Starting a chiropractic practice means navigating a maze of insurance decisions. Between malpractice coverage, general liability, workers' comp, and property insurance, it's easy to feel overwhelmed. Here's what you actually need to know: the right insurance protects both your patients and your livelihood. With 80% of chiropractic audits leading to claim recoupments and increasing regulatory scrutiny in 2025, adequate coverage isn't optional—it's essential for keeping your practice running smoothly.
Whether you're opening your first clinic or expanding an established practice, understanding your insurance options helps you make smart decisions that protect your business without breaking the bank. Let's break down exactly what coverage you need and what it costs.
The Four Essential Coverages Every Chiropractic Practice Needs
Think of insurance like building a safety net for your practice. Each type of coverage protects you from different risks, and together they create comprehensive protection. Here's what you need:
Professional liability insurance (also called malpractice insurance) is your first line of defense. It covers claims related to your treatment decisions—like if a patient claims an adjustment worsened their condition. Costs typically range from $1,000 to $3,000 annually, depending on your specialty. Chiropractors focusing on subluxation and spinal structure pay around $3,000 per year for $1 million in coverage, while those with broader musculoskeletal practices might pay slightly more. If you've been practicing for years with a clean record, you might qualify for rates as low as $700 annually.
General liability insurance handles the everyday risks of running a business. If a patient trips over a loose rug in your waiting room, or if you accidentally damage property while making a house call, this coverage steps in. The average cost is just $37 per month when purchased separately, making it one of the most affordable protections for your practice.
Workers' compensation insurance becomes essential the moment you hire your first employee. Whether it's a receptionist, massage therapist, or chiropractic assistant, most states legally require you to carry this coverage. It protects you if an employee gets injured on the job—say, they strain their back lifting equipment or slip on a wet floor. Chiropractic practices pay an average of $53 per month for workers' comp, though costs vary by state and the number of employees you have.
Commercial property insurance protects your physical assets—your treatment tables, X-ray machines, computers, office furniture, and the building itself if you own it. If a fire, theft, or natural disaster damages your clinic, this coverage helps you rebuild and replace essential equipment so you can get back to serving patients.
The Smart Money Move: Business Owner's Policies
Here's an insider tip that can save you money: instead of buying general liability and property insurance separately, bundle them into a Business Owner's Policy (BOP). A BOP packages these two essential coverages together at a discount. Chiropractors typically pay $59 per month for a BOP—that's $713 per year for protection that would cost more if purchased separately.
A BOP is particularly cost-effective for small to mid-sized practices. It covers your office equipment, diagnostic tools like X-ray machines, furniture, and protects you from liability claims—all in one package. For solo practitioners or small clinics with just a few employees, this bundled approach often makes the most financial sense.
Additional Coverage to Consider as Your Practice Grows
Beyond the essentials, several specialized coverages become important as your practice evolves. Cyber liability insurance protects against data breaches and electronic health record theft. With patient records now primarily digital, a single breach could expose you to significant financial liability and regulatory penalties. As healthcare regulations tighten, this coverage is transitioning from optional to essential.
Employment practices liability insurance (EPLI) shields you from employee-related lawsuits, including wrongful termination, discrimination, or harassment claims. Once you have several employees, this coverage helps protect you from costly legal battles even when claims are baseless.
Commercial auto insurance becomes necessary if you or your employees use vehicles for business purposes—whether that's making house calls, picking up supplies, or traveling between multiple clinic locations. Your personal auto policy won't cover business use, leaving you exposed if an accident happens during work-related travel.
What Affects Your Insurance Costs
Insurance companies don't pull numbers out of thin air. Your premiums depend on several measurable risk factors. Your location matters significantly—practices in states with higher lawsuit rates or stricter workers' comp requirements pay more. Your years of experience also play a role; seasoned chiropractors with clean claims histories typically qualify for better rates.
The services you offer affect your professional liability costs. Practices that perform higher-risk procedures or work with special populations might face higher premiums. Your coverage limits matter too—higher limits mean more protection but also higher costs. Most chiropractors carry $1 million per occurrence with a $3 million aggregate limit, which provides solid protection at reasonable rates.
Your claims history has perhaps the biggest impact on your rates. A clean record with no malpractice claims can qualify you for significant discounts. Conversely, multiple claims in recent years will drive up your costs. This is why investing in solid documentation practices and patient communication isn't just good medicine—it's good business.
Protecting Yourself in a Changing Regulatory Environment
The landscape for chiropractic practices is shifting. Medicare implemented a 2.8% payment cut for chiropractic services in 2025, and regulatory scrutiny has intensified. Claims are being audited more carefully, with 80% of audits in 2024 resulting in recoupments. This environment makes solid insurance coverage more critical than ever.
Your insurance does more than just pay claims—it provides legal defense when you need it. Professional liability policies typically include coverage for legal fees, which can be substantial even if you ultimately win the case. This protection becomes especially valuable as billing regulations tighten and the risk of administrative penalties increases.
How to Get Started With Chiropractic Insurance
Start by assessing your current situation. Are you a solo practitioner or do you have employees? Do you own your building or lease? What services do you offer? These questions help determine which coverages are essential versus optional for your specific practice.
Get quotes from multiple insurance providers who specialize in healthcare businesses. Companies like NCMIC, ChiroSecure, and The Hartford have chiropractic-specific programs and understand the unique risks your practice faces. Compare not just the premiums but also the coverage limits, deductibles, and any exclusions in the policies.
Consider working with an insurance broker who specializes in healthcare practices. They can help you navigate the options, identify coverage gaps, and often find discounts you might miss on your own. The investment in professional guidance typically pays for itself through better coverage at competitive rates.
Insurance might feel like just another business expense, but it's really an investment in your practice's longevity. With the right coverage in place, you can focus on what you do best—helping patients feel better—knowing that you're protected if something goes wrong. Start with the essentials, add coverage as you grow, and review your policies annually to make sure they still fit your needs. Your future self will thank you.
