Do Associate Dentists Need Their Own Malpractice Insurance?
As an associate dentist, you focus on treating patients, improving clinically, and building production.
But every procedure you perform also carries malpractice risk.
Your employer may already provide malpractice insurance. If you work for a larger group or DSO, it may simply be included as part of your employment.
So the question is:
Do associate dentists need their own malpractice insurance policy?
That is the question I am seeking to answer today.
If your employer provides good coverage, you may not need to purchase another policy.
But you should not stop at:
“My employer covers me.”
You need to understand how they cover you, what happens when a claim occurs, and what happens to that coverage when you leave.
Here are the questions I would ask.
1. Is My Employer Actually Providing Malpractice Coverage for Me?
Start with the simplest question.
Who is responsible for your malpractice insurance?
Your employment agreement should make this clear.
The practice may purchase the policy and pay the entire premium.
The practice may reimburse you for your own policy.
Or the contract may make you responsible for obtaining coverage yourself.
Do not leave this vague.
Malpractice insurance should be specifically addressed in your employment agreement, including who purchases it and the limits you are required to carry.
The ADA also recommends addressing professional liability insurance directly in an associate employment agreement, including the type and amount of coverage required.
If your employer provides the coverage, ask to see evidence of it.
You are the dentist performing the procedures.
You should understand the insurance protecting you.
Learn more: Dental Malpractice Insurance for Dentists
2. Is the Policy Occurrence or Claims-Made?
This is one of the most important questions.
There are two common forms of dental malpractice insurance: occurrence and claims-made.
Occurrence Coverage
An occurrence policy generally responds based on when the treatment or incident happened.
If the covered treatment occurred while the policy was active, the policy can generally respond even if the patient makes the claim years later, subject to the policy terms.
Claims-Made Coverage
Claims-made coverage works differently.
Generally, the policy needs to be active when the claim is made and reported, and the treatment must fall after the applicable retroactive date.
This is where associates need to pay very close attention.
Because eventually, you are probably going to leave that job.
And when you do, you need to know what happens to the work you performed while you were there.
3. Who Pays for Tail Coverage When I Leave?
In our opinion, this needs to be addressed before you sign the employment agreement.
If your employer provides a claims-made malpractice policy, ask:
Who is responsible for the tail when I leave?
Tail coverage, technically called an extended reporting period, allows certain claims to be reported after a claims-made policy ends for treatment that occurred while the policy was active.
Without the right arrangement in place, you could leave the practice but still have exposure from dentistry you performed while working there.
This is why tail coverage should be part of the contract negotiation.
Do not wait until you resign to start asking:
“Who is paying for my tail?”
Get the answer in writing before you start.
Ideally, the employment agreement should clearly state whether:
- The employer pays for the tail
- The associate pays for the tail
- The cost is shared
- The obligation changes depending on why employment ends
- Prior acts coverage with a new insurer may satisfy the requirement
There is no single arrangement used by every dental practice.
But there should be an arrangement.
Our recommendation is simple: make sure your previous work remains properly insured when you leave, and make sure the contract clearly explains who is responsible for making that happen.
That can become a significant financial issue if it is ignored.
4. What Are My Malpractice Limits?
Next, find out how much coverage you actually have.
A common malpractice limit might look something like:
$1 million per claim / $3 million aggregate
But do not stop at the number.
Ask:
Are these limits specifically available to me?
Are any limits shared with other dentists or the practice?
Does the entity have separate coverage?
Group malpractice programs can be structured differently.
The phrase “we provide malpractice insurance” does not tell you enough.
You want to understand how much protection is actually available if you are named in a claim.
5. Does the Policy Cover Everything I Do?
Your malpractice insurance needs to match the dentistry you actually perform.
That sounds obvious, but it is worth checking.
If you perform procedures such as:
- Implants
- Oral surgery
- Endodontics
- Sedation
- Botox
- Other advanced procedures
make sure the insurer knows what you are doing.
Also look at where you are working.
If you only work at one location for one employer, this may be simple.
But what if you:
- Moonlight at another office
- Work for two practices
- Pick up weekend shifts
- Perform work outside your primary employer
- Work as an independent contractor somewhere else
Do not automatically assume your employer’s malpractice insurance follows you everywhere.
If you work outside the practice, that can be one of the strongest reasons to consider carrying your own policy.
6. Who Controls Whether a Claim Is Settled?
This is where autonomy becomes important.
A malpractice claim is not only about money.
It involves your name.
Your reputation.
Your professional history.
If a patient brings a claim against you, there may come a point where the insurance company considers settling the case.
You need to understand who gets to make that decision.
Look for the policy’s consent-to-settle provision.
Some policies give the insured strong consent rights before a case can be settled.
Others may contain what is commonly called a hammer clause, which may create financial consequences if you refuse a settlement recommended by the insurer.
This is an important distinction.
Imagine the insurer believes settling a case for $50,000 is cheaper than taking it through litigation.
From a pure financial standpoint, that may make sense.
But you may strongly believe the treatment was appropriate and want the case defended.
That is when the wording in the policy matters.
Having your own individual malpractice policy can sometimes give you more autonomy over your insurance relationship, but the important thing is still the actual contract.
Whether the policy is purchased by you or your employer, find out:
Do I have the right to consent before a claim against me is settled?
7. Are Defense Costs Inside or Outside the Limits?
This is another question associates often overlook.
Suppose your malpractice policy has a $1 million limit.
There are two very different possibilities.
If defense costs are outside the limit, attorney fees and other covered defense expenses generally do not reduce that same $1 million liability limit.
If defense costs are inside the limit, the cost of defending the case can reduce the amount remaining for a settlement or judgment.
For example, if a case costs $150,000 to defend and defense is inside a $1 million limit, you may have $850,000 remaining.
Same $1 million headline.
Different protection.
Ask the question.
8. What Happens When I Change Jobs?
This is where all of the previous questions come together.
Associates change practices.
You may move.
You may receive a better opportunity.
You may eventually buy your own practice.
Your malpractice insurance needs to transition with you.
Before leaving, understand:
- Whether your current policy is claims-made or occurrence
- Your retroactive date
- Whether tail coverage is required
- Who is contractually responsible for the tail
- Whether a new insurer can provide prior acts coverage
- Whether any claims or incidents need to be reported before the old policy ends
You do not want to discover a malpractice coverage problem two years after leaving the practice.
So, Do You Need Your Own Malpractice Policy?
Maybe.
But not necessarily.
You may not need your own policy if:
Your employer provides strong malpractice coverage, the limits are appropriate, all of your procedures and locations are covered, you are comfortable with the settlement provisions, and your employment agreement clearly addresses what happens when you leave.
In that situation, your employer-provided policy may be perfectly adequate.
You should consider your own policy if:
- Your employer does not provide malpractice coverage
- You are an independent contractor
- You work for multiple practices
- You moonlight outside your primary employer
- The employer’s policy does not cover everything you do
- The limits are not adequate
- You want greater control over your insurance relationship
- You want coverage that can move with you between jobs
The important thing is not simply whether the policy is yours or your employer’s.
The important thing is whether the coverage actually protects you the way you think it does.
Questions to Ask Before Signing an Associate Contract
Before signing an employment agreement, I would want answers to these questions:
- Who is responsible for purchasing my malpractice insurance?
- What limits will I have?
- Is the policy occurrence or claims-made?
- If it is claims-made, who pays for tail coverage when I leave?
- Does that obligation change depending on why I leave?
- Are all of my procedures covered?
- Are all of the locations where I practice covered?
- Do I have consent before a claim is settled?
- Are defense costs inside or outside my limits?
- What happens to my malpractice coverage when my employment ends?
Those are questions worth answering before there is ever a malpractice claim.
The Bottom Line
As an associate dentist, you do not automatically need to buy your own malpractice policy just because your employer provides coverage.
But you do need to understand the coverage protecting you.
And in our opinion, one of the most important parts of that conversation happens before you even start the job.
Malpractice insurance should be part of the employment contract negotiation.
Know who pays for the policy.
Know what kind of policy it is.
Know your limits.
Know your settlement rights.
And if the policy is claims-made, know exactly who is responsible for protecting you after you leave.
That is much easier to negotiate before signing an employment agreement than after you have already resigned.
Have Questions About Your Associate Malpractice Coverage?
At Insurance by Dentists, we work specifically with dentists and dental practices.
If your employer provides your malpractice insurance and you are not sure what it covers, or you are reviewing a new associate contract and want to understand your malpractice options, we would be happy to walk through it with you.
Learn more about dental malpractice insurance or schedule a call with Insurance by Dentists to review your coverage.
This article is for general educational purposes and is not legal advice. Employment agreements and insurance policies vary. Dentists should review contractual issues with appropriate legal counsel and insurance coverage with a licensed insurance professional.
