One-to-one care produces claims with no third witness.

Sexual abuse & molestation

Covers allegations of abuse by staff or volunteers. General liability usually excludes it outright, and any organisation working with children, patients or vulnerable adults will be asked to carry it by name.

Without it — Direct one-to-one care is an abuse allegation exposure, and general liability excludes it outright in most forms — while funders and districts require it by name.

Professional liability

Covers the advice, the drawing, the diagnosis — the work itself, rather than someone getting hurt on your premises.

Without it — A treatment decision that harms a client is a professional claim, and it is the coverage every licensing board expects you to hold.

General liability

Third-party bodily injury and property damage — the line nearly every contract names by default.

Without it — Premises injuries, and the limit a vendor contract names before you can be approved.

Hired & non-owned auto

Covers vehicles the business does not own but its people drive on the job — rentals, and employees running errands in their own cars. Their personal auto policy will not cover a business trip, and the claim lands on the business.

Without it — Staff driving their own cars between homes, schools and clinics are uninsured for the business use the moment their personal insurer learns of it.

Workers compensation

Required in almost every state the moment you have employees. Priced on payroll and class code, which is why the class code is worth arguing about.

Without it — Transfers, lifting and behavioural incidents injure therapy staff, and it is required the moment you have an employee.

Crime & employee dishonesty

Theft by your own staff, funds transfer fraud, and the dishonesty bond a home care contract will ask you for by name.

Without it — Staff working unsupervised inside clients’ homes and rooms is a theft allegation exposure as much as a theft one.

Cyber & tech E&O

Breach response, ransomware and the notification costs that follow. Technology errors and omissions sits on the same policy and covers the software or service itself failing a client, which is the half most tech companies find out about too late.

Without it — Treatment notes are health records, and a breach carries notification duties whatever the size of the practice.

Umbrella & excess liability

Extra limit stacked above general liability, auto and employers liability. Usually the cheapest million dollars on the policy.

Without it — Vendor contracts and hospital affiliations routinely require limits above primary.

Is my malpractice policy enough?

For your own clinical work, often yes. For the business around it, usually not. A practitioner policy covers professional liability and little else. No abuse and molestation. No hired and non-owned auto. No general liability at contract limits, and no workers compensation. Those are exactly what a regional center, a school district or a hospital asks for. It is why a practice insured for years suddenly cannot satisfy a vendor packet.

Why is abuse and molestation coverage required so often now?

Because the organisations contracting you have been on the wrong end of those claims, and because general liability policies exclude abuse in most standard forms. If you deliver one-to-one care — particularly to children, elderly clients or people with developmental disabilities — expect it to be named in the contract with its own limit. It is not an optional extra in this class.

My staff use their own cars. Is that covered?

Not by your general liability, and often not by their personal auto policy either once the insurer learns the trip was work. Hired and non-owned auto is what answers for it, and it is inexpensive relative to what it covers. Any practice sending therapists to homes, schools or facilities has this exposure whether or not it owns a vehicle.

Do you help with the risk controls underwriters ask about?

Yes, and for a new practice it is often what gets the account written at all. We help insureds put in and maintain the controls carriers expect — annual MVR screening for anyone driving to clients, an infectious disease prevention plan, and for a business just starting out, an owner resume review that shows the underwriter the principal actually has the background to run this. A new venture has no loss history to argue with, so the only evidence available is that the risk is being managed deliberately. Presenting that properly is the difference between a decline and a quote.

What makes these claims different from other liability claims?

The absence of a witness. Care delivered one-to-one, often in a private room or a client’s home, means an allegation is decided on documentation, on your chaperone and supervision policy, and on what your policy actually covers. Practices that keep contemporaneous notes and have a written policy defend these; practices that do not, settle them.