Positive Health Online

The major changes in social attitudes that took place after the Second World War and the educational philosophy 'the child is right' must have had considerable responsibility for the development of an unwillingness by many to accept personal responsibility for any mistake or misfortune. Such apparent widely held attitudes produce an ideal condition for the growth of the so-called 'compensation culture' which is having repercussions across the whole of the personal insurance industry.

The rapid acceptance of alternative and complementary medicine by the general public and its increasing acceptance as a legitimate health care by the medical profession are rapidly blurring the hitherto clear separation between the orthodox and complementary systems. The medical doctor has a duty of care that encompasses all personal and professional ethics including confidentiality, honesty and trust and providing the best care possible. Using his skills and training the alternative or complementary practitioner should offer no less.

A few years ago insurance was much less a concern. Doctors practised under the guidance of their professional body, protected by a comprehensive medical malpractice/professional liability policy. Therapists, if they were insured – and many were not – were likely to be protected by a 'treatment risks' policy.

Treatment Risks Policies

Treatment risk policies provide protection for the therapist should clients suffer loss or injury as a result of:

* a treatment given by the insured therapist;
* products used or supplied as part of the treatment;
* advice given in connection with the treatment, including aftercare advice;
* accidental loss or injury whilst attending for a treatment (public liability).

Payment of legal costs and expenses are an essential part of the insurance and should be payable additional to any indemnity provision.

Today most therapists protect their livelihood by insurance and for many a treatment risks policy remains a popular and appropriate choice as either an individual policy or within an Association group scheme policy. However time does not stand still and for increasing numbers of therapists a policy with a true professional indemnity wording may be the better choice.

Practitioner insurance is often referred to as 'professional liability insurance', which is perhaps the most misunderstood phrase in a therapist's vocabulary. Practitioners tend to assume they already have professional liability cover or if they are seeking insurance are likely to request it. In reality it is a treatment risks policy wording that they are most likely to have or to receive. In these policies the inclusion of clauses giving protection for giving wrong advice or information is most likely to be linked only to treatments that the therapist is providing.

Professional Liability Policies

The increasing popularity of life training skills, neuro-linguistic programming (NLP), personal development training, stress control management, personal enrichment programmes and counselling are causing a re-assessment of insurance needs. Therapists working in these areas are more reliant on a detailed knowledge of the individual client and the practitioner is more dependent on the trust of the client than is the case with most treatment-based therapies.

Professional liability insurance encompasses all the practitioner's business ethics, be he/she a doctor, surveyor, accountant or health care therapist. Professionals have a duty of care towards every client, and the clients, who have to rely on the professional advice and opinion of their chosen expert, have the right to expect complete confidentiality in all their dealings. No practitioner will set out to abuse a client's trust, but a single unintentional lapse, one unguarded comment, can profoundly damage a client's character and integrity and consequently result in an action for damages citing breech of confidentiality and possibly slander or other allegations. The possibility of ruin for the therapist is clear if he has no appropriate insurance in place.

'Claims Made' and 'Claims Occurring' Insurance Policies

It may not be immediately evident in which format an individual policy is written but for practitioners it is important that they know.

Most policies are written under a 'claims made' format. This simply requires that a valid policy is in force at the time a claim is made.

'Claims occurring' policies will accept claims at any time providing that a valid insurance was in force at the time the cause of the claim occurred. The fact that the insurance has since lapsed has no bearing on the validity of the claim.

It is not uncommon for therapy claims to arise months or even years after a particular treatment was given. One claim we received was submitted almost four years after the treatment had been given and the practitioner had long since retired. The claim was accepted and paid. There are many reasons for practitioners' insurance being allowed to lapse, the most common being for maternity reasons and taking time out to undertake further training or to travel. It is reassuring for therapists to know that should any 'late' claims arise they will be honoured. They need to remember, however, that the settlement of a claim, including the level of indemnity, will be governed by the terms of the insurance which were applicable at the time the events causing the claim actually took place.

Practitioners holding policies with 'claims made' wording need to buy 'run off' insurance to protect any periods that their practitioners cover is allowed to lapse. On permanent retirement the recommended period for 'run off' insurance is six years. The cover is not expensive but the danger is that the practitioner may himself/herself not be aware of the importance of having the extra cover or may be forgetful and fail to make the arrangements. There have been several instances of retired practitioners being left in considerable debt as a result of a claim being made against them during a period in which they were not working and were uninsured.

Insurance for Teaching

Practitioners, many of whom have previously undertaken lectures and demonstrations as part of their work, are now turning to teaching their therapy skills to others on a part-time basis.

Insurance companies have traditionally accepted lectures and demonstrations as an extension of the normal practitioner/client situation. They have also excluded workshops and other formal teaching activities from standard practitioner cover. Client-based treatments usually present a one-to-one practitioner/client situation.

Teaching usually requires that several untrained persons practise treatments on each other or on other third persons whilst being supervised by a single trained practitioner. The increased level of risk and the advisability of additional insurance is self evident.

Individual policies can easily be tailored to include any teaching cover required although possession of an acceptable teaching qualification will be required in addition to therapy qualifications.

Quotations for the supplementary premium needed for teaching insurance is based on:

* the subject/s to be taught;
* the average number of students per class;
* the length and frequency of the classes that are to be held.

Insurers will usually provide quotations for additional teaching insurance, but individual applications need to be made. For those insured under group scheme, applications would need to be made through the association administering the scheme. It is possible that some may not be able to offer this service.

Insurance Whilst Training

Practitioner insurance is often defined as that available to those who are qualified therapists working within the limits of their training, knowledge and experience.

Students will usually (but not always) be protected by a policy held by the college or tutor, which protects them 'whilst working under the direct supervision of a qualified tutor'.

This begs the question as to the position of the student and practitioner student undertaking work experience or independent work compiling case studies, which have become a requirement of most vocational training.

The first has an easy answer. Any person that is engaged in connection with a work experience or training scheme is deemed an employee of the business and should therefore be registered under the compulsory employers liability insurance policy.

Compiling case studies is quite a different matter. They now form a requirement of most training syllabuses and may be an easy way of enabling a student to obtain additional practical practice before qualifying.

Horror stories abound:

* of students being told to practise (uninsured) an advanced technical treatment on several members of the public in order to be awarded their qualification certificate;
* of students encouraged to practise cutting and treatment techniques on family and friends when only one week into a hairdressing training course;
* of another college telling a student to practise an advanced treatment at home. The result left the student's female model suffering 75% baldness.

Notwithstanding the above, student insurance cover can be obtained under a number of group insurance schemes. Clearly there should be a number of safeguards in place before insurance can be obtained. In our own Independent Professional Therapists International (IPTI) scheme, insured members can apply to have their existing insurance cover extended to cover practical work that is an integral part of additional therapy training. Students undertaking their first therapy training can obtain insurance for independent practical work that is part of the syllabus requirement. In both cases, however, the course needs to lead to an approved qualification and the students' participation has to be registered and is monitored in a bid to avoid irresponsible incidents such as have been mentioned.

Group insurance schemes provide cover for the majority of practitioners. They seek to provide adequate and appropriate insurance for all participants, but inevitably the resulting policy is something of a compromise. Individual practitioners need to be sure that their individual insurance requirements are included. They may need to ask for a copy of the full policy wording if, as sometimes appears to be the case, only a summary of the insurance provisions is sent to the participating group members.