You've completed your Doctor of Chiropractic degree, passed your boards, and you're ready to open your own practice. But before you see your first patient, there's one critical step that can make or break your business: getting the right insurance in place. Here's what most new chiropractors don't realize—even qualified, knowledgeable practitioners make mistakes, and without proper coverage, it only takes one unhappy patient to bring your business to a halt.
The insurance needs of a chiropractic practice evolve as you grow, but getting the foundation right from day one is essential. This guide walks you through exactly what coverage you need at each stage, what it costs, and the common mistakes that can leave you vulnerable.
Day One: The Essential Three
Before you unlock your office door for the first time, you need three core insurance policies. These aren't optional—they're the baseline protection every chiropractic practice requires.
Professional liability insurance (malpractice coverage) is your first priority. This protects you against claims of negligence, errors, omissions, and patient injuries during treatment. Some states actually require it—Florida mandates $100,000 per occurrence and $300,000 aggregate coverage, while California and Texas don't legally require it. But here's the thing: even in states where it's not mandatory, you absolutely need it. New chiropractors can get malpractice coverage for as little as $50 through specialized providers like ChiroPreferred, ChiroSecure, and ChiroFutures.
General liability insurance is your second must-have. This covers accidents that happen at your office—think patients slipping on wet floors, tripping over equipment, or getting hurt in your waiting room. The average cost is $37 to $59 per month for $1 million in coverage. It's separate from malpractice because it covers facility-related injuries, not treatment-related claims.
Workers' compensation insurance becomes mandatory the moment you hire your first employee—whether that's a receptionist, massage therapist, or another chiropractor. Most states require this coverage, and some health organizations won't work with you without it. It covers medical bills and lost wages if an employee gets injured or becomes ill because of their job. In 2025, expect to pay about $0.27 per $100 of payroll.
The Smart Bundle: Business Owner's Policy (BOP)
Here's a cost-saving tip many new chiropractors miss: instead of buying general liability and commercial property insurance separately, bundle them into a Business Owner's Policy. A BOP typically costs around $55 to $59 per month and combines both coverages into one package with better rates than buying them individually.
Commercial property insurance (included in the BOP) protects your physical assets—exam tables, adjustment tools, X-ray machines, computers, and furniture—from fire, theft, vandalism, and other disasters. When you're just starting out and investing thousands in equipment, this protection is crucial. The standard BOP gives you $1 million per occurrence, $2 million aggregate coverage with a $500 deductible.
When to Add Coverage: Growth Triggers
Your insurance needs evolve as your practice grows. Here are the key moments when you should add or increase coverage:
When you start collecting patient health records electronically, cyber liability insurance becomes essential. This protects you from the financial devastation of data breaches or cyberattacks that expose patient information—X-rays, medical histories, insurance details, and billing records. Healthcare practices are prime targets for hackers because of the valuable data they store. A single breach can cost hundreds of thousands in notification costs, credit monitoring services, legal fees, and regulatory fines.
If you buy or lease a vehicle for your business—whether for house calls, running errands, or transporting equipment—you need commercial auto insurance. Your personal car insurance won't cover business use. Most states require this coverage for business-owned vehicles. Medical professionals pay an average of $216 per month for commercial auto coverage.
As your practice grows and you rely more heavily on your location and equipment, consider adding business interruption insurance (often called business income coverage). This keeps money flowing if you have to temporarily close due to a covered loss—like a fire, flood, or other disaster. It replaces lost income and helps cover ongoing expenses like rent, utilities, and payroll while you're rebuilding or relocating.
What This Actually Costs: Real Numbers for New Practices
Let's talk real numbers. U.S. chiropractors pay an average of $720 annually for comprehensive business insurance—that's about $60 per month total. For a new practice with minimal claims history, you might pay even less. Your actual costs depend on several factors: your location, the specific services you offer, your years of experience, how many employees you have, and what coverage limits you choose.
Here's a realistic budget breakdown for a solo practitioner just starting out: Professional liability (malpractice) runs $50-$100 per month. A Business Owner's Policy with general liability and property coverage costs about $55-$59 per month. If you hire one employee at $15/hour working full-time (about $31,200 annually), workers' compensation insurance would cost roughly $84 per year, or $7 per month. That's a total of around $112-$166 per month for comprehensive protection.
Common Mistakes That Leave You Vulnerable
The biggest mistake new chiropractors make is skipping insurance early on to save money. It feels like an unnecessary expense when you're watching every penny, but here's the reality: without coverage, a single malpractice claim can shut down your practice permanently. Even if you win the case, legal defense costs can run into six figures.
Another common error is choosing claims-made coverage without understanding what happens when you switch carriers or retire. Claims-made policies only cover you for claims filed while the policy is active, even if the incident happened years earlier. You'll need "tail coverage" when you leave that policy, which can be expensive. For new practices without many assets, claims-made is often the right choice because it's cheaper, but understand the long-term implications.
Don't forget to update your coverage as your practice evolves. That means increasing your policy limits as you acquire more equipment, adding cyber liability when you go digital, and getting workers' comp before hiring employees—not after. Some chiropractors wait until they think they need it, but insurance doesn't work retroactively. You need it in place before the incident happens.
How to Get Started
Start by getting quotes from chiropractic-specific insurance providers like ChiroPreferred, ChiroSecure, and ChiroFutures. These companies understand your unique risks and often offer better coverage at lower rates than general business insurers. They also provide risk management tools and claims defense support tailored to chiropractic practices.
Check your state's requirements through your state chiropractic board—they'll tell you exactly what's legally required where you practice. Then add the coverages that protect your specific situation. Be honest about your services, revenue projections, and any prior claims when getting quotes. Accurate information ensures you get the right coverage and avoids claim denials later.
Insurance might not be the most exciting part of starting your chiropractic business, but it's absolutely foundational. For roughly $60-$166 per month, you protect everything you've worked for—your education, your investment, your reputation, and your ability to help patients. Don't cut corners here. Get the right coverage from day one, and adjust it as you grow. Your future self will thank you.
