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Fall 2017 eNews

AAOIC Announces 2018 Dividend

The AAOIC is pleased to announce the declaration of a 22 percent dividend for 2018 renewals.  The dividend will be given as a premium credit on renewal so our insureds will pay only the net premium after subtracting the credit. 


There will be no waiting for a dividend check. This dividend is the largest ever declared in the history of AAOIC and represents the company’s goal of providing our insureds low cost professional liability insurance with a claims management team headed by your peer orthodontists, not just a claims adjuster.


AAOIC has declared a dividend nine consecutive years in a row, while providing the best coverage and Risk Management training in the industry.


For those currently insured by other carriers who wish to insure with AAOIC for the first time, AAOIC offers a 25 percent discount on the first year.  For recent graduates, there are even bigger discounts available.  Why insure with anyone other than AAOIC?


Protective Eye Wear is a Must for Patients

We all know accidents happen, and sometimes, they’re challenging to avoid. However, taking proper preventative measures can significantly reduce the risk of an accident resulting in a malpractice claim. Our AAOIC Claims Department has seen a recent influx in eye injuries to patients stemming from failure of the orthodontist to provide patients with eye protection. Sharp instruments, wires and acid etch are consistently used in close proximity to the patient’s eyes. 


It is imperative that every patient wears safety goggles during their entire appointment. A patient’s personal eye glasses are insufficient. For example:  If the clipped end of a wire, or some acid etch flies into a patient’s eye, the consequences can be very serious, especially if damage to the eye is permanent. In situations like these, you can expect to receive a malpractice claim filed against you.

Providing protective eyewear to every patient at each visit is a minor expense that can result in major savings and peace of mind that you are protecting your patients.


The More You Know …

What happens to a practice when the orthodontist becomes incapacitated?  Orthodontic treatment is a long-term process throughout which patients require continuing care.  Here at the AAOIC, the claims department staff has heard myriad after-the-fact problems that arose as a result of an orthodontist becoming incapacitated. Here is an example of what can happen:


A doctor’s wife reported that her husband, the orthodontist, had passed away and she was having difficulty arranging for continued care of the patients.  The office was in a remote location with few orthodontists nearby. No one else was close enough to assume care of the patients, and the patients were unwilling to travel. The wife was stressed due to the loss of her husband and doubly so at having to deal with practice transition problems about which she had no experience. 


Who provides the treatment for the deceased doctor’s patients?  Who will assist the grieving spouse with transitioning the patients and dissolution of the practice?  This is a serious and real situation.  Patients cannot be abandoned for any reason. 


If you do not want to leave a quagmire for your survivors, or face one yourself when the problem is too big to solve, it is wise to arrange for a transition plan…before a problem develops.  Many of you belong to study clubs and from within, the member orthodontists have or can arrange for an agreement that most or all members may substitute for each other in the event of incapacitation.  If you are not in a study club, try to arrange for such an agreement with other local orthodontists.  It will be beneficial for all. 


If you don’t currently have a practice continuation plan in place, the AAO and the AAOIC can help. Our legal department has developed sample agreements for you and your colleagues to consider.  Just visit  and click on the Informed Consent tab to download a copy of the sample agreements.  You may also contact the AAOIC Underwriting Department at 800-240-2650.


Patients who start orthodontic treatment deserve to have treatment. Put a plan in place to ensure that occurs. Doing so is a good plan for you, your survivors and for the specialty. 


Stay on Top of Risk Issues and Save 10 Percent on Your Premium
The 2017 AAO Annual Session Risk Management Program is available for purchase.   If you did not attend one of the informative risk management programs at the 2017 AAO Annual Session in San Diego, it is not too late to gain invaluable knowledge about avoiding tricky situations and earn a 10 percent premium discount on a new policy with AAOIC or on the upcoming renewal of an existing AAOIC policy.


The program is available on DVD for a cost of $50.00 for active AAO members.   Flash drives are available for $55.00. To order the program, you may visit and click the Store tab at the top right section of the page. 


You will need to complete the accompanying exam and return it to our office prior to the effective date of a new or existing AAOIC policy renewal.  If you have not renewed your policy, the 10 percent will appear as a premium credit at the time that you renew your policy and the following year too!  Two years’ premium credit for both new and renewal policies! 


An Orthodontist’s Guide to Informed Refusal: What Is Informed Refusal?

Informed refusal is a decision by a patient to forego treatment, either from you or from a specialist you’ve recommended. There are varying degrees of refusal; a patient may identify specific treatments or alternatives that he or she wishes to allow or not allow.


Patients have the right to make their own decisions about orthodontic treatment, and you, as the orthodontic specialist, have an obligation to provide all necessary and relevant information. Whether refusing treatment or consenting to it, the patient should fully understand the need, prognosis, time, and cost of treatment, as well as the alternatives and risks of no treatment.


Determining the underlying reasons for refusal requires patience and support, but this extra effort may strengthen the patient/practitioner relationship, thus increasing overall patient compliance and reducing risk for both parties.


How Do You Ensure a Patient Is Fully Informed?

An informed refusal (or consent) should involve more than getting a patient to sign a form. Open communication between patient and practitioner establishes a healthy relationship that can support a complete understanding of health issues.


Outlining proposed treatments (need, prognosis, time, cost); alternatives (including no treatment); and likely risks (including risks of no treatment) are the hallmarks of informed refusal (or consent). In addition, practitioners are encouraged to use language that is easy to comprehend, and incorporate open-ended questions to facilitate two-way communication and assessment of a patient’s level of understanding.


A refusal (or consent) should include a verbal discussion, and it may require further written or recorded documentation depending on the recommended treatment. Ensuring comprehension without seeming to coerce is a delicate balance to achieve, but it protects the patient and protects you and your practice.


How Do You Accurately Document Informed Refusal in a Patient Record?
An informed refusal should be accurately and promptly recorded in patient records. A refusal of treatment form can be used, although a blind signature on a form will not completely mitigate risk.
Access the AAO’s Declines Treatment Supplemental Informed Consent Form
After logging in, scroll down the page to the Informed Consent Videos and Forms section.


Clear notations on the patient’s condition, proposed treatment, possible risks, and consequences of failing to undergo treatment should accompany the form. In addition to any alternative treatments offered, indication of any referrals to specialists should be noted with the reason and risks of not seeing the specialist.


Finally, an account of the patient’s refusal should be included with details on the reason provided and any specific instructions on the degree of acceptable treatment, if any. Documentation and a signed refusal form would provide the strongest protection against a possible claim and offer an additional opportunity to verify full understanding by the patient.


Steps to Follow in the Event of a Patient Complaint or Claim
If you receive a patient complaint or claim, consider the following recommendations:

1.    Call your insurance representative. If you have a conversation with a patient or a family member who has expressed dissatisfaction with the treatment, give your insurance representative a call to discuss what happened and what to do.
2.    Have your information on hand. You will need to provide key information from the patient's record. Access to the file or computer record during the telephone call will save time.
3.    Anticipate a return call. Make sure you leave telephone and fax numbers so that your insurance representative can contact you. If you are insured with the AAO Insurance Company (a Risk Retention Group) (AAOIC) and have encountered an incident or claim, contact AAOIC Claims Representative Jessica Kaesberg, or AAOIC Claims Manager Elizabeth Franklin at 401 N. Lindbergh Blvd., St. Louis, MO 63141-7816. The AAOIC hot-line number is 800-240-2650. You can also report an incident or claim through the AAOIC website ( The AAOIC welcomes the opportunity to work with you.