How to Report Claim
What to do in the event of a “claim”, “incident” or dental board complaint.
If a patient or a family member has a problem or has expressed dissatisfaction with treatment, give your professional liability claim department a call to discuss what happened and what to do. The claims staff can offer support and assistance, and they may be able to help you keep a claim from developing. Our toll-free number is 800-240-2650.
What is an incident?
It is any contact with the insured or insured’s patient that represents facts and circumstances that leads you to believe that a risk of claim exists.
What is a claim?
It is when the patient or parent makes an actual demand for money or services against the insured. This demand can be in writing, verbally, made either directly or through the patient’s attorney.
What coverage is available for regulatory body complaints?
If you become the subject of a civil investigation by a state regulatory agency or a similar review board because of an injury as a result of an orthodontic incident covered by an AAOIC policy, we will provide legal representation to you in such a proceeding by an attorney of our choice. Regulatory complaint coverage is for defense only. There is no coverage for fines, fees, penalties, sanctions, damages, expenses or costs assessed.
Immediate reporting is required!
Refer to Section VI of the AAOIC professional liability policy which states, in part: When you are first made aware of an orthodontic incident (or an alleged orthodontic incident) you must immediately provide written notice of any such orthodontic incident to us. We are here to help, but we can only do so effectively if we know about the incident as soon as possible.
Steps to follow:
Call 800-240-2650 and ask for the AAOIC Claims Department. You may speak with either a Claims Adjuster or our Claims Manager.
Please leave your office, home and cellular phone numbers and anticipate a return call. Be assured we will respond to you as soon as possible! Be sure to have the patient’s records available or access to your computer so you can provide essential information promptly.
What if you are sued?
AAOIC works with a panel of highly skilled and experienced dental malpractice defense attorneys. When litigation is reported because of an injury as a result of an orthodontic incident covered by this policy, a dental malpractice defense attorney will be assigned to you promptly.