Dental Essentials. Claims Scenarios

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1 Dental Essentials Claims Scenarios

2 Dental Essentials Claims Case Studies We know how hard and time consuming it is to run a professional practice. That s why we designed an exclusive, competitive and comprehensive insurance cover to help you protect your operations and the investment you have made in your business. Our Dental Essentials Insurance Policy offers an extensive range of cover options for your dental practice such as damage or breakdown of your dental equipment, loss of revenue, cyber liability, management protection and many others. It can also be tailored to meet the requirements of your business and your budgetary constraints for example increase excesses to lower the premium you pay. To help you understand the importance of some of the policy sections and covers, we have provided a selection of claims case studies in this document *. Please take the time to read the scenarios and please contact us if you have any questions on what your insurance policy covers in these situations. Your circumstances will change with time and our advice is for dentists to have a detailed review of their insurance policies at least every 5 years. Your practice is not the same now as it was five years ago which means your risk exposure has changed and needs to be reassessed by an experienced broker who can offer good advice and a full market range of insurance options. Contact Dental Essentials today for an obligationfree review and quote on your insurance needs. We guarantee to beat your existing Practice Insurance premium by 10%. About Dental Essentials Dental Essentials is a specialist provider of insurance and risk management services for Dental Professionals and the market leader in Dental Practice Insurance provision. As a joint venture between Bruce Insurance, a leading business insurance broker, and Dental Innovations, a national network of dentists, we have the insurance expertise and the dental profession understanding to provide quality advice and excellent insurance services for your specific business needs. *Certain information about the businesses involved has been withheld to protect the confidentiality of our customers and some of the scenarios are fictional. The case studies have been presented in a summarised form and do not include all relevant details or circumstances pertaining to the claim. This booklet does not cover all claims scenarios or all benefits of the policy and should be used as a general guide only. Depending on your actual policy terms and the sections that you are insured for, a similar situation occurring to your business may be covered completely, partially or not at all. Unless specified otherwise, the claims cases are examples of dental surgery claims. Innovative Insurance Joint Venture Pty Ltd T/as Dental Essentials ABN is an Authorised Representative of Bourchier Nominees Pty Ltd AFS License

3 Contents 3 EQUIPMENT BREAKDOWN AND CYBER RISKS 4 Dental tools breakdown 4 Cyber risks - computer hacking and computer virus 4 PROPERTY DAMAGE AND BUSINESS INTERRUPTION 5 Storm damage 5 Dental chair connection failure 5 ACCIDENTAL DAMAGE 6 MANAGEMENT LIABILITY 7 Employment practices liability 7 Statutory liability 7 BURGLARY, THEFT, GLASS & MONEY 8 EMPLOYEE DISHONESTY 8 TAX AUDIT 9 PUBLIC LIABILITY 9

4 Equipment Breakdown and Cyber Risks DENTAL TOOLS BREAKDOWN Example 1: Dental air compressor motor burn-out The dental air compressor motor of a dental practice burned out and no longer worked. Cost to reinstate motor $5,690 Loan unit required for 2 weeks during reinstatement $500 Example 2: OPG Xray unit breakdown A dentist s OPG Xray unit broke down. Inspection by the technician revealed that the unit s main circuit has burnt out. Cost to reinstate the equipment $ 8,000 Dental Essentials Insurance Policy will provide blanket cover for all equipment and machinery when this section of the cover is selected. CYBER RISKS - COMPUTER HACKING AND COMPUTER VIRUS Practice s computer network infected with virus A computer virus infects a dental practice s network, rendering the server and workstations inoperative. The practice s management hired IT professionals to restore data and fix the system. Temporary equipment was rented during this time. In addition, employees were required to work overtime to make up for the lost appointments due to this interruption. Cost to restore data: $10,000 $10,000 Increased costs of working including staff overtime and rental equipment $9,500 Dental Essentials Insurance Policy provides up to $10,000 for restoration of records and $10,000 for additional costs of operating your business following a computer virus or an attack by a computer hacker. This additional benefit is provided automatically when Electronic Equipment Breakdown is included in your policy. This benefit is unique to the market and is exclusive to Dental Essentials Insurance Policy.

5 Property Damage and Business Interruption 5 STORM DAMAGE Property damage caused by storm A severe storm ripped off the roof of a dental practice. The practice s equipment and shop fit-out suffered from severe water and storm damage. The premises landlord was not very helpful. He provided no indication of the timeframe for the building repair. The dental practice was unable to trade, which resulted in loss of income. It was agreed that the surgery will re-establish in a new location. DENTAL CHAIR CONNECTION FAILURE Equipment damage which resulted in a business interruption The dental surgery suffered from water damage to its carpets and cabinets due to the failure of a dental chair connection during a weekend. Cost to reinstate carpets $5,500 Cost to reinstate cabinets $10,000 Cost to reinstate damaged equipment and to ship fit-out $45,350 Loss of business revenue $82,500 Penalty for breaking the lease $7, Most insurance policies have limits on what they pay. Make sure that the limits are sufficient for your business. The Dental Essentials Insurance Policy automatically includes extensions to cover your business. For example: Removal of debris of $100,000 Architects fees of $50,000 Rewriting of records and documents of $50, Business Interruption is an essential part of most insurance policies. While it costs extra, it provides cover for any income you lose if you are unable to trade and other costs incurred to get your business back in operation.

6 Accidental Damage A STAFF MEMBER DROPPED THE EQUIPMENT X-ray sensor damaged An Xray sensor was accidentally damaged when dropped by a staff member in a dental practice. The inspecting technician confirmed that the sensor was not repairable. Cost to replace $11,768 INCORRECT CONNECTION FOR WATER LASER Water laser damaged An operator of a dental practice accidentally connected the water line of the laser to an air line, which caused damage to the water laser. Cost to reinstate $15,407 It is essential that your insurance cover includes accidental damage. The Dental Essentials Insurance Policy includes accidental damage for all items insured.

7 Management Liability 7 EMPLOYMENT PRACTICES LIABILITY Example 1: Sexual harassment A female dental assistant at a small dental practice claimed that her manager had sexually harassed her at a work function. The assistant also claimed that she was tagged as a troublemaker after she made a formal complaint about the harassment. She then proceeded to make a formal claim against the firm and the principal dentist. The firm settled for $45,000. Example 2: Redundancy and discrimination A dental group with multiple branches was forced to make some staff members redundant. Whilst all the appropriate procedures were followed, three employees felt they were discriminated against because of their mature age. These employees made a claim against the company for discrimination. The company ended up settling the claim with each employee for $20,000 a total of $60,000. STATUTORY LIABILITY Example 1: Dental assistant hurt onsite A dental assistant was seriously hurt at a worksite. The dental practice was subject to a full Occupational Health and Safety (OHS) investigation, resulting in a $25,000 fine and $80,000 defence costs. Example 2: Selling items without safety labels A dental practice was investigated and found guilty of selling certain items without the required safety labels attached. They were fined $15,000. Including Statutory Liability cover as part of your Management Liability package provides cover for fines and breaches like these up to the selected limit of indemnity. Include full Employment Practice Liability cover in your insurance policy to protect your practice from claims against management.

8 Burglary, Theft, Glass and Money Employee Dishonesty STOLEN DENTAL AIR COMPRESSOR Stolen equipment A dental air compressor was stolen from a dental practice. The air compressor was removed from building over the weekend. The practice incurred expenses for hiring a temporary rental unit and the replacement cost for the compressor when it became available from supplier. Cost for loan unit $350 Cost for replacement unit $9,930 DENTAL PRACTICE ROBBED Property damage and theft A dental practice was robbed on a Sunday night. The front glass doors were smashed and the locked drawers were damaged. Cash, a laptop and camera equipment were stolen. Both the glass window and the shop front signage needed to be replaced. The glass window and doors were temporarily repaired until the required replacement glass was available. DISHONEST EMPLOYEE STEALING CASH A practice manager was stealing from a dental surgery over a period of 6 months. The stolen money comprised a total of $12,048 in bank transfers from the surgery to her own account, $650 cash received but not banked, and $1,750 in unauthorised use of the practice s credit card to pay for her home improvements. The full stolen cash amount $14,448 The Dental Essentials Insurance Policy includes the standard employee dishonesty cover for up to $20,000. Additional cover can be purchased if a higher policy limit is preferred. Laptop and camera equipment $56,000 Glass window and doors $1,250 Cost for temporary repairs $250 Signage $750 Cash $300 The Dental Essentials Insurance Policy includes signage cover of up to $8,000, full theft standard cover up to a $2 million limit, cash standard cover under the theft section of $500, temporary repairs cover, and standard cover for attendance by a security patrol or guard if required.

9 Tax Audit Public Liability 9 AUDIT CARRIED OUT BY THE AUSTRALIAN TAX OFFICE The Australian Tax Office (ATO) carried out a random audit of a dental practice to ensure that all tax returns were correct. The audit encompassed five years of: Business Activity Statements (BAS) general ledger debtors income tax depreciation car log books. The business s accountant charged the practice a fee to retrieve, supply and send the information to the ATO. Professional fees charged by accountant $9,367 The ATO has the right to audit a business s tax returns, which usually involves the services of an accountant. Your accountant normally charges extra for this. The Dental Essentials Insurance Policy provides Tax Audit as a standard benefit for up to $10,000. Additional cover is available when Management Liability cover is taken. PATIENT FELL OVER AND SUSTAINED INJURIES An elderly dental patient fell over at a dental surgery. She claimed that her fall was caused by an associate dentist bumping her from behind in a hallway. She broke her shoulder and sustained bruising and lacerations in the fall. The associate dentist disputed the claim. He believed the patient was unsteady on her feet and fell on her own because she failed to use her usual walking aids. The matter eventually ended up in court. Legal defense costs $50,000 Negotiated compensation $45,000 INSURANCE LESSON Practices cannot foresee or prepare for all events. Accidents happen and liability insurance can ensure that a practice is covered for such unfortunate events.

10 CONTACT US DENTAL ESSENTIALS P: F: E: W: Lumley Insurance is a trading name of WFI Insurance Limited ABN AFS Licence No The Greater Than symbol is a registered trademark of Lumley Insurance. MKT4968 (1014)