Frequently asked questions

Professional indemnity insurance protects you against a claim alleging that you have been negligent in the practise of the profession of dentistry. It covers the costs and expenses of defending a legal claim, as well as any damages (compensation) payable.

The Dental Board require the professional indemnity policy to cover all aspects of your practice, all locations where you practice and include appropriate retroactive cover and automatic reinstatement. The ADAQ insurance policy meets these requirements, as standard.

You are personally responsible for meeting the Dental Board’s registration standards relating to professional indemnity insurance. Ahpra undertake random audits to ensure that you have appropriate coverage.

If you practise without adequate professional indemnity insurance, Ahpra can take action against you which may include, for example, suspending your registration. Having appropriate professional indemnity insurance also provides you with personal security, it means that you are not personally liable to make payment for claims made against you.

The ADAQ insurance policy covers the practise of dentistry in any of the following fields:

• dento-maxillofacial radiologist/oral and maxillofacial radiologist/dental radiologist;
• endodontist;
• specialist in oral medicine/oral medicine specialist;
• oral pathologist;
• orthodontist;
• specialist in paediatric dentistry/paediatric dentist/paedodontist;
• periodontist;
• prosthodontist;
• specialist in public health dentistry;
• specialist in special needs dentistry;
• forensic odontologist/forensic dentist;
• dental hygienist;
• dental therapist;
• oral health therapist;
• dentist;
• clinical supervision of other practitioners;
• audit of other practitioners; and training of other practitioners.

*Please note the policy does not provide coverage to oral and maxillofacial surgeons.

The ADAQ insurance policy also provides limited additional cover (at no extra cost) for:

• Inquiry costs
• Defamation
• Intellectual property
• Medicare fraud and audit
• Health fund audits
• Privacy complaints
• Lost documents
• Court attendance costs
• Public relations expenses
• Molestation cover
• Good Samaritans act

Yes. Provided you notify ADAQ that you are placing implants as part of your practice and pay the loading, you will be appropriately covered. Anyone who places implants as part of their practice needs to notify ADAQ, except registered specialist periodontists.

Restorative procedures on implants do not require notification and are covered under the standard professional indemnity policy. 

Yes. Provided you notify ADAQ that you are performing fixed orthodontic treatment as part of your practice and pay the additional loading, you will be appropriately covered. Anyone who performs fixed orthodontic treatment as part of their practice needs to notify, except registered specialist orthodontists.

Removable appliances, such as clear aligners, and fixed retainers do not require notification and are covered under the standard professional indemnity policy.

Non-Cosmetic 

If a dentist is undertaking a treatment which falls within the scope of practice as a dentist, and the use of botulinum toxin or intra oral dermal fillers are in conjunction with a dental procedure and not for cosmetic improvement, the dentist will be covered under the standard professional indemnity insurance policy, and they will not need to take out the cosmetic injectables extension. This may include botulinum toxin or intra oral dermal fillers used in conjunction with dental procedures and as a treatment for TMJ issues, DAO and gummy smile. 

For cosmetic improvement

Members who have an ADAQ Insurance Policy may obtain extended professional indemnity insurance cover for the use of botulinum toxin and dermal fillers that are for cosmetic improvement. The standard ADAQ Insurance Policy remains in force. This botulinum toxin and dermal filler option is an extension available on request and on payment of an additional premium. The cover is available either for $1 Million or $2 Million, and Members may choose which amount of cover meets their needs.

An injectable cosmetic procedure in relation to the coverage afforded under the policy is defined by the following:

1. Cosmetic application of botulinum toxin outside of the oral cavity or jaws; 
2. Injections of dermal fillers within the peri-oral region, as well as the face; or 
3. Use of acrylic-containing materials, silicones, and hydroxyapatite fillers in the lips, cheeks and peri-oral region, provided that: 
   1. the above listed services are provided in conjunction with one or more other services listed in subparagraphs (i) to (xvii) of the "Dental Services" definition in the policy wording; and
   2. any injectable product administered is approved for use by the Australian Government Therapeutic Goods Administration; and
   3. the policyholder is appropriately registered and licensed as required by law to provide these services.  

The cosmetic application of botulinum toxin is limited to the face, as are injections of dermal and other fillers.  

The total liability in respect of all claims made under this extension during any period of insurance, will not exceed $1,000,000 (or $2,000,000 if selected), or the remaining limit of indemnity, whichever is the lesser. In all other respects the policy will remain unaltered. 

Yes, there is a retention or excess of $2,500 payable for claims paid.

You do not have to pay this if notifying circumstances or seeking advice and support from the ADAQ Compliance & Advisory Service Team. The retention is cost exclusive which means that the $2,500 is only required to be paid if a claim is made, accepted and paid by your insurer. This retention helps keep premiums down and only impacts those making claims, similar to other insurance policies you may hold such as car insurance. Please refer to the policy wording for further information or contact the ADAQ Compliance & Advisory Services Team [email protected]

Yes, absolutely. As long as you maintain your ADA membership you can insure through ADAQ. ADA Members from different states who wish to purchase an ADAQ insurance policy, please contact [email protected].

Run-off cover is available at no additional cost for qualifying members who notify ADAQ within the policy period. Your policy will be endorsed to provide ongoing indemnity cover for 84 months following the date you ceased practice.

It is important to notify ADAQ when you cease practice and within the insurance period. If you don't advise ADAQ, your policy will not be endorsed to provide run-off cover which may expose you to liability arising from claims, you first learn about beyond the date you ceased practice.

Professional indemnity insurance is structured on a “claims made” basis.  This means that you must hold insurance at the time the claim is made, not at the time the incident occurred.  Because of this structure, the Dental Board requires you to hold professional indemnity insurance at all times (which includes retroactive cover) and if you cease practice, to take out run-off cover (which is essentially, professional indemnity insurance for people that cease practise permanently) for the treatment you provided while practising in Australia. 

So, what this means is that whilst you are a student, you are covered by the university for work with the university only.   The university insurance cover would not typically provide you with retroactive cover, which covers the work that you undertook prior to studying. Therefore, if you do not hold additional insurance, you are in breach of the Ahpra guidelines and place yourself at risk for any claim that is made against you. 

ADAQ offers what we call a “government” policy which will provide you with retroactive cover, if you are solely working for the university.   If you are working for the university and also in private practice, then you will need to take out our “government/part-time private” policy.

Up to 20 hours per week is considered part-time.

Professional indemnity insurance is structured on a “claims made” basis.  This means that you must hold insurance at the time the claim is made, not at the time the incident occurred.  Because of this structure, the Dental Board requires you to hold professional indemnity insurance at all times (which includes retroactive cover) and if you cease practice, to take out run-off cover (which is essentially, professional indemnity insurance for people that cease practise permanently) for the treatment you provided while practising in Australia. 

ADAQ offers what we call a “part-time” policy which will provide you with retroactive cover while you are on parental leave. If you’re unsure what policy category you are in, contact ADAQ.   

ADAQ understands the jump from student to practitioner is a big step. To help support you, we offer up to 18 months of complimentary professional indemnity Insurance of $10,000,000 upon graduation. 

Terms and Conditions:

• Must be an ADAQ member and retain a current ADAQ membership throughout the period of insurance.
• Must complete new insurance proposal form for each policy period (prior to 30 June each year). ADAQ will contact you when this is due.
• The complimentary policy applies to Professional Indemnity Insurance with a limit of indemnity of $10,000,000 only and any additional insurance is available for purchase.
• The 18-month policy period commences from date of graduation and will be on a pro rata basis if applying throughout the 18-month period.
• All applications for insurance are at the discretion of ADAQ and the insurer. The offer for complimentary professional indemnity Insurance is not transferrable to another party, for cash or any other service.

Your policy covers:

1. The individual dentist (Policyholder) for their:
   1. direct professional liability arising from Dental Services; and
   2. any vicarious liability for employees who are not registered dentists (i.e. hygienists, nurses etc) but who do provide Dental Services under the Policyholder's supervision.
2. Any Practice Entity controlled by and owned 100% by the Policyholder for the Practice Entity's vicarious liability for the Policyholder's acts, errors or omissions arising from Dental Services.

If you own a group practice or the definition of practice entity does not cover your circumstances, contact PSC Mediprotect to discuss Practice Entity Insurance. 

Claim is defined in the policy as: means any:

1. written demand; or
2. civil or administrative proceedings,

that seeks compensation to a Third Party first made or brought against the Policyholder or the Practice Entity (as the case may be) during the Policy Period.   

The following are types of claims that dental practitioners may receive:

1. An Initial Notice 9A pursuant to PIPA;
2. PIPA Part 1 Notice;
3. Contribution Notice pursuant to section 16 of PIPA;
4. Notice from Ahpra or OHO that a complaint has been made by a third party against a member.
5. Notice from a patient that they intend on seeking compensation from a member.

A professional indemnity insurance policy operates on a claims made and notified basis, which means that it covers the dental practitioner for claims made against them and notified to the insurer during the period of insurance. This is different to a public liability insurance policy, which is an occurrence-based policy. 

Before you enter into an insurance contract, you have a duty to tell us anything that you know, or could reasonably be expected to know, may affect our decision to insure you and on what terms.

You have this duty until we agree to insure you.

You have the same duty before you renew, extend, vary or reinstate an insurance contract.

You do not need to tell us anything that:

1. reduces the risk we insure you for; or
2. is common knowledge; or
3. we know or should know as an insurer; or
4. we waive your duty to tell us about.

If you do not tell us anything you are required to, we may cancel your contract or reduce the amount we will pay you if you make a claim, or both.

If your failure to tell us is fraudulent, we may refuse to pay a claim and treat the contract as if it never existed.

You should notify ADAQ. It is a condition of your professional indemnity insurance policy that a claim is notified as soon as practicable and during the same policy period that the claim has been made.

If you receive a written or verbal notice of demand for compensation, correspondence written pursuant to PIPA or notice from Ahpra or OHO that a complaint has been made by a third party against you, you should speak to the Compliance and Advisory Services Team at ADAQ as soon as possible [email protected].

The Personal Injuries Proceedings Act 2002 (Qld), as the name suggests, deals with personal injury matters and outlines the pre-proceedings procedure that has to be followed for attempting resolution for personal injury matters. Before a claimant commences proceedings for a personal injury claim in court, there must be compliance with the pre-court procedures in PIPA.  

Regulatory complaints: the focus is on the public safety and what is in the public interest. It will consider disciplining professionals who have been involved in misconduct. Secondary focus is on reaching agreements between patients and dentists in an informal setting.

Negligence claims: the focus is on fixing a wrong and compensating a patient for any damage/loss that they have suffered, usually through the PIPA process and then court litigation. In order to be successful a claimant must establish that a duty of care existed, there must have been a breach of duty and that breach of duty must have caused the loss, injury or damage.

Unsatisfactory performance is knowledge, skill or judgement of the practitioner is below the standard reasonable expected of a health practitioner of an equivalent level of training or experience.

Professional misconduct (which is more severe) is unprofessional conduct which is substantially below the standard expected, more than one instance of unprofessional conduct, conduct which is inconsistent with the practitioner being a fit and proper person to hold registration.

Pursuant to section 129 of the National Law a registered health practitioner must not practise the health profession in which the practitioner is registered unless appropriate professional indemnity insurance arrangements are in force. Failure to hold professional indemnity insurance may constitute behaviour for which health, conduct or performance action may be taken by Ahpra and the Office of the Health Ombudsman.

You are required to notify Ahpra and the Dental Board of Australia as soon as you become aware and within 7 days that you have practised without professional indemnity insurance. This is what is considered a self-notification. 

If you become aware that you do not hold professional indemnity insurance, please speak to the Compliance and Advisory Services Team at ADAQ.

If you do not have professional indemnity insurance and have practised dentistry, for any period of time, Ahpra will take action against you in the Queensland Civil and Administrative Tribunal seeking an order that you have engaged in either unprofessional conduct or professional misconduct, depending on the severity of the matter. Typically the sanctions issued by QCAT including conditions being imposed, a period of suspension as well as a reprimand.

In Queensland, the National Law states that concerns about a health practitioner’s health, conduct or performance are to be raised with the Office of the Health Ombudsman (OHO) at first instance.

Under the Health Ombudsman Act 2013, the OHO retains and assesses and investigates health complaints or notifications about registered practitioners that involve:

1. alleged conduct that may amount to professional misconduct; and
2. where another ground may exist for the suspension or cancellation of the practitioner’s registration.

When complaints or notifications about registered practitioners are not likely to meet the above criteria, they are referred to Ahpra to assess and/or investigate. 

OHO can refer serious complaints (professional misconduct) to the Director of Proceedings (DoP). DoP is a statutory position within the OHO responsible for independently assessing complaints and other matters from a legal perspective and deciding whether to take them before QCAT.

In referring a matter to QCAT, the DoP is guided by:

1. principle that the health and safety of the public is paramount;
2. the seriousness of the matter;
3. the likelihood of success; and
4. any orders that QCAT may make.