James said: “This distinction is crucial for policyholders to understand, as it affects how and when they are protected. Not having the appropriate insurance cover in place could result in claims not being paid out. The role of a good insurance broker is to explain the difference between the two types of cover, and to make this complicated matter as clear as possible.”

A ‘claims occurring’ insurance policy provides coverage for when the incident occurred, even if it is made after the policy has expired. There is no need for a retroactive date or an extended reporting period with ‘claims occurring’ policies because they cover any incident that happened during the policy term, regardless of when the claim is reported.

In contrast a ‘claims made’ policy is based on when the claim is made and must have been notified to insurers within that policy period. This policy puts the onus on the policyholder to make sure any incidents that could give rise to a claim have been raised to avoid a claim being rejected.  

James added: “We usually recommend that operators in the health and care sector choose a ‘claims occurring’ policy if possible. This is because if a claim occurred in the past, the insurer providing the cover at the time is liable to pay the claim. Some insurers will accommodate a retroactive date if they are made aware that the client is currently on a ‘claims made’ policy and they need to cover the gap. However, this might be costly depending on the numbers of years required.

“The key is for the health and care operator to understand what type of policy they have in place and to give careful consideration when changing insurers. Alternating between the two types of policies can cause major problems. It’s also worth noting that some insurers will only provide cover on a ‘claims made’ basis. This type of policy is a good option in some instances, especially if it’s the type of cover that’s been in place historically, but health and care operators should seek the advice of a specialist broker to make sure there are no gaps in cover.

“For ‘claims made’ policies, this also means making sure that there is a strict reporting procedure in place for any health and care business, so that all potential instances where a claim could arise are reported to a responsible person within their business to then be passed onto the insurer. Understandably, this can be very onerous on the business to make sure they implement the necessary procedures and provide the training needed to all employees across the business.

“We have had an incident historically where we took over a new client who was previously on a ‘claims made’ policy. Unfortunately, the client was not informed by the previous broker that all instances that could give rise to a claim during the policy period should have been notified, not just a potential claim. A historic abuse allegation has now come to light and turned into a claim, the insurer is refusing to cover the claim given that this incident was known about at the time, but the information was not passed on to the insurer.”

TL Dallas provides insurance services to care homes, domiciliary care providers, supported living and day care providers, children’s homes, foster care agencies, hospices, retirement homes, dental practices and GP surgeries, as well as providers of complementary and alternative therapies.

The firm partners with numerous care associations across the UK, which are independent membership groups. The partnerships allow TL Dallas to share knowledge around risk management as well as health and safety guidance, to help clients navigate claims.

TL Dallas also works closely with other industry experts including solicitors, risk management professionals and Care Quality Commission (CQC) advisors to help provide a wealth of knowledge and relevant guidance to clients. Click here for more info – https://www.tldallas.com/health-and-care-insurance/

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The division has a team of eight brokers with more than 100 years’ combined industry experience based across offices in Bradford, Lincoln and London.

Account executive, James Bright moved to TL Dallas from Marsh Commercial last year along with Rico Young, to further strengthen the UK wide proposition. James said: “Our expert broking team and longstanding insurer relationships combined with our own in-house claims team, gives us a compelling offering for operators in the health and care sector.

“With great interdepartmental collaboration at TL Dallas, clients benefit from working with a larger independent broker, but with one dedicated point of contact, and we also deal with any claims internally, rather than outsourcing them. We therefore appeal to both smaller independent health and care operators, as well as large multi-site businesses, and we have the expertise and capability to manage all types of clients in this sector.”

Clients include care homes, domiciliary care providers, supported living and day care providers, children’s homes, foster care agencies, hospices, retirement homes, dental practices and GP surgeries, as well as providers of complementary and alternative therapies.

James added: “We provide a ground up gap analysis review of all current and recommended ancillary policies including motor-fleet, property, management liability and cyber insurance to ensure any potential gaps in cover are addressed. We are highly focused on mitigating the risks that businesses face in the health and care sector, including medical malpractice and professional indemnity to protect our client and their business.”

TL Dallas has over the past 18 months, partnered with a number of care associations, which are independent membership groups. The partnerships allow TL Dallas to share knowledge around risk management as well as health and safety guidance, to help clients navigate claims.

TL Dallas also works closely with other industry experts including solicitors, risk management professionals and Care Quality Commission (CQC) advisors to help provide a wealth of knowledge and relevant guidance to clients.

Polly Staveley, managing director at TL Dallas, said: “‘We have been working in the health and care sector for over 20 years, but since last year have increased our focus on creating a dedicated division for this. The positive feedback and testimonials from our clients alongside the relationships the team have built in the health and care sector, have resulted in several client referrals including this most recent client win, and we look forward to continuing to grow our offering in this sector.” 

For more details, click here – https://www.tldallas.com/health-and-care-insurance/

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Specialist health and care insurance broker, TL Dallas & Co Ltd (TL Dallas), works with many independent and corporate care home groups and domiciliary care providers across the UK and is offering an all-encompassing service, including access to a wide range of insurance packages, risk management and business advice, to help care providers reduce costs and plan for the future.

Headed up by two brokers, Rico Young and James Bright, who have almost 25 years’ combined health and care industry experience, TL Dallas understands the issues care providers face and can arrange tailored insurance packages, designed to meet individual client needs, covering all aspects of insurance and risk management, as well as cyber security and management liability. TL Dallas can also provide advice to providers that require CQC assistance and guidance, ranging from CQC applications to inspections and interventions.

James Bright said: “We understand that care providers have a lot on their plates! Often insurance is only something they think about at renewal time, or when they need to make a claim. However, partnering with an independent broker like TL Dallas, that takes the time to understand your business throughout the year, will ultimately help mitigate future risks.

“Over the years we have heard horror stories of care providers falling foul to incidents, such as personally being sued over employee claims, as they have the wrong level of directors’ and owners’ liability cover, only getting a percentage of re-build costs paid out as they were under-insured or falling victim to fraud with no compensation. The key to making sure that care providers are insured correctly, is taking the time to thoroughly understand the business.”

Rico Young added: “We can offer care providers a review of what policies they have in place at any point during their policy period, to ensure they have the right cover, not just at renewal, and can advise care operators that want a second opinion. A policy can appear cost effective, however, if it’s not addressing real issues in the business, it’s worthless.

“As a broker TL Dallas is not tied to a specific panel of insurers, which means we can approach a wider range of insurance companies. As such we are providing an unbiased solution, by placing business with the right insurers.

“We also work with a specialist risk management consultancy that can review a care providers business, helping identify what they can do if for example, the CQC has put them into special measures. We know of providers, where in extreme circumstances, insurance cover has been pulled overnight after a poor CQC rating, so having access to consultants who understand this process before that happens, is hugely valuable.”

TL Dallas works with care providers that are just starting out in the industry, as well as long standing industry leaders and everything in between. James added: “All clients need to feel reassured that their broker cares about them and their business. As times change, new risks emerge, such as cyber insurance, which care providers can’t afford to ignore. As care plans become digital, sensitive information is held on devices or in the cloud. What happens if the technology fails? We heard about one provider who held everything on a USB stick – the implications for the business if that was lost or stolen are vast! 

“We work with key insurance providers that can offer a free review of IT systems to identify where the issues are through expert IT software analysis. Any problems can be addressed and certified, so an insurance company can see that the care operator has rigorous processes in place.

“If a provider is expanding their business, we can help plan for this. If they are struggling with recruitment and want to offer employees a package of benefits that will help attract people to their team, our sister company, TL Dallas Independent Financial Services can provide advice regarding this.

“It’s not just about the annual renewal for us, we do everything we can to protect clients as well as helping them grow and thrive. We discuss long-term agreements with insurers and negotiate rebates where there are low levels of claims.

“Insurance is a complex business, but we are here to make it as straightforward and as valuable as possible.”  

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