Coverage Overview: Claims-Made vs. Occurrence
The two primary types of policies provide malpractice coverage on either an occurrence or claims-made basis. The major difference between the two types is when the incident in question occurred and when the actual claim is filed.
Occurrence Policy | | Claims-Made Policy |
Occurrence coverage responds to a claim based on when the dental treatment occurred, regardless of when the claim is actually made against you. As long as the incident occurred during the policy period, your occurrence policy will respond according to the terms and conditions of the policy—even if the claim is made after the policy period expires. When a dentist selects an occurrence policy, they will have coverage for treatment rendered while the policy is in effect, even after the policy period is over. This could be of particular interest to young dentists who are much more likely to relocate from state to state, change careers, return to graduate school, or have family responsibilities. In each of these instances, you would be able to suspend your practice and still have coverage based upon the terms and conditions of your policy for all dentistry performed during the policy period. | Claims-made coverage, by contrast, responds to claims based on when the claim is first made against an insured. You must have a policy in effect when a claim is filed regardless of when the incident actually occurred. Each claims-made policy contains a retroactive date. This retroactive date allows the policy to “look back in time” and cover prior incidents and reflects the beginning period of coverage prior to the effective date. As long as the incident took place after the policy’s retroactive date and the claim is first made during the current policy period, a claims-made policy will respond. Please note that in situations where a dentist has a claims-made policy and moves out of state, leaves a particular group, switches to occurrence coverage or is no longer practicing, he may need to purchase an Extended Reporting Endorsement (or “Tail”) in order to have continuous coverage unless he can find a new insurer to pick up his past exposure. Today many insurance companies will provide a free tail policy at retirement, or death or disability, as long as the dentist meets certain conditions. |
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