Complaints and claim handling in aesthetics - Hamilton Fraser


Many aesthetic practitioners and business owners dread complaints. In reality, serious formal claims against clinics are quite rare, but no matter how skilled you are, complaints can arise in any business, so it’s important to know how to tackle them effectively. Many complaints are focussed on dissatisfaction. If a patient is unhappy with the outcome of a treatment, it can be upsetting and stressful for you as a practitioner, as it can damage your business and reputation if a claim is made or if you receive negative online reviews. However, it is important to remember that patients have the right to be heard and treated with respect, so it is important not to take it personally and to respond professionally and in a timely manner.

In this guide, we will explore some of the key things you need to be aware of when it comes to complaints and claims handling to help you better understand the types of complaints you might receive, how to handle them effectively, and the steps to take to prevent a claim from being made against you.

Identifying the type of complaint

There are two main types of complaints you may receive from a patient: a ‘dissatisfaction’ complaint, also known as a ‘notable’ complaint, or a ‘formal’ complaint, also known as a ‘reportable’ complaint. Identifying the type of complaint accurately is crucial as this will determine whether it triggers your policy.

“A dissatisfaction is when a patient is unhappy with a result, or the treatment did not work – it did not inflict bodily harm, but the patient feels unsatisfied. Reportable claims tend to be more serious and occur when there has been an issue with the treatment which has led to bodily injury or if a patient has legal involvement and a solicitor’s letter has been received. In both circumstances, a practitioner should inform their insurance provider right away.”
- Emma Bracchi, Senior Client Services Technician

A dissatisfaction or notable complaint occurs when a patient is dissatisfied with the outcome of a treatment. This could be because the treatment was not as successful as anticipated or because they found the aftercare unsatisfactory. In such cases, the patient may request a refund or additional treatment at no cost to address their concerns.

A formal or reportable complaint arises when a patient makes a formal claim. This typically involves more serious issues, such as bodily injury resulting from a treatment. In such scenarios, you might receive a solicitor’s letter or a request for compensation. It’s known as a reportable claim because it needs to be reported to the insurance company.

The table below  is a helpful tool in establishing the type of complaint you're facing:

Whatever the nature of the complaint, we will be happy to discuss potential scenarios with you and advise on the best course of action if you may need to make a claim.

“We recommend that you tell us every situation  which may give rise to a claim”,
“So, for instance, even if you had a patient who wasn’t happy with the results, or they feel that the treatment hasn’t worked. We still need to know about that just so we can make notes on our system in case it does turn into a formal complaint later down the line.”
- Emma Bracchi, Senior Client Services Technician

“The message is talk to us. We see so many of these types of things. The vast majority can be handled quite quickly and easily, so you won’t have to stop practising. You just carry on, and we take over.”
- Eddie Hooker Hamilton Fraser, founder and CEO

Many practitioners worry about doing this because they are concerned about impacting their insurance policy or premium, but Emma explains, “If it was a notable claim and it was just a dissatisfaction, that wouldn’t affect your premium at all because we don’t actually report it to the insurance company.  

“If you have a situation where a solicitor has got involved, that is a reportable claim, and it does go to the insurance company. However, if it is for notification purposes only, it will go down with a zero reserve, so it won’t affect your premium. It’s only when it is actually a formal claim that there is a reserve pot on the claim.”

At Hamilton Fraser, we always work with you to resolve notable matters to prevent them from escalating into a formal complaint and, potentially, a claim. Conversations with us would be noted on your policy, but no claim would be lodged against you. We can also provide you with a range of in-house templates to assist you in liaising with the patient, depending on how you prefer to resolve the issue.

How should I handle a complaint?

Complaints are very emotive, so handling them can seem daunting. However, how you deal with complaints can make or break your reputation, so it is important to make sure you follow a transparent and well-structured process.

Five key steps to effective handling of notable complaints arising from dissatisfaction

1. Acknowledge receipt of your patient’s concerns within 24 hours

While this is not a legal time frame, it is important to prioritise complaint handling and acknowledge the patient’s concerns within 24 hours of learning about them. A patient who feels heard and taken seriously is much less likely to escalate their complaint further.

We often get asked if you should tell the complainant that you are insured at this stage if there's a problem.

“We would recommend that you don’t tell them that you have insurance in place purely because if a patient realises that you do have insurance they may see it as an opportunity to try and get as much out of you as possible”, advises Emma. “What we would recommend is that you tell them, ‘We have an internal complaints procedure, the matter does have to be investigated, and we will get back to you shortly’.”
2. Provide an estimated timescale for resolution

There is no formal timescale within which you need to have resolved a complaint , but the sooner the better. Swift resolution of complaints avoids them hanging over your business and also provides reassurance to your patient that all complaints are followed up in a timely way. It is, of course, important to be realistic and factor in time to review patient notes and liaise with your insurance company if necessary. If the time frame you provided is coming to an end and you are unable to meet your deadline then it is best to communicate this to the patient as soon as possible, providing them with a revised date when you plan to have resolved the complaint.

3. Investigate the complaint

It is extremely important to carry out a thorough and honest investigation into both the treatment and the complaint. You do not need to disclose the full outcome of this investigation to the patient, but you should use it to reflect on the complaint once it is resolved so that you can learn from any issues that arise and avoid the same scenario from happening again.

4. Provide a summary of your findings

This should be an objective and professional summary of your patient’s treatment journey, concluding with your findings as to whether you believe the complaint is valid. You must not admit liability, but you can apologise and be sympathetic to your patient’s concerns. Our goal at Hamilton Fraser is to make sure that you are provided with help at every stage of the claims process until a conclusion is reached.

It's also important not to be defensive in your response. Of course, receiving a complaint can sometimes feel like a personal attack against you and your professionalism, but it's best to remain calm and objective throughout your communications with the patient.

5. Conclusion and next steps

The aim following your investigation is to reach a satisfactory outcome for both you and your patient. You should conclude the complaint with a formal response to them outlining the next steps. This will usually fall into one of three categories:

  • Thank the patient for bringing their concerns to your attention but explain that, following a thorough investigation you cannot uphold the complaint and no further action is required
  • Explain that, as a gesture of goodwill, you can offer further treatment to the patient that may resolve a side-effect they are experiencing
  • Offer a refund for the treatment cost as a gesture of goodwill
“When it is at the dissatisfaction stage, we work together with the practitioner”, says Emma. “At that point, we give them the freedom to say what they want to do. For instance, we could come to an agreement with them to offer a refund if they are happy with that or maybe a further free treatment. Or, if they believe everything has been done correctly and there weren’t any issues with the treatment, then we can also say, ‘We will stand by you if you want to maintain that everything was done correctly’.”

Following the above steps should help to bring a swift resolution to a notable complaint .

Portrait of a beautiful pensive young woman holding four syringes for injection. Lilac background. The concept of plastic surgery and professional cosmetology.

Formal claims

If you receive a formal notification, you must report it to your insurer as soon as possible.

We will ask you for the following documentation to support your claim, so it is a good idea to familiarise yourself with this list so you know what you would be required to produce in the event of a claim.

  • Solicitor’s letter or request for compensation
  • Full patient consultation and consent documentation
  • Treatment photographs
  • Any leaflets/booklets or electronic documents provided to the patient
  • Training certificate for the practitioner(s) who performed the treatment(s)
  • Correspondence between you and the patient
  • Summary of how you feel the treatment has gone and whether you agree with the allegations

It is important to be honest and open with your insurer so they can decide the most efficient way to handle the claim on your behalf. If a mistake has been made during the course of the treatment you must tell your insurer – they will not penalise you . The quicker your insurer can deal with a matter, the lower the costs incurred will be.

What do I do if a complaint is made against a self-employed practitioner working within my clinic? Am I responsible, or are they?
“There is actually an element of exposure to both parties”, explains Emma. “If you're a self-employed or mobile practitioner, you should have your own policy which covers you for your own treatments; however, if you are working within the clinic, we would always recommend that the clinic actually includes that practitioner on their own policy, the reason being, if a complaint comes in about the individual practitioner it would obviously be referred to their policy. If the complaint comes in and is addressed to the clinic, they've obviously got an element of exposure, so they would also have to notify it of their own clinic policy. The majority of the time, if the practitioner does have their own policy, the claim will actually get redirected back to them, but for larger companies, it is always worthwhile getting all the practitioners noted on their policy just to cover that element of exposure under the company name.”

“If you are a clinic owner who is bringing in outside practitioners, it’s worth noting that if that practitioner causes a problem or has a complaint made against them and you can't find that practitioner again – say they have flown in or refuse to engage with the claim process – if you have got that practitioner noted under your policy, at least you can then deal with the claim, and the insurer will pick it up. Because a good lawyer is going to scattergun the complaint. They will go out of their way to find someone who is going to pay for this, and if they can't get the practitioner, they'll go after the company.”
- Eddie Hooker

Top tips to prevent a claim

Claims can and do happen, but there are preventative measures you can take to minimise the chances of a claim being made against you.

1. 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. If there are any indications uncovered during the consultation and consent process that suggest the patient is not suitable for treatment, then it may be worth advising them that you do not think you are the right practitioner for them as you cannot meet their expectations.

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.

In our recent survey, many practitioners said they had experienced situations where they had to decline to treat a patient. A total of 30.7% of respondents said they had turned patients away once or twice, while another 30.7% had done so at least three times, and 24.8% said they had said no to treating unsuitable patients more than three times. Only 13.7% said they had never turned a patient away.

Read our ultimate guide to patient selection and our article on how to say no for more information.

“You need to make sure that the patient is actually ready for that type of treatment and is the right candidate for it”, says Emma. “If it's something that is not going to work for them, you need to let them know because, if you go ahead and do a treatment and it doesn't work, then you could get a claim that comes in.”
2. Understand their motivations and manage their 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.

3. 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.

“The patient has three years and four months to bring a formal claim against you. That’s why we always stress the importance of patient files”, says Emma. “Make sure that your patient files and all your notes are really up-to-date and detailed. And make sure you take photos. You should be keeping patient files for 10 years. Even though there is a limitation period, we do recommend you keep the information as long as possible, just in case.”
4. Make sure the patient gives informed consent and understands the aftercare advice given

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.

5. 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.

6. Make sure that you 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 provides 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.

How Hamilton Fraser can help you

If you're covered by Hamilton Fraser, our in-house claims team will work with you to resolve complaints of dissatisfaction and try to prevent them from escalating into a formal claim. You can contact us here. Our goal at Hamilton Fraser is to make sure that you are provided with help at every stage of the claims process until a conclusion is reached.

Any complaints that involve injury or solicitor involvement will be promptly notified to the underwriters, and solicitors will be appointed to deal with either the defence or to negotiate a settlement if there has been any negligence.

We also have the Cosmetic Redress Scheme, which was set up to assist clients with service-related complaints against your business.  Becoming a member of this scheme means that if you or your company receives a complaint regarding the service that you have provided, one of our experienced handlers will assist in dealing with the complaint.

Dos and don’ts if a claim is made against you

  • Do remain calm – remember, not all complaints go to a claim
  • Don’t put your head in the sand and think it’s going to go away, but give yourself a bit of breathing space while you take some advice
  • Do talk to your insurance broker immediately
  • Don’t admit liability … Don’t say …“I’ve actually done that wrong.” Do say … “I’ve never seen that happen before”, or “Leave that with me, and I’ll come back to you”
  • Do speak to the product manufacturer if the complaint is product specific, and check whether they have received similar complaints. They could provide recommendations
  • Don’t offer a refund or complimentary treatment without asking your insurance company for permission. This can be seen as an admission of guilt, even though you don’t intend it to be
  • Don’t indicate that you have insurance because that can put up the cost of a claim
  • Don’t take a complaint too personally

To sum up

In an ideal world, patients would be satisfied all the time, but complaints can happen, even to the most skilled practitioners. Try not to see complaints as a personal attack but as a way to learn and grow and welcome any feedback from patients, good or bad. It's wise to take steps to minimise complaints from happening in the first place, but it's equally important that you take any complaints made against you seriously, investigate them in full and resolve them as efficiently and effectively as possible.

You can view our cosmetic insurance claims guide and infographic here.

Download our claims guide here

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