Your Dental Malpractice Renewal Went Up. Read These Four Lines Before You Switch Carriers

Your dental malpractice renewal arrives, and the premium is higher than last year.

Your first reaction may be to shop for another carrier.

That may be the right decision, but price should not be the only thing you compare. A less expensive proposal can create a serious coverage problem if it changes your policy form, liability limits, retroactive date, or license defense protection.

Before you switch carriers, place your current policy, renewal proposal, and alternative quote side by side. Then read these four lines carefully.

Why Dental Malpractice Premiums May Be Increasing

A higher renewal premium does not necessarily mean the carrier applied a simple rate increase.

The cost can change because of:

• A change in the carrier's filed rates
• Increased liability limits
• A change in procedures or services
• The addition of an associate dentist
• A new location
• A change in annual revenue or patient volume
• Claims or reported incidents
• The removal or reduction of a discount
• Movement through the early stages of a claims made policy
• Changes in the broader professional liability market

The 2027 Insurance Marketplace Realities report from WTW forecasts increases of 10 to 20 percent for healthcare professional liability broadly. It also notes that competition remains strong in many segments. That is not a dental specific prediction, and it does not mean every dentist will receive an increase within that range.

It does indicate that claim severity, medical costs, settlement values, and large verdicts continue to influence professional liability pricing.

The important question is not simply, "Why did my premium increase?"

It is, "What changed between my current policy and this renewal?"

Line 1: The Premium and What It Is Based On

Start with the annual premium, but do not stop there.

Ask whether the higher number reflects an actual rate increase or a change in the exposure being insured.

Compare the expiring policy and renewal proposal for:

• The dentists listed
• The legal entity named as the insured
• Practice locations
• Procedures and specialties
• Annual revenue or patient volume, when used
• Part time or full time status
• Applicable discounts
• Claims history
• Policy fees
• Liability limits

A premium can rise even when the carrier's underlying rate has not changed.

For example, adding an associate dentist, increasing policy limits, opening another office, or beginning to perform higher risk procedures may increase the premium because the exposure changed.

Claims Made Step Rating Can Look Like a Rate Increase

Dentists with newer claims made policies should also ask whether the policy is still progressing through a step rating period.

A claims made policy may begin at a lower premium because the carrier initially has a limited period of prior exposure to insure. As the policy continues and the period of covered professional services grows, the premium may increase until it reaches a mature level.

That scheduled increase is not necessarily the same as the carrier raising its rates.

If your renewal increased, ask:

Did the carrier change its rate, or is this policy moving through a normal claims made step?

The answer matters when comparing the renewal with an alternative quote. A new carrier's introductory price may appear lower for reasons that do not make it an equal comparison.

Line 2: The Per Claim and Aggregate Limits

The second line to review is the limit of liability.

Dental malpractice policies commonly show both a per claim limit and an aggregate limit.

The per claim limit is the maximum amount available for a covered claim, subject to the policy's terms. The aggregate is generally the maximum amount available for covered claims during the policy period.

A renewal premium may increase because the limits increased. An alternative quote may look less expensive because it provides lower limits.

For example, these are not equivalent proposals:

• $1 million per claim and $3 million aggregate
• $1 million per claim and $1 million aggregate
• $500,000 per claim and $1.5 million aggregate

The first number may look familiar while the aggregate is materially different.

Also ask whether defense expenses reduce the liability limit. Two policies displaying the same limits may provide different amounts of practical protection if one pays defense expenses inside the limit and another handles them differently.

Before reducing limits to save premium, consider:

• State requirements
• Employment agreements
• DSO or group participation requirements
• Lease or lending requirements
• Hospital privileges
• Managed care contracts
• Procedure complexity
• The number of insured dentists sharing the aggregate
• Whether the entity and individual dentists share one limit

The cheapest quote is not less expensive if it solves the premium problem by removing protection you intended to keep.

Line 3: The Policy Form and Retroactive Date

This may be the most important part of the comparison.

Determine whether the policy is written on a claims made or occurrence basis.

Occurrence Coverage

An occurrence policy generally responds based on when the alleged treatment or incident occurred.

If a covered incident happened while the occurrence policy was active, that policy may respond even if the claim is made after the policy ends, subject to its terms and conditions.

Claims Made Coverage

A claims made policy works differently.

The policy generally must be active when the claim is made and, depending on the form, when it is reported. The alleged professional service must also fall on or after the applicable retroactive date.

If you switch from one claims made carrier to another, do not look only at the new effective date.

Look at the retroactive date.

Suppose your current policy shows:

Retroactive date: January 1, 2017

You receive a less expensive quote from another carrier, but the new proposal shows:

Retroactive date: January 1, 2027

That new policy may not provide prior acts coverage for qualifying professional services performed between 2017 and 2026.

You may need the new carrier to honor the earlier retroactive date or consider an extended reporting period, commonly called tail coverage, from the prior carrier.

Do not cancel the existing policy until you have a clear written answer to this question:

If a patient makes a claim next year involving treatment I performed five years ago, which policy is expected to respond?

"Prior acts included" is encouraging, but verify the actual retroactive date and the people and entities receiving that protection.

For a more complete explanation, read Dental Malpractice Tail Coverage: What Happens When You Sell, Retire, or Change Carriers?.

Line 4: The License Defense or Board Complaint Limit

A malpractice lawsuit and a dental board complaint are not the same thing.

A malpractice claim generally involves a demand for damages arising from alleged professional negligence. A board complaint is an administrative or regulatory matter involving the dentist's license and ability to practice.

A patient dispute can lead to one, the other, or both.

Some dental malpractice policies include license defense coverage. Others offer it by endorsement. The available limit may be much lower than the primary malpractice limit.

For example, a policy may provide a seven figure professional liability limit but only a relatively small sublimit for board proceedings.

When comparing policies, ask:

• Does the policy include license defense coverage?
• What is the applicable limit?
• Is that limit per proceeding or for the entire policy period?
• Do attorney fees reduce the limit?
• Does coverage apply to informal inquiries or only formal proceedings?
• Who selects the attorney?
• Are subpoena assistance or record requests included?
• Are fines, penalties, or lost income excluded?
• What reporting deadline applies?
• Is the license defense limit shared among multiple dentists?

A cheaper policy may provide less license defense protection or omit it entirely.

That difference matters because even a complaint that does not result in discipline may require legal advice, document preparation, correspondence, and representation.

For more information, read Dental Board Complaints: License Defense Coverage.

Four Additional Questions to Ask Before Switching

Once you have reviewed those four lines, ask a few broader questions.

Is the Practice Entity Covered?

Do not assume that coverage for the individual dentist automatically protects the professional corporation, partnership, limited liability company, or other practice entity.

Confirm which individuals and entities are named or otherwise qualify as insureds.

Are All Dentists Properly Listed?

Review owners, associates, independent contractors, temporary dentists, and any dentist who has recently joined or left the practice.

The policy should accurately reflect who is providing professional services and how each person is insured.

Are Your Current Procedures Accurately Described?

A practice may have added implants, sedation, cosmetic procedures, oral surgery, mobile services, or another treatment area since the policy was originally issued.

The carrier needs an accurate description of the practice. Do not assume a new service is automatically included because it falls within the dentist's license.

Are You Comparing the Entire Policy?

Premium matters, but so do:

• Coverage exclusions
• Consent to settle provisions
• Defense arrangements
• Claim reporting requirements
• Coverage territory
• Coverage for employees and the entity
• Cyber or privacy extensions
• Regulatory defense
• Subpoena assistance
• Risk management services
• Carrier financial strength
• Claims handling experience

A quote comparison should identify meaningful differences rather than placing two premiums beside each other.

When Switching Carriers May Make Sense

There are legitimate reasons to move a dental malpractice policy.

Another carrier may offer:

• More competitive pricing
• Better coverage terms
• Stronger license defense protection
• More appropriate limits
• Prior acts coverage
• Better claims service
• Better risk management resources
• A stronger fit for the procedures performed
• More effective coverage for the practice entity and associates

The point is not to avoid switching.

The point is to make sure the switch is deliberate and that protection for prior dental work does not disappear during the transition.

A Dental Malpractice Renewal Checklist

Before accepting the renewal or switching carriers, confirm:

• Why did the premium change?
• Did the number of insured dentists change?
• Did the practice add locations, services, or procedures?
• Are the per claim and aggregate limits the same?
• Are defense expenses inside or outside the limits?
• Is the policy claims made or occurrence?
• What retroactive date appears on the current policy?
• Will the new carrier honor that date?
• If not, is tail coverage needed?
• Is the legal practice entity insured?
• Are all owners, associates, and contractors addressed?
• What license defense coverage is included?
• What exclusions differ between the policies?
• Have any incidents or circumstances occurred that may need to be reported before the current policy ends?
• Has the comparison been completed before the existing policy is canceled?

The Bottom Line

A higher dental malpractice renewal deserves an explanation.

Sometimes the increase reflects a carrier rate change. Sometimes it results from higher limits, a new dentist, expanded procedures, a lost discount, claims experience, or normal claims made step rating.

Shopping the policy may be appropriate. But before switching, read four lines carefully:

1. The premium and rating basis
2. The per claim and aggregate limits
3. The policy form and retroactive date
4. The license defense limit

A lower premium is only an improvement if the new policy still protects the dentist, the practice entity, and the professional services performed in prior years.

If your dental malpractice renewal increased and you would like help comparing it with another option, I would be happy to review the policies side by side and explain the differences before you make the change.

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This article is for general informational purposes only and is not legal advice or a guarantee of insurance coverage. Policy terms, state requirements, underwriting practices, and individual circumstances vary. Coverage is subject to the terms, conditions, limitations, and exclusions of the applicable policy.

For a broader look at the coverage considerations for your practice, visit the dentistry insurance page.