The Appeals Process is one of the most important features of the Professional Protector Plan, and one of the most important duties of the National Advisory Board. It provides a dentist the opportunity to present his or her perspective to a group of peers who have the attention of the PPP partners.
There are two basic reasons why an appeal would be requested: non-renewal or cancellation of an insured's policy.
The PPP's expectation of the NAB's role in this process is to provide an analysis of the dental aspects of the case. The Advisory Board's involvement in this process begins when the PPP selects and assigns a case manager to the impending appeal. Following selection and notification of the case manager each Board member will receive a copy of the appeal report. The Board will be allotted three weeks in which to complete their review of the case being appealed.
After the Board has reviewed the materials, contacted the dentist, and discussed it amongst themselves, the case manager compiles the Board's findings and provides a written recommendation to PPP. This is forwarded to the underwriters for final determination. It is through the NAB's various opinions and input that we can learn more about the particular dentist's practice and dentistry in general, which assists us in more accurately underwriting this risk.