Professional liability insurance: are you adequately covered?

Professional liability insurance is now essential if members are to practise legally. CSP expert Pip White explains why.



What exactly is PLI?

It stands for professional liability insurance. Our indemnity insurance covers you if a patient sues you as a result of your work. The CSP scheme covers you for medical malpractice and professional liability (both for a treatment issue) and public liability (eg if someone slips in your clinic). 

Why do I need professional indemnity cover to practise? 

From July 2014 all registered physios have had to prove they have appropriate professional indemnity in order to be on the Health and Care Professions Council’s (HCPC) register. Without proof of adequate indemnity you run the risk of being struck off. Most CSP members already meet these requirements but some may need to check the cover they have in place. (See Frontline, 3 September 2014 for more details).

But I’m always very careful. Surely I don’t need cover?

Sometimes things go wrong. Failing to spot a ‘red flag’ sign of a serious condition could lead to a claim. The CSP currently has nearly 150 ongoing negligence cases. The highest settlement to date was £750,000. Each CSP member is insured up to £5 million for any one claim and up to £10 million a year.

Will all CSP members need to have insurance? 

If you are registered with the HCPC, yes. That includes members working in education, management and research. There are also certain situations where you need additional insurance cover on top of the main CSP scheme. For example, if you work with animals or work overseas for more than 180 days, or if you run a practice or you employ other people then you really should check what cover you have in place.
What about students, associates and retired members, who don’t have to register with the HCPC?
Even if you are not HCPC registered the vast majority of CSP members still need to be insured. The CSP insurance includes students, associates and some retired members even if they don’t need to be HCPC registered.
For the cover to be valid, students must ensure they are working under the supervision of a registered health professional and associates must ensure a CSP member physiotherapist is delegating their work to them.

If I’m in a job,won’t my employer cover me?

Whether in the public or private sector, employers are responsible for the acts and omissions of their employees and need to indemnify their employees for claims brought about as a result of their work.
However, you may not be covered if you’re shown to have acted inappropriately or outside the terms of your employment contract or job description. And if you were to do any work outside your main employment, your main employer would not cover you for these activities. Sometimes employers may not cover you if you undertake courses at the weekends or outside working hours, even if the course is to help you in your job.
In a few cases, we are aware of employers relying on the personal PLI cover of individual members as a way of avoiding their own employer insurance responsibilities. We are investigating this and as your trade union can offer advice and support to employed members who need to challenge this situation.

Who will be checking I have the insurance the HCPC needs?

The HCPC will ask you to confirm that you have indemnity insurance for the type of work you are doing. You can find out more here.  

What checks do the CSP make?

It’s up to you to make sure you have read the policy closely and to choose the correct membership category for the type of work you do. If you are in the wrong membership category, you may not have cover.
The CSP will only check your membership status if a claim comes in against you. It will not routinely do this when you join or renew your membership.

As a physio running my own business am I – and my staff – covered by CSP insurance?

We’d suggest you seek personal advice from our brokers, Graybrook (see box below for details) based on exactly how you are running your business and who works with you. The CSP policy only covers members as individuals or as a sole trader limited company.
It does not cover any other kind of physiotherapy business. We’ve had cases where a physio thought their company would be covered under the personal CSP scheme for members, and sadly has found out that their company has not been insured for claims against it. 

Are we getting a good deal form the PLI scheme? 

Yes. We buy a ‘group’ indemnity policy that means that the CSP holds a policy that covers all CSP members. This is far more cost effective than buying the same cover individually. And because physiotherapy is less risky than medical practice, CSP members pay far less for insurance than doctors.

What isn’t covered?

Like all insurance policies, the CSP scheme does have a number of terms and conditions so you do need to read the small print of the policy. Apart from business cover outlined above, some of the other things that aren’t covered include: working permanently overseas; working overseas for more than 180 days; treating animals; foreign national physios (except students) working overseas in their home country for any length of time at all; and any cover for criminal allegations against you. (see Advice line, Frontline 6 February 2013). 
Also, from 1 July  we’ve had to exclude treatment of adult professional footballers who fall into certain categories. We have published a full set of full set of FAQS that explain the upcoming changes in relation to treating some footballers. 

Why the changes for physios treating elite footballers? 

The potential costs of defending or having to pay out on a claim from an elite footballer is now too great that our general CSP PLI scheme can’t include this group of patients at an affordable price for the whole scheme.
The change is unique to football and does not affect other sports. It will not affect physiotherapists employed by football clubs where the football clubs have proper cover in place themselves. But it will affect self-employed physiotherapists and those running clinics that treat affected footballers.
We are still discussing with our underwriters the final wording of the footballer exclusion clause to ensure it is clear.  The latest updates will be added to the treatment of professional footballers page.

What do I need to do next?

  • Check your CSP membership status is right for your role.
  • If you work for yourself check whether you need additional business insurance cover. 
  • If you run a clinic, practice or business that has other people involved, check you have suitable business insurance cover in place. 
  • If you work in an area that is excluded from the scheme, log in to check you have suitable cover in place for this area. 
  • If you are concerned about your employer’s cover, ask them to confirm their arrangements. You can contact the CSP’s employment relations and union services for advice, whether you are in the NHS or private sector or just email:;

Pip White

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