Getting your Aesthetics Insurance claim paid

Getting it right is everything in the world of aesthetics and cosmetic procedures. From the initial patient consultation through to allergy testing to the treatment itself, PolicyBee medical malpractice insurance specialist Sian Adams explains why everything needs to follow a well-rehearsed plan

The stakes are high when it comes to people’s faces and bodies, and an allergic reaction, an infection, or a procedure that doesn’t go as expected can spell serious trouble. Not just for your patient, but for you, too.

That’s why medical malpractice insurance is crucial for aestheticians and cosmetics practitioners. It’s there in case your well-rehearsed plan goes out the window, and there’s a claim against you.

Needless to say, a claim that you caused someone physical suffering, disfigurement or worse can be for hundreds of thousands of pounds. So, you really wouldn’t want to be told your insurance can’t help at such a crucial time.

That’s the stuff of nightmares. But it’s a nightmare that could become a frightening reality if you haven’t read your policy wording carefully and met all its conditions. And if you haven’t stuck to that wellrehearsed plan we mentioned earlier.

PLAYING BY THE RULES

The thing is, if you stray beyond your cover’s Ts and Cs, or don’t follow proper procedures, it could mean your claim is kicked into touch; insurers have every right to refuse claims that fall outside their policy wording.

That makes it essential to know exactly what you’re signing up for when you buy medical malpractice insurance. You need to know what is and isn’t covered by a policy. Also, what’s expected of you, as your part of the bargain.

Wordings can differ from policy to policy, but here are some of the things insurers commonly expect, and which you can get wrong - the kind of things with the potential to trip you up should you ever have to make a claim.

TREATMENTS

When you take out a policy, your insurer will want to know what kind of treatments you’re performing. Generally, you’ll only be covered for the ones you tell them about.

If you add any others into the mix, you need to let your broker or insurer know – before you start offering them.

TRAINING AND REGISTRATION

Most policies define minimum levels of training and experience for carrying out different treatments. So, you’ll need to make sure you make the grade.

Medically qualified practitioners must also ensure their registration is up to date with their relevant governing body.

CONSULTATIONS

Talking to patients, gathering the right information, and figuring out whether they’re a good fit for a procedure are key, as is managing their expectations.

Of course, you’ll need to explain exactly what’s involved in a treatment, the risks, any alternatives, and what happens afterwards.

You’ll also need to discuss your patient’s medical history, any medication they’re taking, any allergies, and crucially, the results they’re looking for.

Failing to explain everything to patients can lead to trouble. But how do you prove you spelt it all out clearly and did the proper checks? This brings us to….

CONSENT FORMS

A good consent form can be worth its weight in gold when defending a claim. If everything’s set out in back and white, and signed by your patient, it’s essential proof that they knew what to expect.

But it must be a detailed form, and it should cover all the ground already mentioned. Plus, it must include an exact explanation of the procedure and a warning of any possible side effects.

It should also record your patient’s answers to relevant questions about their medical and previous treatment history.

PATCH TESTS

Insurers will expect you to carry out a patch test for certain treatments. Not having done so can invalidate a claim if there’s a subsequent problem.

If a patient refuses a patch test because they’ve had the same treatment previously, then they must sign a waiver form to acknowledge this.

PHOTOS

The camera never lies. That’s why it’s essential to take before and after photos when a patient undergoes a procedure.

Those images can provide essential evidence if a patient claims disappointing results.

RECORDS

Recording everything you do in meticulous detail in your patient’s file is equally vital. Again, it’s material your insurer can make use of in your defence if there’s a claim.

You should include as much information as possible, down to the time of treatment, products used, exact amounts injected for fillers and precise settings on machines.

Your policy wording may even state how long you should retain records since claims can emerge long after a procedure was carried out. Some may say five years, others ten.

EQUIPMENT AND PRODUCTS

It goes without saying that you’re expected to use high-quality equipment and products and to keep them properly maintained and sterilised.

Not being able to demonstrate this can, in some cases, jeopardise a claim.

AFTERCARE

Your duty of care doesn’t finish as soon as your patient is out of sight - they shouldn’t be out of mind too.

Giving them the right advice on what to expect in the days following treatment, as well as any specific care needed, is essential. That information should be given in writing rather than verbally as a continual reference.

If a problem emerges, it can help prove you weren’t negligent in your patient’s aftercare.

TWO-WAY STREET

Following the right procedures and keeping detailed records can help hugely if you ever find yourself on the wrong end of a claim. They can help prove that you played by the book and did everything possible to secure a good outcome for your patient.

Also, be sure to keep your broker or insurer in the know. You need to tell them as soon as you’re aware of a potential problem. It’s important never to admit liability, get a solicitor involved, or start negotiating with a complaining patient without your insurer’s say-so.

At the end of the day, the devil’s in the detail when it comes to policy wording. Insurance is a two-way thing. And you need to make sure you know exactly what an insurer expects of you before they’ll weigh in on your behalf.

You keep your end of the bargain, and they’ll keep theirs. But failing to read your wording properly and falling short of the terms set out can make for a very expensive mistake.

For more information, visit www.policybee.com.