What Are Your Risks?

How ABMP Liability Insurance Gives You the Security You Need

By Karrie Osborn

Taking risks is thrilling when you’re bungee jumping or rappelling off the side of a mountain. In your professional life, however, undue risk is not something you want to embrace.
When massage therapists and bodyworkers practice their craft without the safety net of professional liability insurance, risk is what they’re living with every day—risk of financial catastrophe, risk of personal losses, and risk of professional undoing. How strong is your safety net?
It’s the Big Things …
Insurance is meant to protect you from the catastrophic occurrences in life. In your professional world, liability insurance means keeping your business secure, even in the case of an exorbitant claim. Could you pay $500,000 for a client’s medical bills and lost wages if she claims you permanently injured her? Would you be able to afford the fees required to even start a conversation with a lawyer, let alone retain one to defend a claim in court? Being accused of cracking a client’s vertebra, rupturing a disc, or causing irreparable scarring after a too-hot stone massage can all add up to extensive medical bills and litigation.
Remember, it’s not always a reflection of the quality of your work, or even your work ethic, when a claim is made. Sometimes accidents just happen. And, unfortunately, sometimes a client may claim (or believe) an accident happened even if it did not. Professional liability insurance can protect you from both frivolous lawsuits and legitimate client injuries, both of which can easily bankrupt the uninsured MT.
Even with a proper intake and doing everything right, massage therapist Marie Kimpel found herself facing a $70,000 claim when a client was allegedly burned by the hot stones Kimpel incorporated into her massage. While there were many variables that led up to, and potentially contributed to, the injury, the claim ultimately landed at Kimpel’s feet and took a toll on her personally, as well as professionally. “It was a horrible experience,” Kimpel says. “It took me six months to come back to normal in my work. I questioned myself: ‘Maybe I really don’t know what I’m doing. What if something happens with the next client?’ It was pretty emotional for me.” From her experience, Kimpel found the strength to not only improve her business practices, but open her own business. Checking in with the client—frequently—was probably the biggest change she’s incorporated. “I never could have imagined that someone wouldn’t tell me if something was uncomfortable during the massage,” Kimpel says, but that’s exactly what the young claimant told the lawyers: she didn’t know she could say something. Now Kimpel makes it a point to ensure every client knows they can speak up, and she explains exactly what the session will entail. “I ask, ‘Do you understand what you’re getting into, what might happen, what you might feel after the massage and during the massage?’ And I’m always checking in with them. I have really good communication with clients now. That’s harder with clients who like to ‘check out,’ but I’m sorry, I need to know. Clients have to be as open to me as I am to them.”
One part of the experience that gave Kimpel comfort—amidst her shaken confidence, lack of support from her employer, and uncertainty about her future—was knowing she was protected financially because of her membership and accompanying liability insurance with Associated Bodywork & Massage Professionals (ABMP). “I didn’t have to worry about that part of it,” she says. “I got an email one day that it was settled.” And that was the last of it.
… and It’s the Little Things
Smaller accidents, like a mild allergic reaction to massage products or bruising after a massage, may seem less catastrophic than a client claiming a ruptured disc or skin grafts. But these can also be expensive and time-consuming claims (and there’s no accident so minor that it can’t lead to the courtroom).
The same principles apply here: a good intake, an extra ounce of precaution (especially if you are not in your normal setting), and client communication will alleviate a lot of potential headaches for you and your clients.
Typical liability insurance will also cover you for accidents that aren’t directly related to the massage itself: spilling oil on a client’s carpet, snagging a client’s jacket on a sharp corner in your office, or having your tent fall on someone during a charity event.
Even if the incident doesn’t result in an insurance claim, communicating effectively with clients before and during your session helps set the stage for a better experience all the way around. Making sure clients understand the benefits of massage, and the outcomes you both hope to reach together, creates a partnership from the beginning, where fewer things are able to fall through the cracks.
Don’t Forget the Obvious
When a client takes a tumble in your business because of a loose tile, a ragged rug, or a dog underfoot, you are at fault. When a client slips because of ice on your stairs, that responsibility falls on you. And when your table collapses under the weight of a heavy client, that’s your fault, too.
Sometimes the result of these slips and falls is a minor bump or bruise; sometimes it’s a major injury. The client who had to have her head sutured back together after falling into a glass case after her massage was not planning on ending her day that way. And neither was her therapist. Some accidents can’t be avoided, no matter how many precautions you take—they are just accidents. 
The slip and fall coverage that is part of most professional liability policies is meant to cover you against incidents like these that happen largely outside your control.
It Can Happen to You
Despite the best business ethics and hands-on practices, massage therapists and bodyworkers leave themselves open to financial disaster if they are not protected by professional liability insurance. “Even the most cautious and caring therapist has to understand that accidents can happen to anyone,” says Katie Armitage, executive director of ABMP, the largest US massage membership association (Massage & Bodywork’s publisher), which includes professional liability insurance as one of its many member benefits.
“We have had many claims for tables collapsing, on-site chairs collapsing, clients falling or tripping, even a candle that ignited some alcohol that spilled onto the client and caused extensive burns,” she says. “I don’t plan on having a car accident on the way home today, but it could happen and that’s why we all protect ourselves with insurance. You want to protect your assets, your future earnings, and your credit rating.”
Shopping for Insurance
When shopping for professional liability insurance, Armitage says there are some key questions to ask.
Is it Occurrence-Form or Claims-Made Coverage?
First, make sure the policy is described as “occurrence-form” rather than “claims-made” coverage.
Occurrence-form policies are the best option for your liability needs, because they continue to protect you even after you are no longer insured, Armitage says. Many lawsuits aren’t filed until the statute of limitations has nearly run out (two years after the incident, in most states). So, for example, if your insurance was effective in July 2012, you would still be covered for any incidents that occurred in July 2012 if a former client waited until now to report that incident and file a claim—even if you have since let your policy lapse, are out of business, or changed insurance providers.
If, however, you had a claims-made policy, you would not be covered in this example. Claims-made policies provide coverage only for claims that are made while the policy is active. If your claims-made policy expires, and someone files a claim against you later, you would have no coverage, even though you were insured at the time of the incident.
Claims-made policies are less expensive because they provide considerably less coverage, in a way that may not be immediately obvious to many buyers from simply reviewing the coverage limits.
Are General and Product Liability Included?
There are three types of liability, and each is an important piece of your insurance portfolio: 1) professional liability covers the work you do; 2) general liability covers the “slip and fall” scenarios; and 3) product liability covers situations where clients have an adverse reaction to a product you use on them (or a product you sell them for home use). Many policies offered for massage therapists may have one, but not all three of these important pieces. ABMP’s coverage includes professional, general, and product liability.
How Does the Aggregate Work?
An insurance policy’s aggregate is typically defined as the total coverage limit allowed under your policy. There are two ways this aggregate can be distributed: individual (per member, per year) or shared (also called universal). Make sure your policy has an individual aggregate. Under a shared aggregate, you must share the coverage limit with all of the insurance provider’s other policyholders, effectively reducing the amount available to you personally.
ABMP has the highest individual aggregate coverages available—$2 million per occurrence, and $6 million aggregate (per member, per year) for professional, general, and product liability.
Other Points to Consider
While the previous questions are the crucial ones when researching insurance options, don’t forget the smaller details. Does the company charge for additional insured endorsements (AIEs), which are often required by your landlord or employer? Many do. Is there legal defense coverage for covered losses? Are those legal costs included in your aggregate, or are they paid in addition to (above and beyond) your aggregate limits? Does the provider cover all the modalities you offer? For example, hot stone massage is excluded from many professional liability policies because of the risk of burning clients.
Preventing injury and ensuring safety is first and foremost what MTs should be doing for their clients; having protection for when things go awry is first and foremost what therapists should be doing for themselves. “You may never use your insurance,” Kimpel advises her colleagues. “But it should be the most important step of starting a business.”
 Karrie Osborn is senior editor for Massage & Bodywork magazine. Contact her at karrie@abmp.com.

Comparing Insurance?
No Offering Stacks Up Against ABMP’s, So Ask These Questions
• Is this claims-made coverage or inferior occurrence-form?
• Are the aggregates per member, per year, or shared among all members?
• Does the policy provide all three levels of liability coverage: professional liability, general liability, and product liability?
• Is there a charge for adding additional insured endorsements (AIEs)?
• Does it cover all the treatments and therapies you provide?
• What is not covered?
• Are defense costs included?
• What other benefits does the provider offer? Are you just paying for coverage or do you have a wealth of member benefits available to you?

Tip: Many high-dollar insurance claims result from therapists who overstretch, overmanipulate, or are too aggressive when performing deep-tissue work. Remember the basics, regardless of how many years you’ve been in practice. Make sure each client fills out a proper health history and undergoes an intake process with you—prior to every session.

Tip: Stay keenly aware of your client’s body language during your session. Check in verbally with the client several times—don’t assume that because the pressure was fine in the beginning, it’s still fine halfway through.

Tip: Always stay within your scope of practice. Don’t try out a new technique on clients until you are thoroughly competent and have added lots of practice time to what you learned on that weekend course.

Tip: Your intake process should explore everything from allergies to medications to recent surgeries and illnesses. Log in to www.abmp.com to download client intake forms, client health history forms, and other guides for a safer practice.

Tip: Shovel your walks and sweep your stairs. Be careful with rugs and electrical cords. Check the stability of your table after each client. As part of your room-readiness routine, check your treatment area to make sure there’s nothing out of the ordinary that could be a hazard to you or your clients.

Protecting Your Business
In addition to professional liability insurance, ABMP also offers optional Business Personal Property (BPP) coverage. This coverage protects against loss of business equipment in the case of fire, theft, or other disasters. ABMP members can add BPP to their memberships for an additional fee—$95 a year for $10,000 in business equipment insurance, or $250 a year for $25,000 in business equipment insurance.

“But I’m a Student”
Just because you aren’t yet practicing your craft in the community doesn’t mean you’re not responsible for the touch you provide. Do you ever work in the school clinic or participate in a school-sponsored massage event? If so, you can likely be held liable if someone is harmed during the course of those events and names you as a responsible party. The school’s insurance may cover only the school and its assets for such claims, not individual students. ABMP’s Executive Director Katie Armitage says ABMP has seen claims in this category reach upward of $500,000. If you’re a student, check with your school to see if you’re protected.

“But My Employer Covers Me”
Are you sure? “Many employers mistakenly think their employees and contractors are covered by their business policy, when, in fact, the policy does not provide for employees’ individual coverage,” Armitage says. “And if you are covered under an employer’s policy, you may not have access to their legal defense provision.” Also, employers’ policies usually only apply to services performed on their premises and won’t provide coverage anywhere else.
Armitage says it’s a good idea for therapists to maintain their own professional liability insurance to be assured they are fully covered. “Some boiler plate policies may not provide coverage for all the services you provide, so you need to be sure.”

“But I Only Work on a
Few Clients and Friends”
Not having professional liability insurance, even if you only work on a few clients and friends, can be a career-ending mistake. Yes, it’s rare to have friends sue friends, but it does happen. Associated Bodywork & Massage Professionals (ABMP) member Anna can attest to that.
After providing massage to a close friend, the friend filed a claim against Anna, alleging a severe back injury that directly led to a herniated disc and an inability to work. A long, arduous lawsuit ensued, with the plaintiff demanding $375,000. More than five years after the initial claim was made, and shortly before the lawsuit was scheduled to go to trial, the claim was settled for more than $200,000.
Luckily, Anna’s liability insurance with ABMP covered her from beginning to end. Without insurance coverage, Anna says, “I can only guess I would be in debt for the rest of my life and perhaps not be able to live independently. My life goals would be crushed.”
 Anna never thought she would have to take advantage of the coverage ABMP provides her, and she never thought a friend would sue her. But situations and relationships change, and you can never plan for the unforeseeable. As Anna tells colleagues, “Why would you compromise your practice, and life, by not having liability insurance?” Professional liability protects you from the unexpected, even if that means saving you from the unimaginable—a friend who is hurt by your work and sues you.

To read this article in our digital issue, click here.