Insurance claims trends

Eddie Hooker, founder and chief executive of Hamilton Fraser, shares the biggest aesthetic insurance payouts in 2024 and other cosmetic claims trends

The world of aesthetics insurance has seen new challenges and trends emerge. While overall reportable claims were down in 2024 from 2023 (in 2023, we had 264 reportable claims and 89 dissatisfactions, and in 2024, we had 250 reportable claims and 66 dissatisfactions), the legal costs of defending these claims are on the rise. We can never completely prevent a claim, or have any control over what the legal costs are, but understanding the key risks and implementing proactive measures is essential.

WHAT IS A CLAIM?

There are two broad categories of aesthetic claims: those related to treatments or patient complaints and business-related claims related to causes such as fire, flood, denial of access, or pandemic. In terms of treatment complaints, you have dissatisfactions and reportable claims.

Senior client services technician, Emma Bracchi, explains: “If a patient has said they are dissatisfied with the results of treatment, but there are no allegations of bodily injury, negligence, or financial loss, and they have not approached a solicitor, then this would not trigger the formal claims process. A formal claim is an allegation of bodily injury, negligence, or financial loss, which can be received directly from your patient or via a third-party solicitor.”

2024 COSMETIC CLAIMS TRENDS

There were 264 reportable claims in 2024, highlighting the need for early intervention to manage issues before they escalate. The cost of these claims has also risen, primarily due to legal fees, which often dwarf the compensation awarded to patients. Understanding this dynamic can help practitioners focus on reducing risks and improving their processes.

As cosmetics claims handler Priya Chander explains, “While overall there were slightly fewer claims in 2024 than 2023, my observation from our daily encounters with our clients is that there is an increasing trend in patients being unhappy with the treatment results.

“While these complaints may or may not be upheld, what’s clear is the cost of investigation and defence is rising.”

The rising trend in legal costs is illustrated by these examples from recent years: *figures have been rounded up:

Largest claim payout ever – £1,593,000

• £1.2 million awarded in damages to the patient
• £300,000 for the claimant’s legal costs
• £93,000 for defence costs
Here, 24.6% of the total payout was legal costs.

Second largest reserve – £547,000

• Includes damages and claimant’s costs with £80,000 in defence cost.

This is still open, so no claimant costs are available to date.

Smaller claims breakdowns:

• £65,000 total payout
• £13,000 damages to patient
• £15,000 defence costs (client’s solicitor costs)
• £38,000 claimant’s costs (patient legal fees)
In this example, 82% was legal costs.

£76,000 total payout
• £25,000 damages
• £10,000 defence costs
• £41,000 claimant’s costs
Here, legal costs made up 67% of the total paid out.

£51,000 total payout
• £17,000 damages
• £6,000 defence costs
• £28,000 claimant’s costs
Here, legal costs made up 67%.

This research shows that, increasingly, for many claims, defence costs for both parties represent more than 60% of the total claim value.

Most common treatments that result in a claim

From January 2020 to November 2024, Hamilton Fraser has managed 1,096 medical malpractice claims. The top three claim types were:

• 245 dermal filler claims

• 210 laser claims

• 91 botulinum toxin claims

Together, these three categories account for nearly half of all claims in this period. Notably, hair transplant claims (categorised under general treatments) are emerging as a significant area of concern due to the high associated legal costs:

Hair transplant examples:

£98,000 claim
• £32,500 damages
• £18,000 defence costs
• £47,000 claimant’s costs
Legal costs made up 66% of the claim.

£84,000 claim
• £27,500 damages
• £7,000 defence costs
• £49,000 claimant’s costs
Legal costs made up 66% of the claim.

£28,000 claim
• £7,500 damages
• £7,500 defence costs
• £12,500 claimant’s costs.
Legal costs made up 71% of the claim.

£19,000 claim
• £7,500 damages
• £2,500 defence costs
• £9,000 claimant’s costs (47% of total cost)
Here, 60% was legal costs.

THE EARLIER, THE BETTER

One critical takeaway from 2024 claims data is that practitioners should notify their insurers of potential claims or complaints as soon as they arise. Timely notification allows issues to be managed effectively, reducing the risk of escalating costs or legal action. Addressing issues early can often reduce claims costs, and clients may be supported without the need for formal reporting.

PROTECTING YOURSELF

In reality, serious formal claims against clinics are quite rare. And, while you can’t control whether or not a patient makes a claim against you, you can do a number of things that are not only good practice but will help you if a claim is made. One of the key things we see that result in the practitioner losing is because of a lack of evidence and record keeping on their part. While you don’t have any control over the legal costs, you do have control over having the right evidence to support yourself should a claim arise.

Patient selection
One of the most important things you can do is at the stage before treatment has taken place, and that is patient selection. Look out for ‘red flags’ and do not treat patients that you think might be suffering from body dysmorphic disorder or have unrealistic expectations about treatment outcomes. Manage expectations Understanding your patient’s motivations will help you assess whether they are the right patient for you. When discussing their expectations, be open and honest about whether you feel they are achievable.

It’s a good idea to document this in your consultation notes as well so that there is evidence that you have had this conversation. Make sure you document everything and keep records for 10 years Documentation is key, and this includes timestamped photos and recoding the settings that are used on any equipment. One reason practitioners come unstuck when a claim is made against them is that they do not have before and after pictures. Some policies require that before and after photos are taken for all injectable treatments, so familiarise yourself with your policy conditions. Take a full medical history and identify any pre-existing conditions. Make sure you document what, if any, cosmetic procedures they have had in the past and if they have ever experienced any side effects. You should keep patient records and data safe and save them for 10 years so that you have evidence if a claim is made in the future.

Obtain informed consent
You must always obtain informed consent. Explain all the risks of the treatment clearly and tell them if there are alternative, more suitable treatments. Make sure that they sign the consent form to confirm they understand. You should also make sure the patient is provided with the relevant aftercare information. It’s recommended that you provide patients with either an electronic or physical copy of aftercare information that they can refer to after they have left the clinic.

Be contactable post-treatment
You must make sure the patient is able to contact you post-treatment. If you know you’re not going to be available, make sure you provide contact details for a peer or colleague who your patient can contact instead. This will prevent the patient from panicking if they develop a side effect post-treatment and are unable to contact you, and it can prevent any concerns from escalating.

Have a comprehensive complaints procedure in place
Don’t worry that this might encourage your patients to make a complaint against you, but instead, feel confident that it will provide you with a clear and professional process if you do receive a complaint. Having a clear and comprehensive complaints procedure in place means that you can deal with any complaints efficiently and consistently if you need to.

THE IMPORTANCE OF INVESTING IN INSURANCE FOR AESTHETICS PRACTITIONERS

Insurance is an essential investment for any aesthetic professional, and like any investment, it’s important to look at quality, substance, and a high level of support services rather than just price alone when choosing which coverage is best for you. My advice is that practitioners prioritise quality and support over cost alone. It’s not a motor policy or a home insurance policy. There are lots of terms and conditions attached to these types of commercial policies, so make sure you understand what you are buying and make sure you are using a reputable Financial Conduct Authority (FCA) regulated broker. That way, if you are sold the wrong cover, there’s a comeback. Make sure that all the treatments you are performing are covered under the policy. Insurance is only as good as when you make a claim.

• Choose an FCA-regulated broker to make sure your policy is reputable and covers all treatments

• Understand your policy terms and conditions. Agood policy includes access to advice and support when claims arise

• Remember, insurance is only as good as its response when you need it

Practitioners must work with brokers who understand the complexities of the industry. When you deal with a broker like Hamilton Fraser, you can ask any question you want, and we can answer it because we understand the business you are in. Early notification of claims is key to preventing them from spiralling out of control.

When starting your aesthetics journey, choosing your insurance partner should be as important a consideration as choosing your product or training provider. It won’t necessarily define your business, but it could one day save it. While claims cannot always be avoided, practitioners can take significant steps to protect themselves and their businesses. By prioritising evidence, communication, and high-quality insurance, practitioners can minimise risks and safeguard their practices.

EDDIE HOOKER

Founder and chief executive of Hamilton Fraser, Eddie Hooker, is an expert in the cosmetic insurance sector with more than 28 years of experience. Hamilton Fraser was the first company to offer medical malpractice insurance specific to the cosmetic industry in 1996, and Eddie is passionate about continuing to raise standards in the sector. Eddie is an accomplished speaker who regularly provides support, advice and education to practitioners as an industry commentator on key topics such as aesthetics regulation, legislation, insurance and business growth.