right cover in place.
The retired dentist has not been successfully sued. That case is yet to be heard. There are two preliminary issues adjudicated upon in the case. One of these issues is raised by the retired dentist, that being non-delegable duty of care.
In this case, the judgement is from a minor court, so it doesn’t alter the legal position and it is not binding on other courts, albeit the higher courts have already decided this issue.
As a principal dentist or practice owner, the question to ask is can you delegate your duty of care to an associate, even if you have a contract that suggests you can? The answer is no, and that has been the case for some considerable time.
I’ve seen posts on social media that suggest some principal dentists believe they have vicarious liability cover, but in cases like this the issue isn’t the cover they hold, but the cover that their associates hold. This part of the case is yet to be heard if the retired dentist decides to introduce the associates into the claim.
Is there anything dentists can do to protect themselves from a vicarious liability claim?
The issue that’s predominately missed is that it’s the cover the associates hold that is crucial. The principal dentist might have vicarious liability cover, but they should make sure their associate has the appropriate cover in place when they contract with them. We already know what the Government’s preferred option of appropriate cover is.
In the Breakingbury case the associates are not named because it’s a preliminary issue. The principal dentist brings the preliminary issue to state the associates are liable and the court disagreed.
The difference is that the claimant in this case is saying you can’t delegate your duty of care you owe me to your associates, and that’s always been the case. And the judge agreed.
The issue this case will raise isn’t the principal dentist’s cover, which it appears he did not have, it’s what is the guaranteed cover the associates had at the time. A lot of principal dentists will be looking at what their associate’s guaranteed cover actually is and crucially past guaranteed cover.
Do you provide support for dentists in terms of vicarious liability?
Yes, and that’s always been the case. The principal dentist is the main policyholder, so they are covered as standard.
What advice do you have for dentists searching for their next indemnity policy?
There are some key questions to consider:
Does the provider you are looking to transfer to offer a policy of insurance or membership where the indemnity is afforded at discretion of the organisation?
If it’s insurance-based, am I covered for life or do I need run-off cover?
Are my past treatments covered or only my present and future?
If the past treatments are also covered is that cover for treatments by way of a prior acts clause or similar if the MDO declines to assist and/or ceases to exist or do you have to pay additional premium for any additional policy endorsements to cover your past? You should also understand the endorsement the provider uses to ensure your past is covered without gaps within the wording they use.
The answers for TDS are simple, however may not be so for other providers.
TDS introduces a contract certain policy of insurance. You do not need run off cover as the policy is claims occurring. Your past treatments are covered in the event your previous claims-made policy or MDO declines to assist or the MDO ceases to exist.
The last part is the most crucial. The prior acts clause will cover the dentists not only if the MDO ceases to exist but also if the MDO declines to assist. This is very likely to be the main topic of discussion over the next few years.
What does the future hold for TDS?
It’s an exciting time for us given the new cover we are introducing. Along with our 10-year history we are expecting to be inundated with requests to join us.
It has become clear to me over the past 10 years that what’s needed is a policy of insurance that’s not discretionary, a policy where you’re covered in perpetuity and a policy that means you don’t need run-off cover.
However, crucially, that your policy covers past treatment in the event that a previous provider ceases to exist or is unwilling or unable to assist.
Over the next few years, past liability cover will be on all the providers’ lips and the lips of all those in the know in dentistry. Past cover is essential so that you do not need to rely on the capital reserves if you transfer from an MDO.
Visit TDS to find out more about what they offer. Or register at I&I to start comparing policies.
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