Why Shipping Insurance Can Be Your Competitive Advantage

Why Shipping Insurance Can Be Your Competitive Advantage

Shipping insurance can protect your brand and your profits by providing coverage for lost or damaged packages. Whether you are shipping or receiving items, this lesser-known coverage can help replace lost or damaged packages.

By Lisa Lash

A lost or damaged package can disrupt your business operations, and lead to unsatisfied customers, negative reviews and expensive replacement costs.

Shipping insurance – also known as parcel insurance – can’t prevent your packages from getting lost, but it can shield you from costly replacement expenses. Shipping insurance also protects your financial interests by delivering at least 50% savings over coverage from shipping carriers at the point of sale (POS).

While import volumes are below the record-setting levels that sparked port congestion, shipping backups and wayward packages at the height of the pandemic, volumes are still higher than pre-pandemic levels.[1] Higher volumes can lead to more lost or damaged packages, making shipping insurance a more important investment than ever to protect your business and your reputation.

Who is parcel insurance for?

If your business ships lower-priced items, such as t-shirts valued at $5, the automatic coverage of up to $100 available through UPS, FedEx, USPS and other carriers at the POS may be enough coverage.  

It’s companies that ship or receive a high volume of goods, typically at least 3-5 packages a day, at an individual value of $100 or more, that can benefit most from parcel insurance. That’s because it is more cost-effective and covers more than what is automatically available at the POS from a shipping company. In fact, parcel insurance can cost 50% less than coverage available at the POS.

What does parcel insurance cover?

Not everyone is aware that parcel insurance is available as an alternative to POS coverage. If your company ships a high volume of goods, obtaining parcel insurance can provide a competitive advantage because the cost for parcel insurance is based only on the value of the items you ship, not the size or weight of each package. Insurance costs are also not based on a set monthly premium. You pay only for each box shipped.

Shipping insurance can cover high-cost goods, including the following items:

  • Furs
  • Artwork
  • Jewelry
  • Laptops
  • Cell phones

Commodities not usually covered by parcel insurance include gift cards, lottery tickets, game tickets, loose diamonds or stones, and personal or gift items shipped by employees. Parcel insurance also does not cover items delayed in transit, or fraudulent claims.

How does parcel insurance work?

Parcel insurance coverage is right-sized. Therefore, your monthly coverage costs are based only on the value of what you ship each month, based directly on your manifest report. For example, if you ship more items during the holiday season, your parcel insurance costs will be higher at that time than the months when you ship less.

Parcel coverage safeguards against lost or damaged items and can also cover items shipped to you. Insurance providers simply need to know the industry you’re in and the types of goods that you typically ship. Since international buyers tend to lose parcels more frequently, this coverage can be especially valuable for global shipping.

Any drastic changes to what you typically ship must be reported to your shipping insurance provider. For example, if your business typically ships customer packages and then when participating in a tradeshow, you need to ship items to the event, such as six big-screen TVs and a display and other high-value items, you would need to report the different types of items being shipped to ensure coverage.

What are some common parcel insurance claims?

Packaging items well and tracking delivery can help avoid claims, but mishaps still happen even to the most careful shippers. Here are two common claims scenarios:

  • The delivery that disappeared. This typically involves a misdelivered package. The buyer didn’t receive the package, even if there’s a delivery scan. In this scenario, shipping insurance covers the cost of refunding the buyer if they really didn’t receive the item.
  • The dropped and damaged delivery. Often, a box will fall and damage the contents, such as the glass on an electronics screen. Other times, it could be a rare item that breaks, such as a set of expensive china or pottery. Shipping insurance offers protection when contents are damaged.

How long does it take to get started?

Businesses can start using their Parcel Insurance on the same day they obtain it, and most insurance providers can provide you a quote and issue a policy in one day as well. After uploading the free software from your parcel insurance provider to integrate with the manifest shipping software, your insurance provider will have access to your packages shipped and can begin your coverage.  

For more information about parcel shipping insurance, contact  Parcel Insurance Plan.


[1] Port Calls “US record imports streak ends, volumes still high,” September 2022.

How to Close Your Law Practice and Ensure You’re Covered by a Malpractice ERP

How to Close Your Law Practice and Ensure You’re Covered by a Malpractice ERP

By Christina Melia, Esq.

Lawyers want to make sure their malpractice coverage tail supports them well into retirement. Reducing your future liability requires a clean transition to retirement phase.

When it’s time to close the books on a fruitful practice, lawyers must strategize much like they would when building a legal case. A retirement playbook for attorneys must consider liability exposures even after the practice closes its doors. 

Prior to the pandemic, about 15% of lawyers planned to work after age 65.[1] Yet, many baby boomers are now retiring sooner than retirement age,[2] and the generation’s attorneys are no exception. To remain covered by insurance when retiring, malpractice liability requires lawyers to adhere to specific requirements. This is especially true if an attorney plans to practice law in any other capacity.

Extended reporting periods: What are they? Why are they important?

Owners of law practices secure malpractice insurance to protect their businesses — and their own assets — from financial damages resulting from any legal actions pursued by an aggrieved client or other party. Once a lawyer retires, it’s critical to maintain this liability coverage so that any claims made based on past exposures would potentially still be covered. An extended reporting period (ERP) or policy tail helps meet the objective of continued coverage. Ahead of retirement, make sure to obtain an understanding of your current policy limits, because the ERP will mirror the limits of your current policy.  

One individual retirement ERP, for example, allows the owner of a law practice to report claims, acts or omissions up to seven years after the firm closes. To qualify for a Retirement ERP at no additional premium, a lawyer must be at least 55 years old and have an active malpractice liability policy with that individual ERP for at least three years. Here are a few other requirements for this ERP coverage:

1. To activate the ERP, you must inform your carrier via letter of your retirement plans. If you don’t, you could jeopardize ERP coverage.

2. You must cease the practice of law to retain the policy tail. Here are some situations to avoid which will render your ERP null and void:

  • Acting in an “of counsel” capacity to another firm or client
  • Notifying an insurance carrier that the firm has been closed or sold and still practice law
  • Filing a notice or brief in a courthouse

3. There are some situations in which you can still use your legal expertise subject to carrier approval and be covered under the Retirement ERP:

  • You can represent yourself
  • You can act as a mediator between two parties
  • You can teach continuing legal education classes
  • You can act as executor of a will or trustee for a trust arrangement

In order to avoid these requirements or restrictions a firm can purchase an Optional ERP.

13 Things You Need to Know When Closing Your Law Practice: A retirement checklist

Plugging gaps for exposures is an important consideration while you practice law and after you retire, but there is more you need to do before officially closing your practice.

  1. Give clients and staff sufficient notice — in person, by phone or mail — that you’ll be retiring and ramp up collection activities for outstanding balances owed to your firm.
  2. Decide whether there is enough time to litigate open cases or if clients must be referred to another attorney. Outline the process for seeking new legal representation and if necessary, facilitate the search for a new attorney.
  3. Politely decline new cases and provide detailed instructions on how to proceed for existing clients whose legal matters will likely continue beyond your retirement date.
  4. Craft specific messaging around your retired status for inbound business phone calls and emails. Set up active phone numbers and email addresses for forwarding so that clients clearly understand where to go for files or additional information.
  5. Send notifications of retirement and instructions on next steps to a last known physical address for existing clients who cannot be located. Retain funds for these parties or consider turning the monies over to a common interest on lawyers’ trust accounts (IOLTA) fund or other government entity.
  6. Take careful measures on information safety and data security when transferring client files. Electronic files should be password protected and/or encrypted, which can help reduce the chance of compromise or data breach.
  7. Seek the court’s approval before removing yourself as counsel from any active case and refund any fees paid by clients for planned services that extend beyond your retirement date.
  8. Determine status of inactive client files and retain original client materials. Keep any information and/or trust account activity statements that your client may need at a later date.
  9. Maintain active client files as well as client trust account statements for the amount of time specified by the laws of states where you practiced.
  10. Send a trackable letter updating your new status to the Bar Association as well as state and local licensing bureaus.
  11. Analyze partnership agreements (if applicable) for concluding the relationship per the terms of the contract.
  12. Extend the liability portion of your malpractice insurance for claims that may arise from past activities. An extended reporting period (ERP) is often available as “tail coverage,” which can protect you at a prescribed dollar amount for a set number of years.
  13. Extend the liability portion of your malpractice insurance for claims that may arise from past activities. An extended reporting period (ERP) is often available as “tail coverage,” which can protect you at a prescribed dollar amount for a set number of years.

In your line of work, you understand the importance of attention to detail. That mindset must continue as you approach retirement. For more information on how you can mitigate risks when closing your law practice, contact Lawyer’s Protector Plan.

This information is intended for informational purposes only. Nothing contained in this publication is, nor is intended to be, legal advice. Lawyer’s Protector Plan is not liable for any injury, loss, damage, or expense arising out of or in connection with the use of this information.


[1] Clio, “A guide to Preparing for Lawyer Retirement,” November 24, 2021

[2] Pew Research Center, “Amid the pandemic, a rising share of older U.S. adults are now retired,” November 4, 2021

When should you refund a dissatisfied patient?

When should you refund a dissatisfied patient?

Issuing refunds to patients is not out of the ordinary for dental practices. To protect your livelihood, you will want to follow some prescribed guidelines, reducing the chances of an unhappy customer filing a malpractice claim.

By Ty M. Galvin, D.D.S., and Michael A. Gile, D.D.S

Dentists understand they must issue refunds to unhappy patients from time to time. It’s not an unusual circumstance nor should it be disruptive to your practice. Maybe you performed a basic service that ultimately wasn’t covered by the patient’s insurance, or a structural issue arose with a crown or bridge that you feel responsible for.

In these cases, there are ways to reduce your liability and still defuse the situation when offering out-of-pocket dollars back to the patient.

5 steps to processing a refund

In your practice, you’ve come to know many patients — some better than others. If a refund request occurs, you might be tempted to write a check and quickly put the incident behind you. But this could pose a problem regardless of how well you know the patient. So, it’s prudent to establish and consistently abide by a formal process for refunds. Here’s how.

1.     Determine the reason for the refund.

Before issuing a refund, investigate the reason for the patient request and determine the validity of the patient claim. That starts with a basic fact find. A patient’s concerns will usually be conveyed via an initial phone call or email to your office. Make it a point to have your staff gather as much information as possible about the issue when this occurs.

You’ll then need to review the facts before deciding to provide a refund. It may be a snap decision to refund $40 for a fluoride treatment that’s not covered by insurance, but refunding the full cost of an implant will warrant a more thorough review. 

 2.     Search for an alternate resolution to the issue.

Money may not be the only remedy to a patient’s dissatisfaction. If the issue pertains to reconstructive dental work you performed, addressing and fixing the perceived issue with a tooth, bridge or crown might alleviate the concern. When the patient recognizes that you’re taking every conceivable step to correct the problem, your goodwill could be enough to make everything right.

Your ultimate goal is to make the patient happy, but in some cases that objective may be unrealistic. Some individuals may persist with their claim to a refund despite your best efforts to placate them.

3.     Document every step of the process.

It’s critical to gather all pertinent information surrounding the frustrated patient’s experience. Document each communication between the patient and your office, noting the date, time and specific details of conversations and emails. Make sure to log all work performed or discussed in the patient’s chart.

Make note of the patient’s demeanor during face-to-face meetings or phone calls as well and use neutral language when interpreting or documenting their behavior. Observing hostile or irrational behavior may not cloud the facts of an issue but documenting state of mind could have some bearing on outcomes — if the dispute finds its way into the legal system.

4.     Incorporate a formal release document into the refund process.

If the patient agrees to a settlement, refunding or waiving a payment is only one part of the deal. Formalizing the terms in writing could help deter any further action taken on the patient’s behalf. In some instances, you may simply be forgiving a balance due but before writing a check, obtain a signed release, which could help permanently close the case, or provide the necessary documentation should it proceed to a claim, lawsuit, or State Board action.

The release form is a document the patient signs to lessen the risk of litigation or a board complaint. A signed release should be secured before you refund a patient. Asking for a signature on a release could trigger an unpleasant reaction from an aggrieved patient. Faced with that possibility, you might look for another way to diffuse the situation.

Note that the general release form should be recreated on your office’s letterhead. If you mail the release to the patient to sign, include a self-addressed envelope to make the process easier for them, along with a letter that notes the following information:

  • The refund won’t be processed without a signature on the release
  • A mention that a payment removes your office from any future liability
  • A time frame within which the release must be signed and returned

You don’t need to self-report a simple refund to the National Practitioner Data Bank, but payments from state law actions or lawsuits must be.

5.     Stay mindful of potential malpractice claims.

Malpractice claims are an unlikely result of a refund request, but the possibility can’t be entirely dismissed. A simple refund process won’t require you to contact your insurance broker or carrier, but escalation beyond an open and shut case will mandate a notification.

Two occurrences indicate that the patient may be pursuing legal action: If you receive notice from an attorney representing the patient, and/or the patient turns the matter over to the state dental board. If faced with either of these consequences, inform your broker or carrier immediately.

It goes with the territory

Unhappy patients are just part of the landscape of having a dental practice, and sometimes you simply have to sever ties with them. Consider these mildly unpleasant circumstances a cost of doing business. You can hope that refund requests get resolved quickly and simply but be wary of how dissatisfaction might turn into something more complex and costly.

For more information on how to protect yourself from unwanted claims, contact PPP Risk Management.

This information is intended for informational purposes only. Professional Protector Plan for Dentists is not liable for any loss or damage arising out of or in connection with the use of this information.


Why Savvy Couples Say “I Do” To Wedding Insurance

Why Savvy Couples Say “I Do” To Wedding Insurance

With an average of 12 vendors hired and $27k at stake, wedding insurance can help provide protection when the unexpected happens on, before or even after your big day. Here’s a look at key considerations in choosing a policy that’s right for you.

By Regina Burnett and Meagan Phillips

Congratulations! With a wedding on the horizon, there’s a good chance that you’ve been visiting venues, choosing menus and making dozens of decisions for a truly memorable day. But there’s more that you can — and should — do to protect your big day from the unexpected.

Planning a wedding takes time and money, with the average wedding costing $27,000[1]. Couples typically hire as many as 12 vendors for their wedding to ensure their special day runs smoothly.[2] For this reason, adding a wedding insurance policy can be an important part of your to-do checklist.

Even the most careful wedding planning can’t completely prevent the unexpected, from forgetful photographers and suddenly shuttered venues to extreme weather and sudden family illness.

Beyond counting on vendors to show up, and hoping for clear skies, obtaining a wedding insurance policy can both help protect your special day — and provide peace of mind that reimbursement is possible for a covered loss.

What does wedding insurance cover?

Wedding insurance is a special event insurance that can provide coverage when your planning or private event gets derailed in some way. This includes venues closing, military deployment, vendors going out of business or not showing up, extreme weather, unexpected sickness or injury and more.

It can protect you in the months leading up to your wedding, at the event itself, and even after, including the making of your contracted wedding video and photos. It can also help protect you from liability if one of your guests causes property damage to the wedding venue, for example. 

Consider these scenarios:

  • A perfect storm: A severe storm knocks out power and disrupts travel for days, causing a couple to postpone their wedding. Because policies are based on the total anticipated cost of the wedding, wedding insurance can reimburse for the contracted expenses of caterers, property and equipment rental, transportation and other expenses, including invitations and flowers.
    Note:
    A 14-day extreme weather exclusion applies. Purchase a policy early to ensure coverage is in place.
  • The runaway band: After months spent choosing a wedding band, the band breaks up before the big day, and keeps your deposit. Wedding insurance could reimburse you the contracted lost deposit paid, helping you secure a new band before your event, without missing a beat.
  • A second take: When the photographer’s memory card malfunctions, and he doesn’t deliver the photos as promised, wedding insurance can provide coverage for the cost of retaking new wedding photographs after the event.

How much wedding insurance coverage do you need?

Obtaining wedding insurance that spans the entire planning time will help protect you from these types of unanticipated scenarios. There are also ancillary coverages that are built into each policy to protect against incidents that may impact your special day but not actually cancel it, including the loss of deposits, videos, wedding attire, rings and special gifts.

Policies are based on the total anticipated cost of the wedding, so the coverage protects your total financial exposure. Premiums to cover your wedding can cost as little as 1% of the total cost of your wedding.

Does your policy cover your entire financial exposure?

Not all wedding insurance policies are created equal. Some cover only the day of the event, while others cover the event and the expenses leading up to it, from vendor deposits to day-of catering and photography.

Remember, the event itself is just one area of liability, which is why it’s important to obtain a wedding policy that covers your whole financial exposure. You may not realize that when you rent a venue for your event, you will be responsible for incidents that occur at the wedding as well. For example, if someone falls while dancing and breaks their leg, you may have to cover that expense.

When is the best time to buy?

Consider buying wedding insurance as soon as you begin planning your wedding, signing contracts and putting money down as deposits. You can purchase it up to two years in advance. The price of the policy is the same regardless of when you buy it, so it’s a good idea to be covered as soon as possible.

Make sure you do everything you can to have an unforgettable wedding, including obtaining insurance coverage that protects your investment on your special day. To learn more about wedding insurance, contact The Wedding Protector Plan®.

Underwritten by Travelers, the Wedding Protector Plan®. provides wedding insurance coverage for the ceremony, reception, rehearsal, rehearsal dinner, and a post-wedding brunch without a deductible. There’s also the option to add liability coverage for the many other things that could go wrong. With the Wedding Protector Plan®, you can ensure that nearly every risk is covered. Learn more about this valuable coverage and Get a Quote or Purchase A Policy when the wedding planning begins.

*The information in this post is general in nature. Any description of coverage is necessarily simplified. Whether a particular loss is covered depends on the specific facts and the provisions, exclusions, and limits of the actual policy. Nothing in this post alters the terms or conditions of any of our policies. Please read the policy for a complete description of coverage. Coverage options, limits, discounts, and deductibles are subject to individuals meeting our underwriting criteria and state availability.

[1]The Ascent “This Is the Average Cost of a Wedding in 2022,” July 2, 2022.

[2] The Wedding Wire “2021 WeddingWire Newlywed Report: COVID-19 EDITION,” 2021.

Are your excess limits sufficient for 2023?

Are your excess limits sufficient for 2023?

With the unsteadiness of the current economy, it’s more important than ever for companies to think about the adequacy of their management liability insurance limits.

Economic headwinds such as inflation and interest rate volatility, supply chain disruptions, labor shortages and changes in the global political climate may all be potential factors leading to an increase in frequency or severity of management liability claims. CEOs, CFOs and risk managers need to ask themselves, “Are we buying enough limits in this economic environment?”

Companies in distress are often aware of their potential exposures, but even healthy companies with growing revenue and a strong employee and customer base may want to re-evaluate excess insurance limits during these uncertain times.

6 exposures that necessitate revisiting your excess coverage

Consider the following six risk exposures that may affect your company — and your excess coverage needs — in 2023:

1. Employment costs

Compensation costs for private industry workers have been on the rise for years, with a 4.4% increase in 2021 and another 5.1% by the end of 2022.[1] At the same time, benefit costs increased a total of 7.7% during the same period.1 This cost creep will have an effect on any organization’s bottom line.

2. Downsizing

If your business is looking to downsize as a cost reduction strategy, allegations of discrimination, retaliation, or wrongful termination and possibly class action suits may arise. With remote work, “single site work environments” are becoming somewhat of a moving target definition, subject to court interpretation. Lawsuits are expensive and potentially damaging to the brand; Having excess limits in place may help mitigate the impact of EPL related lawsuits.     

3. Rising defense costs outpace inflation

Prices for legal services are 305.21% higher than in 1986, with an average inflation rate of 3.92% per year — higher than the average yearly inflation rate of 2.75% during the same period.[2] This trend, on top of the current inflationary environment, means it is more important than ever to make sure you have adequate limits to transfer risk. With prices rising, excess limits should as well.

4. Enforcement trends of the Equal Employment Opportunity Commission (EEOC)

The Biden administration has increased staffing and budget allocations at the EEOC[3] and made enforcing EEOC Right to Sue letters a new focus.

Class action EPL claims make up a significant portion of employment discrimination suits. In 2020, EPL suits had the highest settlement amounts of any class action litigation at $422.68 million.[4] The EEOC’s 2021 expansion of the use of virtual mediation led to $176.6 million in recovery to claimants, $20 million more than 2020.[5]

The White House’s renewed expansion of the EEOC means more employment-related charges in the near future. Businesses who haven’t increased excess EPL limits could be in danger as the EEOC’s concentration on this space continues.

5. Increased fee litigation for retirement plans

In the past, fiduciary coverage for 401(k) plans was not a hot topic. Fiduciary coverage has historically been relatively inexpensive with a nominal retention. After a recent period of double-digit investment loss, fees associated with the administration of defined contribution plans have come under additional scrutiny initially by employees of large healthcare and educational institutions.

Fiduciary liability saw significant claims and subsequent losses in 2021, which disrupted multiple insurance segments.[6] Plaintiff firms are doggedly following fee and expense claims and have received large settlements across an increasing array of markets and industries. This squarely puts adequate fiduciary coverage back on the radar of risk management teams.

6. Risks around M&A.

M&A growth is expected this year,[7] with many analysts suggesting Q3 2023 may be an inflection point. Once the interest rate environment stabilizes, companies are likely to seek out traditional M&A targets to acquire expertise they don’t currently have in house or to further expand their footprint geographically. This can bring about changes in management, shareholder disputes, employee turnover, regulatory issues and countless other considerations that could lead to allegations of wrongful acts.  

Your company may be a target for an M&A — even without your knowledge — making it essential that you have considered adequate limits before a transaction is initiated. Unfortunately, such coverage may not be readily available to a company mid-transaction. 

Whether you are the target or acquirer, management liability limits are essential.

Right sizing your risk

Insureds may benefit from refreshing their consideration of limits adequacy amongst a myriad of factors. Limits may experience more rapid erosion in the current environment than they ever have in the past.

Excess insurance policies are one way to mitigate this growing risk.

To learn more about how to manage management liability insurance-related risks, contact us today.

This information is intended for informational purposes only. Protector Plans Executive Liability is not liable for any loss or damage arising out of or in connection with the use of this information.


[1] U.S. Bureau of Labor Statistics “Employment Cost Index Summary,” January 31, 2023.

[2] Official Data Foundation “Prices for Legal Services, 1986-2023,” Accessed February 15, 2023.

[3] Business Insurance “EEOC funding would increase 10.6% under proposed 2023 budget,” March 29, 2022.

[4] Seyfarth “17th Annual Workplace Class Action Litigation Report,” January 2021.

[5] The National Law Review “EEOC Roundup: Top 5 Takeaways for Employers on the 2021 Enforcement and Litigation Statistics,” April 7, 2022.

[6] Willis Towers Watson “Fiduciary liability: 2021 in review and a look ahead to 2022,” January 4, 2022.

[7] PwC “Global M&A Industry Trends: 2023 Outlook,” January 2023.

Considering dismissing a difficult patient? Here’s when and how dentists can do it

Considering dismissing a difficult patient? Here’s when and how dentists can do it

Dentists have the right to dismiss unruly patients, but when done without due diligence, practitioners are vulnerable to wrongful abandonment and discrimination lawsuits. Know when and how to end a provider-patient relationship.

By Ty M. Galvin, D.D.S. and Michael A. Gile, D.D.S.

Are you obligated to continue treating a patient who repeatedly misses appointments, argues over treatment, disputes financial agreements or is increasingly rude to your staff?

While “patient divorce” may carry a stigma, the well-being of the doctor, staff and patient are worth the uncomfortable dismissal process. It is within a dentist’s full right to dismiss a patient if the dismissal is not for a legally impermissible discriminatory reason.[1]

As health professionals, we believe in our duty of care to our patients. This can make the decision to dismiss one particularly challenging but is a key component of doing our jobs well and providing optimal care to all.

When is it appropriate to dismiss a patient?

First and foremost, you cannot dismiss a patient based on their race, gender, national origin, disability, religion, genetic information or age. Practitioners are responsible for accommodating disabilities, such as providing interpreters for individuals who are hard of hearing during their treatment, for example.

It is a person’s behavior toward you and those within your office which will drive a decision to separate. Here are three key reasons to dismiss a patient:

  1. They are abusive to others within your office. Your first responsibility as a dentist and employer is to your patients and staff. When another patient becomes verbally or physically abusive, or sexually inappropriate to your team or toward fellow patients, they are a liability to your practice.

Case in point: When a young patient’s crown fell off days after treatment, instead of calmly requesting a replacement, one mother berated the dentist’s staff and threatened to ruin the office’s reputation. After a new crown was cemented, completing the treatment, the child and mother were dismissed from the practice due to harassment, libel and extortion of the office staff.

  1. They continuously miss appointments or refuse the recommended treatment. Refusal can take a variety of forms, from not scheduling follow up appointments to dictating the type of materials you use. Before you dismiss these patients, you can inquire about concerns or fears that may be causing them to ghost or implement policies like charging for no-shows.

Case in point: A new patient comes in for a replacement of four crowns. The patient refuses the dentist’s standard process and recommendations, insists on the use of a different lab and porcelain fused to metal crowns instead of zirconium. If the procedures have not been started, the patient can be dismissed on account of dictating treatment other than what the dentist recommends.

  1. They refuse to pay for performed treatments. A common cause for dismissal is nonpayment. In these instances, it is important to distinguish between patients who cannot pay and will not pay. Providing payment plans is one way to accommodate those who need assistance, but a refusal to make these payments is also reason for dismissal.

Case in point: A patient commits to a quadrant of dentistry including two crowns and a filling.  The patient agrees to financial arrangements but refuses to pay after the treatment is completed and tells the office staff “The work is already done, what are you going to do about it?”

Real concern happens when a difficult patient’s non-compliant behavior escalates. Paying attention and noting incidents can help track behavior and indicate the need for dismissal. Comprehensive chart documentation can support your decision should it lead to a claim.

The dos and don’ts of dismissing a patient

A successful “patient divorce” occurs when the patient does not leave the relationship angry and litigious. Here are best practices for ending the relationship quickly and without further incident.

DO:

  • Have the right documentation. If a patient should ever dispute their dismissal, you’ll need objective documentation of all incidents to substantiate your decision. This includes any emails, voicemails or texts from the patient as well as records of any outreach to them concerning their behavior. Keep these in their chart so they can be easily sourced.
  • Consult your State Board guidelines. States may have specific requirements around dismissing patients including how many days you must provide emergency care after dismissal.
  • Send a discharge notification letter by regular and certified mail. This maintains a one-way communication, void of dispute. Phone calls and emails are not recommended as they encourage potentially argumentative discussions. It is also best practice to include notes within this communication detailing additional care you recommend for the patient, as to avoid any accusations of abandonment.
  • Continue care for 30 days from the date of the notification letter. Remember, check your state for additional requirements.
  • Be courteous but concise. Practitioners are not required to provide a specific reason for service termination. Instead, recommend resources for finding a new dental office and explain how you will transfer medical records when appropriate.

DON’T:

  • Admit to not meeting the patient’s needs. It’s instinctual to apologize when you’re in uncomfortable situations or to avoid conflict. However, you don’t want to confuse the situation with malpractice.
  • Recommend another dentist. It’s better not to be blamed for another unsuccessful doctor-patient relationship. Keep your recommendations to resources such as the patient’s friends, family, social media and the internet to guide their search.
  • End a relationship in the middle of a treatment phase. The patient’s wellbeing takes priority. Make sure to time the discharge as to not endanger the patient’s oral health.

We all have those patients on the schedule that cause stress for the doctor and staff. While ending a relationship is never easy, dismissing a challenging patient can not only be a relief for the entire team, but it also likely puts the patient in a situation where they can receive better care.

When you follow the recommendations on when and how to end a relationship with a difficult patient, you’re building an environment more conducive to helping your other patients and keeping you and your staff safe. 

For more information on protecting your practice in difficult situations, contact PPP Risk Management.

This information is intended for informational purposes only. Professional Protector Plan for Dentists is not liable for any loss or damage arising out of or in connection with the use of this information.


[1] American Dental Association “Patient dismissal: Guidelines for Practice Success | Managing Patients | Patient Relations,” 2023.