The exclusion that catches med spas is not a procedure. It is who was supervising and what your advertising promised.
A med spa needs medical malpractice written for its injectables and energy devices, covering every injector and the medical director, plus general liability, property for the devices and workers comp, and the policy only holds if each injector is licensed and supervised the way your state requires and your procedures are not on the carrier’s excluded list.
Tell us the situation.
One licensed human replies the same business day — not five agents, not an auto-responder. If the policy you have is already the right one, we will tell you.
We use this to quote and service your insurance, and we do not sell it or pass it to lead networks. Privacy policy.
Send us what you have. We’ll tell you if it’s right.
Your current policy paperwork, a renewal notice, or nothing at all. A licensed agent reads it and replies the same business day.
What med spa businesses actually need.
Medical malpractice / professional liability
Injury from injectables, lasers, peels and any treatment performed under medical direction.
Without it — The core coverage, and the one whose exclusion schedule decides what is actually insured.
Named insured coverage for every provider
The medical director, nurse injectors, NPs and PAs each named on the policy rather than assumed.
Without it — Work by a provider who is not named on the certificate is excluded outright, however qualified they are.
General liability
The premises, the waiting room and injury unrelated to treatment.
Without it — The base every lease requires, and it will not answer a single treatment claim.
Abuse and molestation
Allegations arising from treatment in private rooms, including intimate-area procedures.
Without it — Excluded from general liability, and unavoidable in a business built on private hands-on treatment.
Business cyber and regulatory
Clinical records, identifiable photographs, card payments and the booking platform.
Without it — Notification duty follows the data, not whether you call yourself a medical practice.
Equipment and business property
Lasers and energy devices — six-figure items — plus breakdown of the platforms themselves.
Without it — A device failing from an internal cause is excluded by property, and it is the most valuable thing you own.
Employment practices
Claims by injectors, estheticians and front-desk staff in a high-turnover sector.
Without it — Excluded from general liability, and frequent wherever commission and scope-of-practice disputes meet.
Crime and social engineering
Injectables and devices, which are worth stealing, and a supplier payment redirected by a convincing email.
Without it — Money sent on a convincing instruction is not a burglary, so the property policy does not respond. Social engineering coverage is the part that does.
Group health and benefits
Injectors and licensed staff whose clients book by name.
Without it — An injector leaving takes their client list with them, and replacing one means recruiting against every med spa in the area.
The claims we actually see.
Ordered by how often we see them, not by how dramatic they are. Each one names the coverage that answers it — and the policy people wrongly assume already does.
Most common
A filler or neurotoxin injection causes injury or asymmetry
Covered by Medical malpractice / professional liability
Only if the injector is a named insured and was supervised as your state requires. Both are exclusions before the injury is even considered.
Most common
A laser or energy device burns or scars a client
Covered by Professional liability
Device claims turn on who operated it and under what delegation. Several states treat laser use as the practice of medicine, which changes who may hold the handpiece.
Common
A result does not match what the marketing promised
Covered by Nothing — warranty of efficacy is excluded
The exclusion covers any guarantee of how well treatment works, including one made through advertising or social media. "Guaranteed results" in a post is the sentence a carrier points at.
Common
A procedure on the excluded schedule goes wrong
Covered by Nothing — read the endorsement
Threads, PRP outside microneedling, IV therapy, fat dissolving, intimate rejuvenation and weight loss programs are commonly excluded. Adding a service without checking is how this happens.
Less common, severe
A patient record or before-and-after photo set is breached
Covered by Cyber, with a healthcare regulatory extension
A med spa holds clinical records and identifiable photographs, and the notification duty follows the data rather than whether you consider yourself a medical practice.
Find the page for what you actually are.
Every one of these is written for that specific operation — the coverages it needs, the questions underwriters ask it, and what it usually gets wrong.
- Estheticians
We cover estheticians whether you are employed, renting a booth or on your own. Read the excluded procedure schedule first: it decides whether the treatment you actually perform is insured.
- Laser Hair Removal & Energy Devices
Who is legally permitted to operate the device, and who it was delegated to, decides whether a burn or pigment claim gets paid. We cover laser hair removal and energy-device treatments.
- Permanent Makeup & Microblading
A face-visible result generates dissatisfaction claims that no other beauty treatment does. We cover permanent makeup and microblading for that, for infection and reaction, and for correction and removal costs.
- IV Therapy & Wellness Infusion
An IV drip is a medical procedure that sits outside most spa and esthetician policies, needs a named prescriber, and travels to the client. We write it properly.
What the policy will not cover.
Pick a procedure to see what the exclusion actually means and whether it can be placed somewhere else.
Injectables are not on this list, and that is deliberate. Neurotoxins and dermal fillers — Botox, Dysport, Juvederm, Restylane and the rest — are ordinarily covered when the person injecting is licensed to do it and supervised the way your state requires. So are microneedling, chemical peels at esthetician depth, laser hair removal, body contouring by device, and laser tattoo removal. The list below is what falls outside that, not a list of everything you do.
Commonly excluded procedures
Liposuction, in every form
Laser liposuction, lipodissolve, lipolysis, lipoinjection and microlipoinjection are excluded together, and usually by name. Carriers treat fat reduction by injection or cannula as surgery regardless of how the marketing describes it.
Can it be placed? Usually yes, but on a surgical or physician-led form rather than a med spa one, with certain carriers only and priced accordingly. The determining question is who performs it and under what supervision, not what it is called.
Mesotherapy
Injection of compounds into the mesoderm for fat reduction or skin effect. Excluded on essentially every esthetician schedule and most nurse schedules.
Can it be placed? Sometimes, with a physician named on the policy and a documented protocol. Expect a specific underwriting review rather than a standard quote.
Autologous fat transfer
Taking fat from one part of the body and placing it in another. It combines two excluded acts, the harvest and the graft, so it is excluded twice over.
Can it be placed? Physician form only. It is not a med spa placement.
Silicone injection
Excluded without exception on every schedule we have read, and it is one of the few where no market will take it. The claims history behind that is severe and permanent.
Can it be placed? No. If a business is doing this, the exclusion is the smallest of its problems.
Thread lifts and mini facelifts
Barbed suture lifts sit on the surgical side of the line even when performed in a non-surgical setting, and "mini" in the marketing does not move them.
Can it be placed? On a physician policy with the performing practitioner named. Not on an esthetician form.
Surgical hair transplant
Follicular unit extraction and strip harvesting are surgery. Non-surgical hair treatments — PRP for hair loss, low-level laser — are usually treated separately and may be covered.
Can it be placed? Usually yes, but on the right form and with the right carrier. Worth separating your hair services on the application rather than describing them as one thing.
Sclerotherapy and vein stripping
Vein treatment is excluded on esthetician schedules and frequently on nurse schedules. Some carriers allow sclerotherapy specifically and exclude the rest, so the wording matters more here than on most items.
Can it be placed? Often yes for sclerotherapy, but only with certain carriers and with a supervising physician. Read the schedule for the specific word rather than assuming.
IV infusion therapy and vitamin injection
The fastest-growing service in this industry and one of the most commonly excluded. The exposure is not the vitamin, it is the line, the sterility and who is placing it.
Can it be placed? Increasingly yes, but with a shrinking set of carriers and full underwriting. It needs a nurse or physician named, standing orders, and a documented protocol. Ask us before you add the service, not after.
Hormone therapy and weight loss therapy
Pellets, testosterone, semaglutide and the rest. Excluded on aesthetic forms because it is the practice of medicine with an ongoing patient relationship, which is a professional liability risk rather than a treatment risk.
Can it be placed? Usually yes, but on a medical professional liability form rather than this one. It usually means a second policy rather than an endorsement.
Platelet rich plasma, outside microneedling
PRP is commonly allowed as part of a microneedling treatment and excluded everywhere else: for hair, for joints, and for intimate procedures.
Can it be placed? The microneedling use is usually already covered. The others need a physician form.
Stem cell therapy
Excluded universally, and it is also a regulatory exposure independent of the insurance: the FDA position on marketing unapproved stem cell products is active and enforced.
Can it be placed? No. This is one to stop offering rather than to insure.
Prolotherapy and carboxytherapy
Injection therapies aimed at tissue or gas infusion. Grouped with the other injection exclusions.
Can it be placed? Physician form, with the practitioner named.
Chelation and colon hydrotherapy
Both are excluded as alternative medical treatments rather than aesthetic ones, and both carry systemic-harm exposure that an aesthetic form is not priced for.
Can it be placed? Specialist market only, and rarely worth what it costs.
Ozone and radon therapy
Excluded outright. Like silicone, this is a category where the market has closed rather than priced.
Can it be placed? No.
Acupuncture
Excluded on the aesthetic policy, which surprises people because it feels low risk. It is a separate licensed modality with its own claim pattern.
Can it be placed? Yes, on its own professional liability policy, which is inexpensive. It just is not part of this one.
Kybella away from the chin
Kybella is approved for submental fat. Used elsewhere on the body it is off-label, and the exclusion is written to the location rather than to the product.
Can it be placed? Chin use is generally covered. Off-label use is not, and no endorsement fixes that.
Deep chemical peels without supervision
The depth is the trigger, not the peel. Superficial peels are ordinary esthetician work; medium and deep peels require the supervision your state and the schedule both name.
Can it be placed? Usually yes, with the supervision documented. Of everything on the list, it is the easiest to fix.
Extracorporeal shockwave therapy
Acoustic wave devices, including the erectile dysfunction application that drove the exclusion onto these schedules in the first place.
Can it be placed? Medical form, physician named.
Non-prescription grade HCG
Excluded specifically because the product is not what it claims to be. Prescription HCG under a physician is a different conversation.
Can it be placed? Not in the non-prescription form. Under a physician, sometimes.
Intimate rejuvenation
Every description of it, including the PRP "shot" procedures. Excluded on every aesthetic schedule we have read.
Can it be placed? Physician professional liability, and expect underwriting to ask for training certificates.
Anything under general anesthesia
General anesthesia or deep sedation voids the aesthetic form regardless of what the procedure itself is. It converts the setting into a surgical one.
Can it be placed? A surgical facility placement, which is an entirely different program.
Tattoo removal by excision
The schedule excludes removal by multiple punch biopsy, cutting the tattoo out, because that is surgery. It says nothing about laser tattoo removal, which is energy-device work and is treated like laser hair removal.
Can it be placed? Laser removal is normally covered already, on the same terms as your other device work. Excision is a surgical placement and a different policy. If you offer both, describe them separately on the application, because one word covering both is how the wrong answer gets underwritten.
Treatment by someone not on the policy
The exclusion almost nobody reads for. Work performed by a physician, nurse practitioner or physician assistant who is not named on the policy is excluded, so having a real medical director is not the same as having one who is a named insured.
Can it be placed? Yes, and this one is usually free to fix. Most of the professional liability carriers we use will include the medical director on the policy, and several will add the whole clinical team, so this is normally an endorsement and a list of names rather than a second policy. Send us every practitioner and we will get them named before the exclusion matters.
Guaranteed results
Any warranty of how well a treatment works, expressed or implied, including in advertising and on social media. "Guaranteed results", "permanent" and "you will lose X inches" are each a sentence a carrier can point at.
Can it be placed? Not an insurance fix, a marketing one. Change the copy, because this exclusion is triggered by your own words.
This is one carrier’s schedule. Yours will differ, and the point is not the specific list but that a list exists, that it is long, and that almost nobody reads it until a claim. Send us your schedule and we will tell you what is on yours. And read every "can it be placed" above as a yes with a but. The but is always the same three things: only with certain carriers, only if underwriting decides it is a risk they want, and priced for what it is. Nothing here is a quote, and nobody can tell you the answer without seeing the operation.
A multi-provider medical spa was carrying a policy bought when the business did facials and light peels. The menu had since grown to injectables, two laser platforms, microneedling with PRP and an IV drip service, and two nurse injectors had joined without being added to the policy.
We read the excluded procedure endorsement against the current service menu and found four live services excluded outright and two providers unnamed. The account was re-placed with a market that writes the full menu, every provider named, and the marketing reviewed for guarantee language before binding. Nothing about the business changed except that what it actually did was now what the policy covered.
A brand new med spa in Texas needed insurance in place to open. Their lawyer had instructed them to buy professional liability under the PLLC, which the medical director technically owned, and general liability and property under the operating LLC. Two entities, two owners, one clinic, and a lender who wanted the new lasers insured before releasing the money.
We worked through the entity structure so that each policy named the right insured for the right exposure, and negotiated the treatment menu with underwriting so that everything they planned to do was covered from the first day. The new lasers were scheduled to satisfy the lender. A structure that is right for the lawyer is only right for insurance if the policies follow it exactly.
“His repsonse times and willingness to communicate on my behalf have been unmatched…”
What our med spa clients ask us.
What gets denied that has nothing to do with the procedure?
Three things, and they are the ones almost nobody reads for. First, work performed by a physician, nurse practitioner or physician assistant who is not actually named on the policy. The medical director being real is not the same as the medical director being a named insured, and the exclusion is written on the name. Second, any warranty or guarantee of how well a treatment works, expressly or by implication, including one made through advertising or social media.
What procedures do med spa policies usually exclude?
Around twenty of them on a typical schedule, and the browsable list further up this page has each one with what the exclusion actually means and whether it can be placed elsewhere. The short version: injection-based fat reduction, anything surgical, most alternative therapies, and anything done under sedation.
Does the medical director need to be on the policy?
Yes, by name, and this is where more med spa claims fail than on any procedure. The exclusion is written on whether the physician, nurse practitioner or physician assistant is designated as a named insured on the certificate, not on whether they exist, are qualified, or have a signed agreement with you.
How does state supervision law affect coverage?
Directly, because the policy borrows the state’s answer. A common exclusion applies to services not rendered under the supervision required by applicable law and by your own license, so the coverage question becomes a scope-of-practice question, and those rules differ enormously by state and change.
How much does med spa insurance cost?
It is driven by the service menu, the provider mix and revenue far more than by square footage, and the range is genuinely wide because a facial-and-wax business and an injectable-and-laser practice are different risks wearing the same signage. Injectables, energy devices, body contouring, IV therapy and weight loss programs each move it.
What is medspa malpractice insurance?
Professional liability for the providers and the entity that employs them. It pays for injury from an injection, a laser, a peel or a device, and it is separate from general liability, which only answers for the waiting room. A medspa carrier prices it off the procedure list first, since injectables and energy devices rate differently from facials, then off whether the medical director is on site or only on paper, and off who injects, because a nurse practitioner and a registered nurse sit on different forms.
Does a med spa need malpractice insurance if the medical director has their own?
Yes. The director’s own policy covers the director, and it usually stops there. The injectors and the business entity are each a separate defendant, and none of them is insured by a policy that names only the physician. What works is an entity policy naming every provider, which is how we build most med spa placements, or a policy per injector with the entity added on. Check the director’s policy too, because many physician forms exclude work outside the practice they were written for, and a medspa is exactly that.
How do I find out what my own policy excludes?
Look for an endorsement with "excluded procedures" or "cosmetic procedures exclusion" in the title, and read the list rather than the policy summary, because the declarations page will not tell you, and the certificate certainly will not. Every carrier writes a different schedule and the same carrier writes different schedules for different license types, so a colleague’s answer is not yours.
Commercial insurance is 96% of what we do — it is not a department here, it is the whole business. Not ready to talk? The guides answer the questions this page raises in more depth. Already insured with us and need a certificate or a policy change? Ask the service team rather than starting a quote — it is faster and it goes to the people whose job it is. We also write home and auto, which is usually cheaper alongside the business policy than apart from it.
Handed a lease, a vendor packet or a client contract with insurance requirements? Paste it into the COI Requirements Decoder to see what each one means for your business, or read what the requirements mean.