Densura Interview


I&I Interview: Densura partner Kevin Culliney 

In an exclusive interview with Kevin Culliney, he tells us why Densura is now opening up its indemnity products to non-corporate dentists.  

We also discuss what makes them different to other indemnity providers, why they only offer claims-occurring cover and how they are enhancing the transparency of their policies. 

Can you give us an overview of Densura and what you offer to dentists? 

Densura began life six years ago after we were approached by Oasis Dental Care (now BUPA). They wanted to see if we could help with two issues they were having; firstly, the cost of dental indemnity was rising rapidly for their dentists and, secondly, they were struggling with being held responsible for claims made against dentists who could not be traced, perhaps having moved abroad, and whose dental indemnity organisation declined to provide indemnity in the absence of their member. 

It took us about 18 months to set up, and a lot of that work was driven by Dr Julian Perry, who was the clinical director for Oasis, and Dr Paul Lambden, then at Oasis and who now leads our dental advisory group. 

Royal & Sun Alliance, an A-rated insurer, came on board to supply occurrence-based insurance, and since then, we’ve grown to become the biggest insurer of dentists within BUPA, we insure around 25% of dentists who work for MyDentist and we also work with the Colosseum group and with Rodericks.  

In total, we now insure around 2,000 dentists and offer a £10m limit of indemnity with no policy excess. Our ambition is to become the largest insurer of quality dentists in the UK. 

While our business model was to create a scheme of indemnity for dentists working within a corporate it also covers those dentists for when they also work in another surgery, as many do.  

It’s an exciting time for us because, having built up all this experience over the past six years, we’re now making our Densura product available to all dentists, not just those who work in corporates.  

Royal & Sun Alliance have insured our dentists for a number of years, they’re comfortable with the way we work and the kinds of claims our dentists have and they’re fully supportive of us moving to the wider market.  

As a result, in February 2021, we will launch this wider service and will be ramping up our marketing to let dentists know that Densura is now available to everyone. However, if someone from a non-corporate practice approached us before then, we’d be able to insure them.  

Clearly you, until now, have specialised in insuring dentists working for corporates. Do you have any other unique selling points? 

Our differential is that we have an advisory team of nine practising dentists who also have a legal qualification. This means that our clients can speak to a fellow peer, who not only has the dental experience but also the legal knowledge, to understand and resolve their issues.  

We don’t insure everyone – if you have lots of claims, we will probably want to talk to you about why that is – but we do cover all the specialisms and implantology.  

The philosophy of our business is to engage with issues as early on as possible; and that applies to both dentists who are dealing with a complaint or possible claim, and it also applies to us responding to our clients. 

When a dentist calls us with an issue, one of our advisors will respond within two hours, regardless of whether it is 8pm, later in the evening or at the weekend.  

If a claim is spurious, we will defend it very robustly with the clinical negligence lawyers who are part of our team. 

But if there is a liability, if it’s not the best day’s work the dentist has ever done, which sometimes happens, then we will work with them to rectify the problem. 

What do you offer a dentist that’s different to the big, main players in the indemnity world? 

One is that very empathetic, very early engagement when you have a problem that I just mentioned above. Having someone to speak to within a couple of hours of contacting us is so important and I think it gives great peace of mind to the dentist at what can be a very stressful time. We are on your side, there to protect you and fight your corner. 

Additionally, you can call us as many times that you need to, if you have a query or you’re worried about something etc., and we won’t penalise your premium.  

In fact, we encourage our dentists to call us. We’d much rather dentists contact us in advance of an issue rather than waiting for something to escalate into a problem.  

We’ve been doing this long enough to know how to insure dentists effectively and we offer competitive pricing, which at an average of £2,800 for full time general dentistry is around 30% less than typically offered by the defence bodies. Premiums are lower for fewer sessions, for dentists working part time and it’s important to remember that what we offer is insurance, rather than discretionary cover based on membership. 

We’re the largest dental indemnity provider on an occurrence basis, which means run-off cover is not required. Dentists are covered for life for the work they perform whilst insured with Densura, no matter when a claim is brought to light. We also provide retroactive cover which means you are protected for any period that you had claims-made cover before joining Densura, something that defence bodies struggle to do.  

That means that you are covered for every eventuality, in perpetuity with an A-rated insurer who have been around for over 300 years. 

We offer online CPD which is included in the policy, and focuses on risk management. For example, we have worked with dentists and lawyers to create best practice guides to patient consent and good treatment planning. 

We understand that how you engage with your patient right at the beginning and plan their treatment is really important, so it is a key area we have focused on assisting our dentists. If something goes wrong or, even worse, if something hasn’t gone wrong but you still receive a complaint, you will be in a much better position if you have consented them properly, planned the treatment properly, recorded the treatment properly etc. That is why we provide personal support, information and feedback from the wider profession on what is happening in dentistry generally.  

What’s the reason that you only other claims-occurring cover, rather than both claims-occurring and claims-made? 

Quite simply because there’s no advantage to claims-made over claims-occurring, as long as you’re providing retroactive cover with a claims-occurring policy, which we do.  

An occurrence-based policy that also provides retroactive cover means you’re covered in perpetuity – you’re covered for everything going forwards and backwards. 

For example, if a dentist was working under a claims-made policy for a long time, the moment they chose to end that policy they would no longer be covered for any of the work undertaken during that time.  

But with retroactive claims-occurring cover, we are still able to cover them for that period – even though the chance of a claim coming in many years later is fairly remote, you still have that peace of mind. 

We can also provide cover in the event that any of the defence unions cease to operate in the future. 

Densura is a part of a bigger group called Lockton, how does that benefit your dentists? 

Lockton is one of the biggest insurance brokers in the world, even though you may not have heard of it!  

They’re the world’s largest privately owned global insurance broker and place more than $20bn of insurance premiums on behalf of their clients. Lockton employ around 9,000 associates and cover everyone from dentists to oil rigs in the Gulf of Mexico.  

Our dentists benefit from that because there’s a lot of security in having access to the resources of such a big broker. By working with them we have a lot of leverage to deal with changes in the insurance market, particularly when it comes to potential price rises by insurers. 

There are good smaller brokers out there and I admire anyone who starts their own business, but they just don’t have that same leverage.  

We own the means of placing the cover, we own the relationships with the big insurers. We can be the big brother that stands behind the dentist, especially if things get tougher than they are at the moment.  

Which brings me on nicely to my next question. How did you adapt the support you give for dentists since COVID-19? 

We kept the base level of cover required in place and gave a pro-rata reduction on what they would otherwise have paid.  

Our dentists are happy with our service and the way we responded during the pandemic; our retention rate is greater than 95%, and the main reason people tend to leave is due to retirement or maternity. 

How do you help your members to reduce risk and build a safer business? 

We have an online CPD programme based on correctly consenting a patient and treatment planning. That programme is provided by a professional firm who deliver CPD for dentists and is worth £300 per year but we include it in our policy for free. 

We also have our team of dento-legal advisors who are not just there to deal with claims but also to answer any general queries anyone might have. We do get calls from people who just want to talk about something technical they might be worried about, and our advisors are more than happy to guide them through it.  

We’re also working on creating more resources that take a more holistic approach and meet the wider requirements of dentists.  

One of our advisors, Julian Perry, who helped to build Oasis and prior to that built his own chain of practices and is a well known implant surgeon, is working with us to create a suite of ‘how to guides’ around wider topics that dentists might be interested in, such as buying and selling practices. 

Is there anything you think the indemnity market as a whole can be doing to help make products and policies more transparent and understandable? 

In the first quarter of 2021 we will be issuing our new policy wording.  

We have a very comprehensive wording, which is great, but we know that not everyone is going to want to read it cover to cover.  

Therefore, we’ve employed a law firm to humanise the wording to make what it covers really clear and what the dentists’ responsibilities are, for example notifying us as soon as it is practicably possible after a patient complaint is received.  

We just want to set the wording out in a very simple, straightforward way that highlights those areas that are of real interest to the dentist. I think no one has done this as clearly as we are doing it. 

What does 2021 hold for Densura and the wider indemnity market? 

We’ve just carried out a survey of dentists and had the first tranche of responses back.  

From the responses we’ve had so far, it’s clear that dentists think they will only see a return to “normal” practice in the second half of 2021. That means there will continue to be difficult trading for dentists in 2021, particularly in the beginning. 

If dentists working in the NHS lose the financial support that the Government has been giving them so far, then working life is going to become a lot tougher for them and that needs to be recognised in terms of the indemnity support provided. 

For example, one of the benefits of the occurrence-based policy is that you can stop cover without having any issues. Whereas with a claims-made policy you have to keep that policy in place in order to be covered for past activities. This will really shine a light on where claims-made isn’t as flexible as claims-occurred.  

We’re working with some of the corporate groups to keep abreast of the advances in technology that they’re using, and how that has advanced since Covid-19 broke out. For example, we’ve covered all the remote dentistry people have been doing during the pandemic.  

It will also become increasingly important to make sure you have cover for cyber issues such as protecting patient records and loss of data, especially clinical. 

The focus for the future, for everyone, should be supporting dentists to work through this tough trading time and being flexible to change premiums. 

And, of course, for Densura, the big change for our future will be making our products available to all dentists beyond those who work in corporates, which is really exciting for us.   

Visit Densura to find out more about what they offer. Or register at I&I to start comparing policies. 

By Insurance & Indemnity