Indemnity vs Insurance 2023 – Which one is best for you? – GF019

Jaz’s Introduction:
Indemnity vs Insurance. I don’t know if it’s like a UK thing. I’m kind of sure it is. Although when I was in Singapore, I was with dental protection. So let’s give you a bit of background first, right? Indemnity is a bit like the big organizations, mutuals like DDU and dental protection, whereas Insurance are kind of like a newcomer in the last 10 years. There’s these different insurance products.

So what’s the need for these? Well, when I was in Singapore, when I moved from the UK to Singapore, I was paying so much lower to be part of dental protection at the time, like, compared to UK fees, Singapore, it was so much easier to get protected as a clinician.

This is because in Singapore at the time, dentists were getting sued way less than they are in the UK, which is nice, and also taxes are lower, which is really cool. Anyway, came back to the UK, and now that I’ve been paying way less in Singapore, to have to pay what I was getting quoted for with DDU at the time, or Dental Protection, or whoever, It was a bitter pill to swallow.

So already I was thinking surely there must be a better way. Why am I a non-implant dentist who hadn’t had any complaints at that point? Why am I paying so much so that it covers the high-risk dentist, right? Cause that’s the way it works. These mutuals, they work because they’ve divided all the costs between all the members.

And this is why your premium goes up year by year by year, even though you didn’t really use their services. That’s when insurances came my radar and my friend, Dr. Neel Jaiswal, who’s a fantastic conscientious clinician. He started PDI, which is Professional Dental Indemnity. So, I had a chat with him, I went to their evening, I met the underwriters, the lawyers there, and I was very impressed with what he was setting up.

But what he taught me and what I learned also from the Facebook groups and dentistry is that, oh, I had this complaint, and my indemnity organization is choosing not to defend me. Now that’s a big eye opener, right? Because what we learn now is that these big mutuals, their cover is discretionary. Meaning that should they choose not to defend you, they won’t.

They’re not obligated to. They’re not an insurance. Okay. It’s different. And this is something that I’ve been learning. And in this episode, as we learn about Indemnity versus Insurance, you see that I’m relearning all these things all over again. Some great analogies there for you. It’s a very tricky thing to get your head around, but you know what? It is so important, right?

Your career is so important to get the right type of insurance for your career is important to make sure you’re protected, and your patients are protected. This episode is not as sexy as bonding and composite veneers and stuff. But like I said, this is really, really key. So please do listen all the way to the end because I guarantee you’re going to learn a lot.

And if you do listen all the way to the end, you might actually gain so much that you will make sure that you have the right product. You’d be clued up next time when you’ll do a renewal and it’ll probably save you thousands. So, let’s listen to Dr. Neel Jaiswal.

Main Episode:
Dr. Neel Jaiswal, welcome back to the Protrusive Dental Podcast. All those episodes ago, the fourth ever episode was on microscopes and something to do with diva mode and that kind of stuff. It went to a funny little digress and that was gosh, so many years ago now. It’s so great to welcome you back in a different reincarnation. Before we’re talking about magnification loops and I remember I came to shadow you, we use your microscope.

And you’ve kind of pivoted a little bit. I know you were involved in the field of medical legal at the time as well, but you’ve grown PDI. And so we want to talk about that. We want to learn about the difference between Indemnity and Insurance. But for those who hadn’t listened to that episode, tell us about yourself, Neel.

[Neel]
So I’m a general dental practitioner. I’ve got a private practice in Hertfordshire and I’ve been involved in various teaching things over the years with microscopes, with tubules, with study clubs. And most of my education was with sort of Frank Spear in the States. Went there over quite a few times, which really changed my whole dynamic.

And I was sort of heading along the clinical pathway and building up the specialist practice. And I think probably at the time that we did our first podcast, we weren’t so happy with the state of affairs, with the GDC, with indemnity, with being let down. And I kind of, I was trying to help people.

And I met my business partner, Gary, who said he was in indemnity for plastic surgeons. And I told him about what was happening, and one thing led to another and PDI started. And it really just came about from wanting to help our colleagues and having someone on our side really. And that was probably about the time that we did our first podcast. So, I’ve come a long way and congratulations to you as well. I mean, how far you’ve come. I mean, amazing podcast.

[Jaz]
I appreciate it so much. And you reach out to me now and again saying that you and Cam listen to it. And it puts your daughter, Aria, to sleep. You told me a few times. I’m sure it puts a lot of people to sleep.

But yeah, I’m so glad that Aria is getting some sleep out of it, which is great. And when you mentioned Gary, I hate Gary, tongue in cheek because we went to the Dentinal Tubules Congress and it was fancy dress, right? And me and him, right. I thought if I go as Alan from The Hangover. Okay. And I have the baby with me, baby Carlos with me and no one’s going to come as Alan from Hangover, and he came as Alan from Hangover.

It’s like he was wearing the same dress as me. That really annoyed me, but yeah, it’s all fun and games. Tell me in terms of how much of what you do now is revolved around you running your dental practice and how much of it is doing the professional dental indemnity, PDI, which is the product that you at the moment seeing the issues that we were having with the traditional indemnity that you raised.

[Neel]
 I think, as you know, being a dentist, just being an associate is a full-time job with the amount of treatment planning you do. Being a father is a full-time job. And running a dentist company is a full-time job. So I think I’ve got three full time jobs. How I split my time, I don’t really, it just sort of becomes, not firefighting, when the practice is a bit of firefighting. But generally, I kind of work two days a week. And two days a week I’m daddy daycare. And two days a week is PDI. But every evening could be anything. And all our clients can WhatsApp me anytime, any day. And we super quick at responding, which is one of our pluses.

[Jaz]
Which is why all those years ago, I switched from my I’m not going to name who I was with. I mean, when I was in Singapore, I was with Dental Protection. When I was in the UK, I was with another indemnity organization. It was all good and stuff. But the quotes that were coming back were getting higher and higher and higher year by year. And I still to this day, touch wood, it’s going to come.

It’s going to come eventually. Touch wood. I still haven’t had a proper complaint that, there was a few like little hints that I approached indemnity for the, ‘Hey, can you help me formulate a response kind of thing?’ And nothing ever came of it. But it’s something that is going to come eventually.

But despite that, despite me feeling like I was doing all the right things, the quotes I was getting back was higher, higher, higher, wasn’t doing implants, still going ever higher. And so I wanted to try something that would significantly reduce the bill, but it wasn’t just about going something that was cheap.

It was something that was something that would regulate and meet the regulatory standards, but also trust. I’m a huge person of trust and I trusted you, Neel. And I said, okay, Neel. You’ve got this new thing. You are obviously disgruntled with the indemnity organizations. You’re starting something. I attended your evening talk and I thought, okay, this makes sense to me.

And the biggest thing at the time, which we’re going to talk about is learning that indemnity organizations, the cover that they give us is discretionary, right? Which is the biggest beef that we have with them. Can you please explain, because it’s something that you day in day out, what this means?

[Neel]
So obviously, for most of my career, I was a dental, well, let’s not say, a big provider. And they were really good, and at that time, we weren’t having this complaint issue, we weren’t having the no win, no fee, and if you were at the GDC, you’d probably have done something naughty. And then the culture changed, whether it’s from the 90s onwards, I remember my dad being a GP, and suddenly it became patients for customer, and it was all about them, and it sort of devalued us as professionals.

So that, and plus obviously the medical legal things changed. And really what happened was, I think the discretionary companies sort of were almost of a past era and not fit for purpose really, and the government has said this as well in their white paper. So, how I’d explain discretionary versus insurance is, let’s say Jaz, you’ve got a like cars, so let’s say you’ve got, you’re doing really well, and you’ve got a Rolls Royce outside.

And that’s your career. You’ve only got one car for the rest of your life. You want to, it’s really valuable to you. It’s really important to you. It’s really important that it works. And you need insurance. It’s obligatory to have cover. So, you can either go to a mutual, and they’ll say, you’ll say to them, I’ve got a Rolls Royce.

I do 10, 000 miles a year. I’m a bit of a dodgy driver. I do curb the alloys. I’m a bit of a risk. Will you insure me? And they’ll go, we can’t insure you because we’re not licensed for insurance. But we can indemnify you. So what we will do is we’ll have a handshake and say, don’t worry, Jaz, you’re with us.

That’s it. So indemnity is a handshake. It’s two people having a handshake that’s of trust. We’ll look after you and we’ll use our discretionary for the good of our members. The issue is the good of the members might not be the good of the individual. And that’s where they get caught out. Or, you could come to us and say, I’ve got this Rolls Royce, I do 10, 000 miles a year, this is my claims history, this is what I do, this is how I drive.

I’ll go, okay, I’m going to write everything down on paper, you’ve told me what you do, how often you do it, you’ve told me your risk, I’ve looked at your past records, I’m giving you a quote. If you write, if you’re honest with us, that’s all we ask, and we will cover you for that. So, if any issues at all, you’ve got a piece of paper that you can refer to.

And you’ve got an ombudsman you can refer to, and you’ve got a very, very tough FCA that really makes sure that they’re acting fairly. And if I can give an example, which happened yesterday, don’t want to mention any names again, but this dentist has been left without cover. Because he took a vertically impacting wisdom tooth out, and caused tongue burning from parasthesia I think it probably did-

[Jaz]
Could happen.

[Neel]
I think he didn’t even elevate the root out. So, he did a coronectomy in the end, because it wouldn’t budge. So I think maybe the anesthetic has caused something. But his indemnifier, which is mutual, has said, ‘Oh, you didn’t tell us you were doing wisdom teeth. You’ve told us you’re doing implants, but you haven’t told us you’re doing wisdom teeth.’

Now I would call that general dentistry. And we’d cover you. And also, we would take a view on it as well because the brokers that we work with in the writers, that’s what we like about them. They’re reasonable. And if I put an argument to them, they will listen. Now his indemnifier has said, no, we’re not covering you and we’re not covering you retrospectively on this since the time you’ve been with us.

So he’s now going to try and, who’s the lawyers to know win no fee, Irwin Mitchell. He’s going to have to go up against them, who do this day in day out, on his own, unless we find him a lawyer. So, I think that’s mostly unfair, and I would have thought the discretionary could use their discretionary for good, and to say, actually, he didn’t know, we didn’t ask him if he does implants, let’s use our discretion to help him. But they’re using his discretion to exclude him.

[Jaz]
Wait, you didn’t ask him that if he does wisdom teeth, you said implants, but you meant wisdom teeth, right?

[Neel]
No, well, he’s covered for implant. They didn’t ask him, these, nowadays, they’re sort of giving a questionnaire of like, what you do, what you don’t do. But they didn’t send that to him. But they relied on him knowing that, oh, we need to know this. But how is he supposed to know this? Dentists are busy. They don’t get caught. So he got caught between a rock and a hard place. But he’s got nothing to go back. He can’t complain. There’s no complaint service.

When I asked about my indemnity file, I’m really not happy with the service. Can I complain? They said, we don’t have a complaint service, which I think is crazy. So it is, do you want to trust that handshake? Which I think as gentlemen, we could do in the past or, but it’s your whole career. It’s your whole livelihood and it’s the only vehicle you have for the rest of your life and you want to make sure it’s well insured.

Now some people will go with cheaper insurance, and you were saying very much you want a price, but you also want the proper cover. Now do you really want the cheapest cover that if your car goes down, you’re not you’re going to end up with a bicycle for hire, curtsy car.

Or do you want like for like or do you want something in the middle? And I kind of think most people want something in the middle. So, there is a little bit of a race at the bottom. I think that’s changed which is good because that doesn’t help anyone. And there is a fair price for things and what you don’t want to do is have to cover the costs of somebody else’s mistakes.

So with an insurance pool, we put all the good dentists, so to speak, in one pool. And we, let’s call them the distress dentists, paying 30, 40, 50, 80, 100 grand in another pool. So, there’s different risk factors and different prices. So if something happens in the other pool, it’s not having a knock on effect on yours, so your premium doesn’t go up.

Whereas with a mutual, everyone’s in the same pool. So that’s why you could be saying, I haven’t had a complaint, why is my indemnity going up, insurance going up every year? Now obviously some of that’s expenses, cost of living, but it’s disproportionately high, but it’s because you’re paying for other people’s errors and omissions.

[Jaz]
Yeah. One of the questions I was going to ask is why is it that when I get an insurance quote, it is much more palatable than an indemnity quote. And so I think a barrier for some people to switch from traditional indemnities to go from insurance is because it is a significant fee drop. They have this queasy feeling in their stomach.

They’re kind of cheaping out that, hey, probably I’m there’s got to be a catch. And the catch probably is that if I’m in trouble, I’m not going to be well supported. What do you think about that?

[Neel]
That’s an interesting point. I hadn’t heard of that. You almost value something, but it’s more expensive. A bit like we do in anything, you know, a coffee at Harrods is more valuable than Caffe Nero. So I think that’s a great point, actually. So, if anyone has those doubts, do let me know, because we’re happy to put the price up so that they feel it’s like for like.

[Jaz]
Please don’t.

[Neel]
But to be honest, from what I’ve seen, if you look at most of the insurers and some of the younger mutuals who haven’t got as much past history to manage, we’re about the same. So it almost becomes a few hundred pounds difference. We kind of, there is now a settling, which is really good because I think wherever you go. You are going to get, for most people, you are going to find a decent price. And then what you’ve really got to look for is those things of, can I get hold of them?

Do I know them? Can I trust them? Is the service there? Will they look after me? And I think it becomes a bit like choosing a dentist. We don’t really know, as a patient, if a dentist is any good. Even when I recommend a dentist, if I haven’t seen their work, all I can go on is, they’re educated, they’re nice, they’ve got a nice website.

So, we’re going on all the other factors to make our decisions. And one of them is actually Recommendation. So recommendation is fantastic. But also, and we’ve got lots of recommendations, and I’m really proud and you’ve kindly given us one. But you’ve also got to be aware, recommendations are generally from people who have had a good outcome.

And in indemnity, if you’ve had a bad outcome, it’s not something you want to shout about. I got a hundred, I lost a hundred grand, and they did treat me very well, and I’ve had to go to court, and all this stuff. That’s not kind of, the recommendations are skewed. They’re still valid.

But you really want to understand yourself is who are you dealing with? What kind of product is, and that’s something we can touch along later. And it’s trust. And like you said, I think it’s trust.

[Jaz]
Excellent.

Hey guys, it’s just Jaz interfering here with an offer for you. If you want to get a quote from PDI to see how much it would cost you and to see if they’d accept you as part of their insurance product.

If you head over to protrusive.co.uk/insurance, that’s protrusive.co.uk/insurance. And you fill out the form with your specific details in terms of what kind of work do you do? How many hours a week do you work? Have you had any claims before? All the important kinds of stuff that usually would fill in.

You’ll find out if they would accept you and you’ll get a quote as well. Now by filling out that form on protrusive.co.uk/insurance, you get a hundred pounds off. So whatever your fee is, you get a hundred pounds off on top of that as well. So maybe if you’re still within big indemnity company, or maybe with another insurer, and maybe you’ll do a renewal.

Or maybe you’re looking ahead and you’re planning ahead, or maybe you’re just downright curious as to how much it would cost you with your individual circumstances. I just fill in the form and PDI will contact you. Now, as part of being a hundred percent transparent with you, I do get a small commission.

This channel gets a small commission if you do get a quote, and if you do sign up. So Protrusive gets a commission, which helps us support the channel, but I wanted to let you know that as part of transparency, let’s join the main episode again.

With insurance then, like I’ve been with you guys as an insurance for four or five years now. Am I disadvantaged in any way going for an insurance product, as you call it, compared to the more traditional big dental indemnifiers?

[Neel]
I don’t think you’re disadvantaged at all, to be honest. I wouldn’t be advocating it if there’s any disadvantages. I think you’re more secure, I think you’ve got more chance of being heard fairly, I think you’ve got more chance of having the correct cover, more chance of less disputes.

The only thing I would say is insurance based, and this is a tricky one, you have to know the terminology. Now we’re not used to the terminology because we’ve had mutuals for 90% of my career. So it’s really important. And again, with the recommendations, find out from people who understand insurance, they’re the recommendations.

Like we had Prateek Akhoury doing one of our indemnity webinars, and he’s got a medical legal background and he spoke really fairly on the pros and cons and what he looks for. Now he’s a member of ours, but he also said these are the negatives and these are the positives. So someone like him who understands it is a really good recommendation.

Whereas someone who just saved 500 quid may be not the best recommendation. But you have to know terms such as claims made, claims occurred, runoff cover, and retrospective cover. Because people get confused with them all the time. And I’ve even seen some of the-

[Jaz]
We need to cover all those. We need to because- let’s go deep now. We need to cover all those because this is like, in Insurance 101, the questions that you probably get asked day in, day out, every time someone’s inquiring about joining. But before we get to those four things that you mentioned, which are so important, what I’m trying to just get my head around is, do you know what percentage of dentists are with a mutual, with a big indemnity and what percentage are with insurance?

And because I feel as though people are still with the indemnity. More. And why is that the case? With everything you’re saying, with the whole discretionary color. Is it the fear of change is it, what is the reason?

[Neel]
Well, I think mutuals are still the majority. I haven’t got the figures. But I would say my guess is the largest mutuals have got maybe half the population of dentists, maybe a bit more. So gone from 90%, 95% because the only 5% who wouldn’t go mutuals back in the day would be those who won’t be covered. So they’ve had a few cases, they’ve had lots of payouts. They get booted out for the protection of the members.

So I would’ve said it’s gone from 95% to maybe 40 to 50. So the Exodus is there and the exodus is probably the under forties, under fifties. So I think there are a lot of dentists, maybe my age and older who’ve been with a mutual all their life, haven’t had a claim. Happy to pay what it is they’re used to paying that.

And as they come to the end of the career, they don’t really want the risk of being let down because they don’t understand the product and they’re hoping that the mutuals will be around in 10, 15 years, which I don’t think they will be, but they’re going with what’s familiar. And as we get older, we don’t like change.

Some of us don’t like change so much. So we’ll go with what’s cozy. We’ll go with the cozy slippers rather than the new shoes.

[Jaz]
Well said. And so, if someone’s thinking of switching from indemnity insurance, the first question they’re going to have is I’ve been with X indemnifier for 25 years of my career. And now it’s just getting like, I haven’t any claims and now I’m having to pay seven grand.

I don’t even do implants. This is ridiculous. And they have a look at you and they might get a much more favorable quote. But now they’re looking at the terms like how to understand the terms. What is runoff cover? And just explain what runoff cover is, why we need it. And how you factor that into the product?

[Neel]
So I’d have to go back one step. So there’s two types of insurance product. Claims made and claims occurred. Would you like me to explain that now? Because that would help with the next question.

[Jaz]
Please. And if you remind me which, do you know which one I’m on? Because you told me at the time, but it’s just there in the contract somewhere.

[Neel]
For client confidentiality, I’ll tell you later. Because I’ll tell you why Jaz, because you are very influential. And you know what people will do is they won’t make their own decision. They’ll go, Jaz is on this. So I’ll do this. And I think it’s really important-

[Jaz]
You explained it to me at the time and we went with that because we said, okay, that’s what’s best for me as an individual. But that was like five years ago and I haven’t changed. So that’s why I don’t mean to say that I don’t care about my indemnity. It’s important in my insurance, but it’s a distinction which I’m happy to learn about, relearn about from you now.

[Neel]
Sure. Well, there’s no right or wrong and they just both got their pluses and minuses. So Claims Occurred is pretty straightforward. It’s like the mutuals. You pay an insurer for that year. And that year, they bank it, and they cover that year in perpetuity. So if anything happens from a claim from 2017, you go back and you think, I was with dental protection, or I was with the PDI, I had a claims occurred policy, I’ll go back to them. So that’s what we’re used to. We paid our year and it’s covered.

[Jaz]
Let’s just make that really tangible. It’s now 2023, and I saw a patient in 2017. I stupidly took out the wrong tooth. This didn’t happen, by the way. I’m just saying, okay? Or I did something accidental. And the patient now is complaining about something that happened in 2017. So, do I now need to look at my records, like, who was I paying in 2017? Or, is it who am I paying now that’s going to defend me for this claim?

[Neel]
That’s exactly why it’s complicated. It depends if your claims are made a claims occurred.

[Jaz]
Gosh!

[Neel]
I know. So let’s say your claims occurred. You were in dental protection, and you moved to a claim occurred product. Which is the way most people go. So you’d go back to 2017, look back who you were with, and say, right, I’m covered with them for the rest of my life, I’ll go back to them. Now, that’s an advantage is because you can rest assured if you ever stop working, those years are covered for life. So you can stop and start your insurance, you can go on sabbatical, those years are covered.

The baton is being held by that person at that time. The downside is it’s more expensive. Because that insurer or indemnifier has got to cover you for the rest of your life. So if you’re a 23 year old dentist, they’re holding that for another 30 years. The other downside is, we had a friend of mine, two years ago, so 2021, had a claim from 1999.

A perio claim with six other dentists. How the hell do you go back that many years and try and figure out who you were with and look at everything? So, it is a trickier one. I mean, if you were with the same people all the time, he’d chop to change a little bit. So one, it’s more expensive, two, who are you with, and three, will they still exist and in what format?

Now, the mutuals are a funny one, because the government white paper every two or three years ago, pre COVID, when they were basically saying, we don’t like indemnifiers, we don’t like mutuals, no other country does it, no other profession does it. We should change. And that’s kind of put back a bit with COVID and all the other things that are happening.

But they are going to have to have some plan of becoming insurance based, I think. So. I’m guessing the government’s going to let them, not going to let them down, but what premium you’ll pay as they move from indemnifiers to insurers, I don’t know. And whether they’ll want some top up or something. So that’s the downside of claims occurrence.

But the upside is, it’s very secure. You’ve done and dusted, and you don’t need any runoff because runoff implies is a Claims Made product. So I’ll go back to a claims made product. Claims Made products are cheaper which is nice, and the baton gets passed on to the next person, to the next person, to the next person.

So, at the end of 2017, your insurance finishes, and it’s like car insurance, it’s gone. So, no matter what happened, they’ve ended their contract with you, and the next person who comes along will then claim it. So you’re still driving your car in 2018, but the insurance for 2017 finished. Who’s your current provider is, and if you have an accident, it’s reported in 2018.

Doesn’t matter when it’s happened, its claim was made in 2018, and so you would go to them. So my analogy is a bit of a relay race. I’ve used this a few times. Let’s see if it makes sense. So with claims occurrence, there’s four relay runners, everyone.

[Jaz]
And just to clarify, Neel, Claims Occurrence is how the mutuals work at the moment.

[Neel]
Yeah. Exactly. So, you’ve got a 4×100, if you remember back to your school days, and there’s a baton that normally gets passed around, and that races your career. So the first person runs, then the second person, then the third person, then the fourth person. That’s your career. And those four people are different indemnifiers.

Now, with claims occurrence, each person keeps his baton. So he doesn’t pass it on to the next person. The next person just runs with their own baton. Next person runs with their own baton. Next person runs with their own baton. And if you get a claim anywhere in that race, anywhere in your career, you look back to who was holding your baton at the time.

That’s claims occurrence. Claims made is more like a proper relay race. The baton gets passed. So then one person has it, next person has it, next person has it, you get to the end of the career, the last person standing has a baton, he covers the whole race.

[Jaz]
Okay.

[Neel]
So you know who you’re with, you don’t have to go back looking to see who it was, you’ve paid less money because the risk for each insurer until the end is less, but someone always has to hold the baton.

So in claims occurrence, if you stop running for a little bit and say, I’m going to have a rest. You can relax because you’re not paying any insurance, the past race is covered, you can have a, go and have a baby, you can have some time off, you can go on holiday for a year, you don’t have to pay. With claims made, as soon as that last person drops a baton, nobody’s got the baton.

So someone always has to hold the baton till the end of your career life. And even if it’s only a nominal amount, someone still has got to pay because they’re covering all the race. So you can’t just stop indemnifying.

[Jaz]
But, my rationale, my thinking now is because after 2017 or 2016, in 2017, when I switched from a mutual to you guys, everything 2017 and before is already covered always because I was with a traditional mutual company at that point. Right?

So now let’s say, let’s project to 2030 because I’ve remembered which product, I’m with now. Let’s assume I’m with a claims made product and let’s go to, let’s project to 2030. And in 2030, and so just follow me here. I’m going to try and keep numbers. Fine. 2030. we get a claim that, so there was some perio issue in 2023.

So today I did some perio issue and 2030, there’s a case that I just got the letter. And then, so basically, I’m assuming I’m still with you at that stage, right? It doesn’t matter who I was with in 2023. It’s the fact that you’re holding the baton in this 2030 when the claim has been made, you’re the one who’s covering me.

[Neel]
Yes.

[Jaz]
But for the privilege of having the previous seven years covered, I’m paying a runoff cover. Is that correct?

[Neel]
No.

[Jaz]
Okay. Now this is okay. This is where I understand. Okay.

[Neel]
So with your claims made policy, so going back to that relay race and you got to the end of the race and you’re on a claims, let’s say claims a current policy. You can relax, you can retire. All the past years are covered. So the last guy might have been us, the guy before them might have been Densura, the guy before them might be BDA, all claims are current, and before that was under protection.

You can think, I’ve gotten to the end of my career, I’m all covered, as long as those people exist, or whatever form they’ll exist, they’ll have to indemnify you in some way, you’re covered. Now with claims made, it’s only the last person standing who’s covering the whole lot. So it’s not in his interest to keep carrying it for years and years and years. Because it’s like, well, why am I, you’ve paid hardly, I’ve only paid one year’s premium and I’m covering the whole lot and now you want to retire.

So each claims made policy has a built in runoff. So what they’ll say is, I’ll hold this, I’m at the end of the race, I’m a bit knackered now, I’m sweating. I’m holding this. How long I hold this for is my runoff cover. So you’ve retired and it’s back 10 to 15 years. So they’ll say, I’m going to hold this for 10 years and most claims come within 3 to 8 years.

So 10 years or 15 years or whatever it’s going to be when you retire, you don’t have to think about it until then. I will hold that baton. So you’re covered at, now if you got a claim at 20 years, you’d be really unlucky, and also a claim has to be put through, as you know, from the time that the patient find out about it within three years.

So they’d really have to find something really a long time away, they don’t have to go to the dentist for 25 years and then find they have a problem. I mean, it’s not, it doesn’t happen. So runoff is-

[Jaz]
So runoff is for when you take a big break or retire?

[Neel]
Not a big break, just retirement. Just retirement.

[Jaz]
Ah, okay, okay, okay. But what if someone’s going to take a sabbatical for a year? Right? And you’re with an insurance product and its claims made, you still need to pay for runoff cover, right? For that one year?

[Neel]
It’s not runoff cover, you just pay for cover. It’s not runoff cover. It’s just, you need to go and cover because even though you’re not working that year, someone’s got to pick up the last year and the year before and the year before.

They might be a nominal amount. And to be fair if it, maternity, we tend to just pause it. The guys are really good. They could ask and we just say, look, actually, your risk probably isn’t any higher. And in COVID, we extended it as well. So for a couple of months, so it’s a chat with your indemnifier and you say, look, I’m going off for a year and it might be that, okay, look, we’re covering 15 years’ worth of you.

We need something, or actually you’re on maternity. You’ve been with us a long time. You’re a good client. We’ll just pause it and put you back on cover. But with claims occurrence, you can have those holiday break. You either pay now or you pay later. With claims occurrence, you paid earlier. So you paid bigger premiums to cover it.

With claims made, you pay a bit later because at some point it’s going to catch up with you. So it really depends on whether you want to deal with your current insurer all the time, or whether you want to go back retrospectively. So I’ve got claims made, and I’m sure Cam won’t mind she’s got claims occurred.

So I know I’m going to be working for the next five, six, seven, eight years. I’d rather pay less of a premium. I’d rather deal with the person. I don’t want to go back and try and figure out who I was with. I can look at my current indemnifier and I’m happy with that. Now, Cam might have a career break and she’s paying, let’s say 600 pounds more than I am, but she knows she can stop for a year or two and just not have to worry about keep insuring herself.

[Jaz]
Okay, so for those two years, she doesn’t need to pay and she doesn’t need a product for those two years.

[Neel]
Yeah, but she’s paid more for that privilege. So, it swings and roundabouts, there isn’t a right or wrong, and again-

[Jaz]
It’s an individual thing-

[Neel]
That’s why we you to have claims occurrence is if you’re chopping and changing. So, if you went from a claim made to claims occurrence to a mutual, you could end up with gaps in your cover. So, that’s why it’s really important, if you are thinking of moving, luckily, we’ve got like 99% retention, but we always say, look, not every dentist and every patient works together.

If you want to leave us, that’s really fine, but don’t just go without telling us. Because they’re the way that we have to make sure that you’re being looked after. Because I know people who, I know one person who went to another provider and they didn’t pick up the retrospective, which we would do. And it’s very naughty.

It makes their premium a bit lower. But they don’t tell the client. Now that client has got three years without cover. Because they went from a claims made to claims occurrence and the claims occurrence didn’t pick up the retro cover. So where you get mixed up is-

[Jaz]
Now this is where it’s getting a little bit confusing. Yeah, that’s where I was getting mixed up, my friend. So I understand now that runoff cover is something more to worry about in retirement. So that if you’re in your 70s, there’s a claim that you are covered. So I get that now. But this retrospective cover, can you just give an example scenario of what might happen if someone left an insurance product, but how could it transpire that they would have, give a scenario where they might, they have gaps in their cover. How could that transpire?

[Neel]
So let’s say you had a claims made product, then another one, and then another one. The baton gets passed so that the third person is covering the three years.

So you’ve just stuck with claims made and the baton keeps passing. So the latest guy is covering the whole lot. Now you move to a claims occurrence policy. And the claims occurrence policy is with a different, newly formed big indemnifier, let’s say. That’s British. And, they naughtily weren’t covering more than three years back.

So they would say, yeah, here’s our premium, it’s five grand, and we’ll cover, in the beginning, they weren’t covering anything. To be fair to them, now at least they’re covering three years. I think three years. So they would cover the last three years of claims made. But if you are within the fourth year, you’ve now got a gap.

So they aren’t covered, they’ve left you without a gap. They may not have told you you’ve got a gap, but unless, I mean we have this so been-

[Jaz]
If you’ve been in four years of insurance and then you go to this-

[Neel]
Claims occurrence policy.

[Jaz]
Let’s say in the fifth-year, claims occurrence, yeah. So the previous three years are covered, but that fourth year back, that will get left uncovered. Yes, because there’s no retrospective cover beyond three years. Whereas with you guys, let’s say people are moving away from other insurance products, and they’re coming to you. If you do a claim made one, then it doesn’t matter because you’ve got the baton, you’re holding that baton for all years.

But which I finally sussed it out now, but now if you, for some reason, that dentist like Cam wanted to have a occurrence one with you for that year, you would then also include in that product, okay, but now we also need to give you retrospective cover for X number of years.

[Neel]
Yeah, we’d pick up the whole lot. Now again, I said things around about, it’s going to cost you a little bit more because now we’re not just covering one year, we’re covering four years or 10 years. But we would ensure there’s no gaps in your cover. It’s really important for us that when you’re with us or you leave us, we really want you to have no gaps in your cover because it’s really dangerous.

And I think it’s remiss of some other insurers who might go on price or whatever their reason of doing not to be, because they’re not insurers. They may not understand what the consequences are. They’re just looking at this is the product we’ve got. This is what you could have. And the dentists don’t know what they’re getting.

So, it’s really important, again, that you actually speak to an expert. And I’m just a dentist, and I’ve learned, like, you’re learning, in front of my eyes, and you’re picking things up. And I’ve picked it up for four years. But you speak to Gary. He’s been doing it 10, 15 years. He will tell you straight.

And the great new, the really good thing about us, we give you honest advice. We never tweak the facts to suit us. As a dentist, as you’re my friend, there’s no way I’d want you to be cajoled into anything. We would just say, this is what it is. These are the pros and cons. If you want to leave, this is what you need to do.

We just want the best for you. And it’s a bit like our patients, we just feel like we do the best for them, then the business will grow, whereas I have found some insurance companies, they think differently, they’re not healthcare, like, in healthcare, we care about the patient first and hope for the rest, generally, I don’t know if that’s changing, but insurances, let’s make our, it’s a business, and the money comes first, and then the dentist comes second, which is why I think what we’ve got is really kind of valuable. It’s dentists first.

[Jaz]
Okay. Just so that I’ve cemented, because I’ve only got one more question after this is, just so cause I’ve learned a lot here, just so that I’ve cemented my learning, is the following statement correct? I am a dentist who’s been practicing, I’m making this up, I’m a dentist who’s been practicing for five years.

For these previous five years, I have been with either, DDU, Dental Protection, a big mutual, okay, indemnifier. So, therefore, that’s a claim occurred agreement that I had with these. So, last five years, I’ve been with a traditional big company. I will now move to, let’s say, your insurance product, and I will decide with you which one to go for.

The only real option, the only logical option there is a claim made one, because the previous five years will always be covered, right? Am I right in saying that?

[Neel]
Yeah, the previous five years, but whether you have a claim made or a claims cleared in your sixth year is entirely what you want to do. We don’t have to pick up the retro, but you might think I want that year claim that year covered for life, like I have been.

[Jaz]
Ah, okay.

[Neel]
Or, do I actually just want to have one year and then it finishes and then move on? And again, that depends on your circumstances, career breaks, how you feel about things. And also, what we’re tending to do is maybe five years before your retirement, we’re moving from claims made product to a claims occurrence product, and bundling the whole thing together.

So you don’t have to worry about runoff. We’ve put it all together, so your runoff then becomes indefinite as it would with claims occurrence. So again, if you have five, six years before retirement, we might just look at you as an individual and think, okay, do you want to pay a bit more now? But then the advantage is rather than 10 years runoff, you’re going to get that for a perpetuity.

So that’s why it’s really important just to not just, don’t just sign something. Don’t just go and quote, have a chat. Here are my circumstances. What do you think is best for me? Let’s get from there.

[Jaz]
Yeah. This is why I appreciate it. Every time I renew, and I just check and you keep me on the right course, which is great. It’s nice to have that personal service from you. But yeah, what I meant, but yes, you’re right that if you’ve been with a indemnifier traditional one for the last five years, you definitely don’t need any retrospective cover. But which policy you choose, claims made, claims occurred, depends on you and your circumstances.

So it’s good to have that chat to decide what’s best for you. And would you say for the majority, it probably would be a claim made policy for the majority who are thinking they’re going to continue to work for the next however long. Would you say that’s the case?

[Neel]
I think for a youngster, define that how you will, 10, 15, 20 years ahead of them. Maybe they’re early in the career, they’re cost focused, they’re not going to have a career break and they just want to put their head down for the next 10 years, claims made is absolutely fine. I think if you’re in your last five years of retiring, if you’re looking to have a year or two out, whether you’re studying or sabbatical, maternity, then probably have claims occurrence.

That’s kind of a broad stroke. Just to clarify one point, we’ve said the mutual act like a claim’s occurrence product. They aren’t a claims occurrence product because they’re not an insurance-based product, but just for making things clear, they act like one. But again, they aren’t insurance based.

There’s no policy. There’s no document. There’s no regulation. It’s a handshake. If they were insurance, they’d call themselves insurers and they’re not allowed to, which is why this word indemnify comes along, because it’s another word to kind of say, well, not insurance based, but we kind of need to come up with a word. So it’s indemnity, lower than insurance, as it were.

[Jaz]
I’m just going to pitch you another random scenario because I think these scenarios help us to understand. Let’s say you’ve been qualified five years and you have been going with an insurance product such as yourselves, and you decided, because you’re a youngster, and you envisaged that you’re going to be working hard head down, and you want, you’re saving towards a house, so you want to keep your cost lower as well. And you don’t want to pay for the claims occurred. You want to do claims made. It’s going to save you some money, but also, you’re going to make sure the baton is held for the next however many years every time you renew the product.

But life happens. Life happened and you just, and you fell in love with a girl from Costa Rica and you go to Costa Rica and you, and you want to spend the next three years and you want to go fishing for three years, right? So at that point, for those three years, would you still then get a product, a non-clinical insurance product saying, okay, I’m going to be, I need a product from you to cover me retrospectively for the last how many years I’ve been practicing, but I’m not practicing now. And then you just give a quote for that.

[Neel]
Yeah. So you can buy sort of retro cover, like you stopped working, but you still need to have the last year claim covered. So you can have that year covered, and then the next year you can have it covered, and then the next year you can have it covered. The problem is it’s really expensive. It’s a premium again.

So it’s almost like if you pay three grand for a premium, and you stopped working, but you still need to cover last year’s, and you need that retro cover for one year as a separate policy, that retro policy might cost you a couple of grand. It’s really expensive to do it. And it’s not just a one off. That one off doesn’t pay you for the rest of it.

You have to keep paying it until the next 30 years. So you can do it, but it’s mega expensive. What we would rather you do is either you continue as an insurance product, but you say I do nought days a week, and so, but I’ll still keep covered, so you can go on our lowest premium possible and pay fifteen hundred or whatever you’re paying, which would be a cheaper way of doing it until you come back, or if you could say to the Venezuelan lady, ‘Can we just go in six months, and I’m just going to move to claims occurrence.’

I’m going to tie up all the retro, and then we can just do what we like. So certain decisions are a bit harder to manage. We’d rather you just give us a bit of time that we can move it to claims occurrence. It’s a cheaper way of doing it, rather than having to pay that retro cover every year for the rest of your life, or leave it exposed.

And GDC, I think, doesn’t allow you not to be undercover. So actually, if you have a missing year, and that’s why we’re talking about when someone went to another indemnifier and they missed a year. They’re actually putting that person in breach of the GDC because they’ve left them without a year of cover.

So I think it’s really important. I think the bottom line is it is complicated. It is a bit confusing. It’s taken me a couple of years to get it. You got it very quickly.

[Jaz]
No, but this is why, Neel, I think this is why 50% potentially plus are still with an indemnifier because there’s so much to get your head around that, and I’m hoping this episode has helped in some way for people to understand, but ultimately whoever you’re going to choose, you need to be able to be able to WhatsApp them, pick up the phone with them, have a chat and decide what’s best for you.

And I think this is why I go with you because I’ve got you at the end of the phone and I just, I just say, Neel. Here’s my scenario. What do I do? And obviously I came out from Singapore, and he explained to me and stuff. So I think that’s why I’m with you and that’s why I’m happy to recommend you on this podcast if you like.

But wherever you go with, make sure they don’t leave any gaps in your cover. Make sure that you understand what product you’re signing up to and that they’re going to be there to support you and help you with your decision making.

[Neel]
And the safest way, if you’re not so concerned about the intricacies and cost saving is probably a claim occurrence policy with the retrospective period back to your mutuals. They’re the two things you need to look for. Is it claims occurrence and are you retro covering me for the last few years until before, when I left the mutuals? If you’ve got those two things-

[Jaz]
If you’re literally just leaving the mutual now, if you’re jumping the ship now, then you don’t even need retrospect to cover.

[Neel]
Just stick with them and then claim occurrence and you’ve got a not a like for like for like product It’s better, but you’ve got a thing that works in the same. You have a claim you go back, and you can you speak to them.

[Jaz]
Great. Now the biggest thing that we want from anyone who’s looking after us and indemnifiers, insurance product is when you get that complaint letter or when you just have that queasy feeling in your stomach, and you just need to speak someone and on the forums X speak to indemnity speak to an insurance. Speak to whoever you get tagged whatever how easy is it to get in touch? Is it email? Is it phone calls? Like how is support available? Because that for me is the most important thing. I’ve only had to use you guys once and it was like a really minor thing and just dealt by email and was like, I did nothing ever came of it.

And so I never even replied to that email. I’m sorry that never applied guys. It just never happened. So what’s the support like?

[Neel]
Well, I think the support is very good. And I think the way I feel it best works is. When you get a complaint, and I’ve had complaints, it’s really soul destroying. You feel like you’re stabbed in the back, you’ve done your best for the patient, you’ve really tried. Now, whether it’s communication, whether it’s the system you work in, or whatever, but whatever you do, we’re all trying to do our best. So, you’re upset, you’re angry, and you want to talk to someone quickly.

So, most people, and I would say, just WhatsApp me. So, you can WhatsApp me and Gary, and I think I’m on my WhatsApp eight hours a day, unfortunately. You know, that’s the phone. I will normally say, when’s a good time to speak, and I’ll talk to them. And they’ll either just want, what’s the helpline number, or who do I contact, or I’ve got a letter, and I’ll put them the right way.

Or they might say, well, nothing’s happened yet, but I’m upset about something, and I just wanted to chat. So, we’re always there to put an arm around you and just say, okay, what happened, okay, let me explain. And see where it is. And then if they want to go to some proper advice, I mean my advice is reasonable, but you really want, if it’s getting serious, you want some proper advice.

What we’ll do is we’ll put you to, we’ll give you the broker’s number, email, whatever you, however you want to contact them. They’ll data gather what’s happening, i. e. the notes, records, put everything together. And from there, we’ll make a decision. Do you need to speak to a dental legal advisor? I. e. it’s something more clinical or something that based or actually is this a lawsuit now you need to speak to lawyers.

And the two act very in different ways really and you have to have courses for courses. There’s no point having a dental legal advisor trying to represent you in court. So we try and add that way for the funnel you and then figure out which pathway and then you will liaise with them. And with us, if you have any issues whatsoever, if you feel like someone’s letting you down or you’re not getting through someone, WhatsApp me.

I’ve got the hotline to Batman, and we will get it sorted for you. So, sometimes mistakes might happen, emails going to junk, you’re not sure about something. What we do is we’re your advocate. You’re not alone. We want to help you through the process emotionally and making sure you’re getting the right people.

And our lawyers are probably the biggest law firm in England. So I think to be honest, most lawyers deal with a few different insurers anyway. So whether you’re with dental protection or with us or whatever. There’s a cross reference of lawyers that people will use, so you know you’re getting a very experienced and the best lawyers and the best advice. And if you’re not, you come and let me know and we’ll make sure anything’s sorted out.

[Jaz]
Neel, having you on WhatsApp is like having your technician on WhatsApp and sending cases and just communications there. And I feel supported, which is great. But I’m going to ask you a tricky question, a bit of a curveball. I’m sorry for it, but I have to do it.

Let’s say you decide that for a family move, you want to, in five years’ time, you want to move to Singapore. You, Cam, are you going to move to Singapore, live the good life in Singapore? And you said, you know what? I’m going to sell PDI. I’m going away. How are things, how are contingency plans and insurance products there to make sure that everything is well looked after and everything’s in order? Is it just you or like, how does it actually work? I’m sorry if that’s a tough question, but I think these are things that we need to know.

[Neel]
Well, it’s a very good career because your career will be longer than my career in indemnity. So we have to see where we’re going after that. And you want that support and help. So as you know, my little one is two, so I don’t envisage ever retiring. So, I’ll probably cut my clinical right down. But to be honest, the indemnity side of thing is actually, I wouldn’t say it’s fun because insurance is a really boring subject. And if you’re just based on insurance and getting premiums and be a salesperson, it’s not for me.

But what’s really nice about my job is helping a dentist pick up the phone, sharing my experience, helping them get better. A bit like you, educating dentists to be better, record keeping, I know you’ve done some brilliant stuff on that. So I can’t see myself retiring, or at least not being a figurehead or being part of it.

And also Cam will be there as well, and she’s a little bit younger than me, so she’s always there as well. So the continuity is going to be there. And by that time, Aria will be a dentist as well. So we’ll have, so it is there, but to be honest, if we just disappear, let’s just say, COVID three, whatever-

[Jaz]
You mentioned, you’ve hinted a few times that there is a doubt whether these other products like the claims occurred, traditional mutual company may not be able to do the handshake product for much longer.

You never know, but this could be the case. And so there’s that uncertainty, but there’s uncertainty with any insurance product that you take basically, but because the baton is renewed every year, I guess that’s what keeps you, keeps it alive, right?

[Neel]
And also your product actually isn’t with us. We are introducers. We are there as your advocates. We are there to help dentists get looked after. Your actual product is with the insurer. And the insurer is, the amount of capital they have is much, much higher than the mutuals. I mean, they are, billion-dollar companies that aren’t going anywhere with the city of London tower blocks.

So your product is always safe for now. And if we’re not there, they’ll still be there. Brokers will still be there. And hopefully we’ve instilled such a good relationship with the team and the brokers that you’ll be equally well looked after. And that’s what you want from a practice, isn’t it? But the principles there are not, you’re going to be there well looked after.

So, hypothetically, 10 years, 15 years down the line, will we still be there? I can never say. But your product will still be there. Your underwriter will still be there. Some form will be there. And hopefully our legacy will still be there.

[Jaz]
Amazing. I think I’m happy that we covered everything because I want to dispel this topic. I learned a lot, as you know. I feel like relearning and stuff because I feel like you explained this stuff to me before, but it’s something I don’t often think about. Thankfully, indemnity insurance is a boring topic. Let’s admit it, right? But it’s such an important one. That’s why we had to talk about it.

So is there anything else that you feel we need to touch on to make sure we’ve armed dentists with enough knowledge about this topic of traditional indemnity versus insurance?

[Neel]
I think probably the take home message is don’t just go on recommendation unless it’s someone learned who understands the product and don’t just go on Facebook if 10 people say something it’s not valid it’s still good to have and it’s a start but do your own understanding make sure you understand the terms even if you don’t want to go with us ring me up and just say Neel I don’t quite understand I’m happy to spend 10 minutes with you explaining it for your own good because you might not want to come to us, but you’ll come to us next year or the year after.

It’s all goodwill. So if you’re not sure, if your indemnifier is not helping you understand, give me a shout on Facebook, Instagram, whatever. So, the bottom line is I’m here to help you whether you’re a client or not in terms of understanding the policy. And second thing is please in an environment of a practice which is supportive where all the team are on board because complaints happen right from the start, when the patient walks in the reception doesn’t smile.

So make sure you’re in that real team effort where you’re supported. And then obviously, third thing is writing your notes and keep learning. And again, I learn every time I watch one of your podcasts and even at my age, it’s really good to just keep going. Don’t get down a funnel of misery because learning is fun and learning new things is fun.

And so don’t feel it’s all doom and gloom and indemnity insurance. You can have like lots of dentists, never a claim, happy patients, productive life. It is possible, so don’t let this topic, understand it, but don’t let it think it’s doom and gloom. This is actually here to support you. And then the odd niggle comes along, we’re there for you, that’s what you’re paying for.

[Jaz]
That’s right, and it’s something that I think you should focus a lot of time and energy on, well not time, but energy and thought and brain power into when you’re at the decision-making stage. Once you did it, once you signed the deadline, set and forget and enjoy your life, right? And then if you ever need it, then have that support.

And we’ll have to discuss how you want people to contact you for advice and stuff, because I imagine a lot of people will be like, you know what, Neel talks a lot of sense, let me get in touch with him. Do you want your phone number, lots of phone calls and stuff, or maybe email and to filter things on Instagram. So we have to figure out a way of doing this.

[Neel]
Well, yeah. I’m happy to email me. That would be easiest. And it’s a Neel, neel@professionaldentalindemnity.co.uk.

[Jaz]
Amazing. I’ll put that in the show notes as well. Neil, thanks so much for your time and we have got a whole series coming up of staying out of trouble.

And so we’re going, I’m not going to reveal any more about that just yet, but there’s lots of different scenarios. We’re going to cover real world scenarios, because I think it’s part of education. Whilst it, this was a big burning question indemnity versus insurance. I’m a big, I like scenarios.

Like those random scenarios I gave you. I love scenarios of what happens if, literally I Instagram saying, Jaz, can you help me? I gave a restored an upper lateral. I gave some local anesthetic articane with adrenaline, and now the patient’s got a droopy eyelid. Now they’re getting severe headaches the day after.

I’m panicking. Any random scenario, basically just what are the things that we should be doing? And then we can look at the factors before it happened. Factors during factors afterwards, how to make sure ultimately our patients are well looked after, but also so it doesn’t steal your piece of today that you can sleep well at night. So those are the focus scenarios that we’ve got coming. So I look forward to that.

[Neel]
Absolutely.

Jaz’s Outro:
So there we have it guys. Thank you so much for listening all the way to the end. Hopefully it’s a little bit clearer now indemnity versus insurance, claims occurred versus claims made. I enjoyed the Rolls Royce analogy. I enjoyed the baton analogy. So who’s holding your baton right now and who’s holding your batons of the past?

If you want to take action on this episode, if you want to find a quote for yourself with PDI, who I trust a lot, I’m a big fan of Neel, such a conscientious, lovely guy. And just anytime I needed him with these kinds of matters, he’s been there for me.

Once again, you go to protrusive.co.uk/insurance, fill in the form and get your quote. You can inquire further by protrusive.co.uk/insurance once again. And for those Protruserati as part of the Protrusive membership, head to protrusive.app on this episode or on your app, answer the few questions and you get this very useful CPD when it comes to medico legal CPD.

Okay. So, you’re going to get a CPD certificate with the reflections all on their email to you by our team. Thanks so much again for listening all the end. I’ll catch you guys in the next episode.