Claims Made vs. Occurrence Policies
EDIC offers dentists two different forms of dental professional liability (malpractice insurance) policies:
Claims Made Policy
A Claims Made contract provides a policy for any covered claims that occur and are reported while the policy is in place. The claim must be reported during the policy term and the claim must have also occurred during the policy term. In addition, the event must have occurred on or after the retroactive date.
An Occurrence contract provides a policy for an event or incident that occurs during the policy term, regardless of when the claim is reported. An Occurrence Policy covers a dentist even if the claim is not reported or discovered until months or years after the policy is terminated.
Frequently Asked Questions (FAQs)
- Is one policy better than another?
- How do I know which policy to choose?
- How long is an Occurrence Policy in effect?
- How long is a Claims Made Policy in effect?
- What is a retroactive date? What is a prior acts date?
- I was told I needed to get a "tail." What is that and why do I need it?
- How much does a "tail" cost?
- Do you need a "tail" with both a Claims Made Policy and an Occurrence Policy?
- Why did my Claims Made Policy rate increase the 2nd year?
- I am going to be moonlighting. What kind of policy do I need?
- What is a full-time policy?
- What is a part-time policy?
- I anticipate moving to a different state next year. Right now I have a Claims Made Policy. Will my EDIC insurance cover me when I move? What do I need to do when I move?
Is one policy better than another?
Both a Claims Made Policy and an Occurrence Policy provide professional malpractice insurance coverage. The best choice depends on your individual malpractice insurance needs.
How do I know which policy to choose?
Choosing between a Claims Made Policy and an Occurrence Policy depends on individual circumstances. Your first step should be to call an EDIC Customer Service Representative, free-of-charge, at 800-898-3342. Our representatives will discuss your individual situation and options, and outline the different costs associated with each policy.
How long is an Occurrence Policy in effect?
The policy term of an Occurrence Policy is that time between the inception date (or start date) and the expiration date of the policy.
How long is a Claims Made Policy in effect?
The policy term for a Claims Made Policy is for one year (365 days) and may be renewed each year. As long as a dentist continuously renews his or her Claims Made Policy with EDIC or has an extended reporting endorsement "tail" coverage, he or she may report claims for incidents that occurred in previous policy years as far back as the retroactive date of the policy.
What is a retroactive date? What is a prior acts date?
A retroactive date is the original "start" date of a Claims Made Policy. A prior acts date is simply a different term for a retroactive date and means the same thing.
I was told I needed to get a "tail." What is that and why do I need it?
When an EDIC insured dentist with a Claims Made Policy leaves the EDIC program for any reason, he or she should purchase an extended reporting endorsement or "tail" coverage. This endorsement provides a single set of limits for all future claims. A dentist needs a "tail" if leaving dentistry or if a new employer does not pick up and provide Prior Acts Coverage.
How much does a "tail" cost?
The cost of a "tail" or extended reporting endorsement depends on individual circumstances. The "tail" is a one-time payment, but the "tail" is free when a dentist is aged 50 or older and has been with EDIC for at least five years or upon death or permanent disability.
Do you need a "tail" with both a Claims Made Policy and an Occurrence Policy?
The "tail" coverage applies only to a Claims Made Policy.
Why did my Claims Made Policy rate increase the 2nd year?
Your Claims Made Policy "steps up" or is structured to increase every year for five (5) years, at which point it reaches "maturity". Each situation varies, but for most dentists, the Claims Made Policy remains less expensive than an Occurrence Policy, even with the stepped-up increases.
I am going to be moonlighting. What kind of policy do I need?
You will need a Moonlighting Policy. EDIC offers a moonlighting policy for those dentists who engage in clinical activities which exceed the parameters of their full-time professional liability policy with another carrier. Moonlighting policies are written on an occurrence basis only and allow for 10 (ten) hours a week chair side.
What is a full-time policy?
A full-time policy is needed for dentists who are working more than 18 hours per week (Sunday through Saturday). EDIC provides two kinds of full-time professional liability policies: a Claims Made Policy and an Occurrence Policy.
What is a part-time policy?
A part-time policy is needed for dentists who work on average 18 hours per week or less (Sunday through Saturday) and no more than 936 hours per year. EDIC offers a part-time policy for dentists who meet these criteria. A part-time policy is written on either an occurrence or a claims made basis.
I anticipate moving to a different state next year. Right now I have a Claims Made Policy. Will my EDIC insurance cover me when I move? What do I need to do when I move?
EDIC insures dentists in Massachusetts, Connecticut, Vermont, Maine, New Hampshire, Rhode Island, New York, New Jersey, Pennsylvania, Virginia and North Carolina. If you are insured by EDIC and move within this region, EDIC will continue to cover you and will rewrite you in the new state. If you move to a state where EDIC does not insure dentists, you will need to make sure that your new employer provides you with Prior Acts Coverage. If not, you will need to purchase an extended reporting endorsement (a "tail") from EDIC.