One of the most common (and potentially costly) misunderstandings when it comes to aesthetic insurance is the difference between claims-made and claims-occurring cover, and how retroactive cover fits into this picture. Our in-house claims team at Hamilton Fraser speaks to practitioners every day who assume they are protected, only to discover gaps in their cover when it’s too late.
From our claims data, gaps in cover (not clinical errors) are one of the most common reasons practitioners find themselves uninsured at the point a claim is made
In a recent discussion with Ella Vranjkovic (Cosmetic Lead) and Nicola Bowtell (Healthcare Account Executive), several recurring issues emerged, particularly around lapses in insurance, returning to practice after a break, and confusion over policy wording.
What is retroactive cover?
Retroactive cover applies to treatments carried out under a previous insurance policy. If a claim is made today for work you performed in the past, retroactive cover determines whether that historical treatment is still insured.
At Hamilton Fraser, the retroactive date is clearly stated on your policy schedule. This date defines how far back you are covered for past treatments under your current claims-made policy.
Claims-made vs claims-occurring: The key difference
This distinction is one of the biggest areas of confusion in aesthetic insurance.
Claims-made policies
A claims-made policy covers you only if the claim is made while your policy is active, regardless of when the treatment itself took place.
For example:
You perform a treatment in March 2024.
The patient makes a complaint in January 2025.
If your policy is live in January 2025, you are covered.
This is why letting your insurance lapse – even temporarily – can be extremely risky. If your policy is not active at the time the claim is made, there may be no cover in place at all.
Claims-occurring policies
A claims-occurring policy covers you based on when the treatment happened, even if the claim arises years later, after the policy has ended.
For example:
You perform a treatment in 2023.
A claim is made in 2026.
You are covered as long as your insurance was live in 2023.
Most aesthetic professional indemnity policies in the commercial insurance market are written on a claims-made basis, not claims-occurring, which makes ongoing cover critically important.
Switching insurers without confirming continuity of your retroactive date in writing is one of the highest-risk points we see. Assumptions made at this stage often only come to light years later, when a claim is submitted.
What happens if you take a break from practice?
The claims team regularly see practitioners who:
Reducing or ‘pausing’ cover without formal run-off or continuity arrangements does not preserve your retroactive protection. Unless specifically agreed, reduced activity does not equal reduced risk.
If your policy fully lapses, and you later restart your insurance, your retroactive date resets to your new start date. This means:
As Ella explains, “When practitioners return after a break, they are often surprised to learn that their new retroactive date only protects them from that point onward.”
Run-off cover: Protection after you stop practising
At Hamilton Fraser, we also offer run-off policies with a five-year extended reporting period. This is designed for practitioners who:
Run-off cover allows you to remain protected against claims arising from past treatments, even after you stop practising – provided the policy is correctly arranged.
This is especially important because:
Why this matters more than ever
The claims team report that a significant number of problems arise from:
As Nicola notes, “Many practitioners see the phrase ‘claims made’ and assume it refers only to whether they personally have ever made a claim, not realising it refers to when the claim is submitted against the policy.”
What this means for different business models
If you operate independently, retroactive cover is entirely your responsibility. There is no clinic umbrella to fall back on.
Key risks for solo practitioners include:
If a patient makes a claim while your policy is inactive, even for a treatment you carried out years ago, you may face that claim personally, unless you have purchased a run-off cover policy.
Clinic owners carry additional layers of liability. Even when working with self-employed or subcontracted practitioners:
If your clinic ceases trading or you sell the business:
Clinic owners should not assume that an individual practitioner’s insurance or run-off cover automatically protects the clinic itself. In many cases, separate run-off arrangements are required to make sure the clinic and its directors remain protected after closure or sale.
Talk to a real claims team with decades of combined experience
One of the biggest advantages of being insured through Hamilton Fraser is access to an in-house, specialist claims team who understand aesthetic practice, treatment trends and regulatory pressures. Whether you are taking a short break, switching between roles, or returning to practice after time away, the right advice at the right time can prevent devastating financial consequences later.
You should always speak to your insurer before you:
• Take a career break
• Pause or cancel your policy
• Switch insurers
• Sell or close a clinic
• Return to practice after time away
If you’re ever unsure, our advice is simple: ask before you pause, cancel or restart your cover. These risks are entirely manageable. The majority of claims-related gaps we see could have been avoided with a short conversation before a policy was paused, cancelled or changed.
To sum up
When things are tough economically, insurance may feel like a “cuttable cost”, particularly if you have stepped away from your practice, but in reality, maintaining continuous cover is one of the most important professional safeguards you can have.
A claim may surface years after treatment, long after staff have moved on, businesses have closed, insurers have changed and policies have lapsed. Retroactive cover and run-off insurance are the only safeguards that bridge this time gap.
Key takeaways for practitioners
Frequently Asked Questions: Retroactive cover and claims-made insurance
1. Is retroactive cover automatically included in my policy?
Yes – this would be included within your policy. Your policy schedule will clearly state your retroactive date – and this defines how far back your current policy protects you.
2. What happens if I cancel my policy and restart it later?
If your policy fully lapses and you later restart insurance, your retroactive date resets to the new start date. This means:
This is one of the most common (and costly) misconceptions the claims team encounter.
3. If I take maternity leave or return to the NHS, do I still need insurance?
Yes – if you want continued protection for past treatments. Even while not actively practising, claims can still be made. If you cancel your policy completely rather than moving to run-off or reduced cover, gaps in protection can arise.
4. What is run-off insurance and who needs it?
Run-off insurance protects you for claims made after you stop practising, relating to treatments performed in the past. At Hamilton Fraser, we offer run-off policies and it is essential if you:
5. I had insurance at the time of treatment – doesn’t that automatically protect me forever?
Not with a claims-made policy. Cover only applies if the policy is live at the time the claim is made, not when the treatment took place. This is why continuous cover is so critical.
6. Does switching insurers affect my retroactive cover?
It can. Some insurers will honour your previous retroactive date, while others may only offer limited backdated cover. This must always be confirmed in writing before you switch.
7. Why do so many people get caught out by retroactive cover?
The claims team report that confusion often arises because:
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