Scope of practice is an underwriting question, not just a licensing one.
Business insurance for physical therapy clinics — including the modalities that sit at the edge of scope and are excluded by some policies.
Tell us the situation.
A licensed human replies the same business day — not an auto-responder, and not five producers calling at once. We shop it across our carriers and tell you if the policy you already have is the right one.
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What physical therapy businesses actually need.
Professional liability
Covers the advice, the drawing, the diagnosis — the work itself, rather than someone getting hurt on your premises.
Without it — Manual therapy injuries and treatment decisions are the core exposure, and some modalities are excluded unless disclosed.
General liability
Third-party bodily injury and property damage — the line nearly every contract names by default.
Without it — A patient injured on equipment or falling in the clinic is a premises claim, not a professional one.
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 — Therapists are injured doing exactly what they treat others for.
Commercial property
Buildings and contents, valued at what it costs to rebuild today rather than what you paid.
Without it — Tables, modalities and clinic fit-out are expensive to replace after a fire or a flood.
Equipment breakdown & spoilage
Covers the walk-in, the compressor and the line when they fail from the inside — a mechanical or electrical breakdown is excluded by property policies, and the stock that thawed goes with it.
Without it — Modalities and clinic plant fail, and property policies exclude the breakdown itself.
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 — Patient records and scheduling systems carry notification duties after a breach.
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 — One-to-one hands-on treatment in a private treatment room is an allegation exposure general liability excludes.
Business income
Replaces the profit and pays the ongoing bills while a covered loss keeps you closed — the part of a fire claim that is not the building.
Without it — A clinic that cannot open is a clinic with no revenue and the same lease.
Kevin Kelsey
Founder | Principal Agent
Owned and ran a home health agency before insurance. That is where the allied health exposures were learned first-hand rather than from a rate manual — the vendor packets, the abuse and molestation requirement, staff driving their own cars to clients, and the he-said/she-said nature of a claim arising from one-to-one direct care where nobody else was in the room.
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What physical therapy operators ask us.
Is dry needling covered by my policy?
Only if it has been disclosed and the policy does not exclude it. Dry needling sits at the edge of physical therapy scope, is regulated differently state to state, and several professional policies exclude it or require it to be scheduled. Performing it under a policy that excludes it is the kind of gap that only becomes visible at claim. The same question applies to spinal manipulation and to any modality your state treats as contested.
What about treatment in patients’ homes or a gym?
Both are placeable and both should be stated. Treating outside your own premises changes who owns the space you are working in, and a facility you attend will frequently want to be named as an additional insured. Mobile and gym-based practice written on a policy that assumes a fixed clinic is a mismatch worth correcting.
Do I need abuse and molestation as an adult clinic?
It is worth carrying. One-to-one hands-on treatment in a private room is the fact pattern these allegations arise from, regardless of the age of the patient, and the standard general liability form excludes them. Where you treat minors or contract with a school or facility, expect it to be required rather than suggested.