Most people considering a cosmetic procedure never think about insurance, and the ones who do assume it is a formality. It is not a formality. It is the difference between a legal right that can be enforced and one that exists only on paper.
What indemnity actually is
Indemnity is the arrangement that meets the cost of a claim brought against a practitioner. In UK healthcare it comes in two broad forms: an insurance policy, which is a contract of insurance, and discretionary indemnity provided by a medical defence organisation, where assistance is granted at the organisation's discretion rather than as a contractual entitlement. Both are common. They behave differently at the margins, and the difference becomes visible precisely when a case is unusual.
For registered healthcare professionals, holding appropriate indemnity is not optional. It is a condition of registration across the healthcare regulators, and practising without it puts registration itself at risk.
Why it matters to you rather than to them
Suppose the worst happens: a vascular occlusion managed badly, a permanent scar, a nerve injury, a filler placed where it should not have been. You take advice, you bring a claim in negligence, and you win.
The judgment is against the practitioner or the company. If there is indemnity in place that responds to the claim, it pays. If there is not, you must enforce against whatever assets exist. A sole trader with no policy and no assets is, in practical terms, uncollectable. A limited company with no policy can be wound up. You will have won a case and recovered nothing, having spent money to do it.
Corrective treatment is expensive. Revision surgery is more so. Ongoing care after a serious complication may run for years. Indemnity is the only realistic route to those costs being met.
What you are entitled to at this stage
- To ask any registered healthcare professional about their indemnity arrangements, which they must hold as a condition of registration.
- To ask any practitioner, registered or not, for evidence of cover before agreeing to treatment.
- To know whether the person treating you is employed by the clinic or self employed within it.
- To bring a claim in negligence if you are injured by treatment that fell below a reasonable standard.
- To a written record of the product used and its batch number, which a claim will need.
Registered professionals must hold appropriate indemnity. A person with no healthcare registration is under no such obligation.
Existence is not the question. Scope is
The question is rarely whether a practitioner has a policy. It is whether the policy responds to what happened to you. Policies in this sector commonly contain limitations that matter enormously.
- Named procedures. Cover may be listed procedure by procedure. A treatment introduced last month may not be on the schedule.
- Scope of practice. Cover typically applies to work within the practitioner's declared training and competence. Treatment outside it may not be covered.
- Setting. Some policies exclude treatment carried out in non clinical settings such as homes, hotels, salons or mobile arrangements.
- Off label use. Using a medicine outside its licensed indication is lawful and sometimes appropriate, but cover can be conditional on documented justification and consent.
- Complication management. Cover for treating a complication, including the use of hyaluronidase, is not automatic and should be confirmed specifically.
- Claims made basis. Many policies cover claims made while the policy is live rather than incidents that occurred while it was. If a practitioner stops trading and does not buy run off cover, a later claim may find no policy at all.
Fully insured, said quickly, with no insurer named and no certificate offered. It is a phrase, not a fact. Every insured practitioner has a certificate and can show it.
The unregistered practitioner problem
A person with no healthcare registration performing non surgical cosmetic procedures has no regulator requiring them to hold indemnity. Some hold cover voluntarily, through a beauty industry policy or a specialist scheme. Some hold none. There is no register you can search to find out, which is why asking directly and asking for the certificate is the only method available.
It is also why the question about who prescribes matters here. Where a prescriber writes a prescription for a patient they have never assessed, and a complication follows, the question of whose insurance responds becomes complicated, and complexity in an insurance dispute is paid for out of the injured person's time. See who is liable.
How to ask, and what to ask for
Ask three questions and ask them in writing. Who provides your indemnity. Does it cover this specific procedure. Is complication management, including hyaluronidase where relevant, within cover. Then ask for a copy of the certificate or the schedule showing the procedures covered and the period of cover.
A well run practice will send it. Indemnity certificates are shown to clinic landlords, to employers, to voluntary registers and to product suppliers all the time. It is a routine document, and treating a request for it as intrusive is unusual behaviour in a sector where everyone else asks for it.
The clinic's cover and the individual's cover
These are different. A clinic may hold public liability insurance covering the premises, and medical malpractice cover for its employees, while an independent practitioner renting a room holds their own. Ask which arrangement applies to the person treating you and whether they are employed by the clinic or self employed within it. The distinction determines who you would be claiming against and whether the clinic is vicariously liable.
If the practitioner is self employed, renting a room, and holds their own cover, the clinic may have very little to do with your claim at all. That is worth knowing before rather than after.
The short version
Ask who insures them, for what, and to see the certificate. If the answer is confident and documented, you have learned something reassuring about the whole operation, because a practice organised enough to keep its indemnity schedule current is usually organised in other ways too. If the answer is a phrase, you have learned something too.