For 30 years, Hamilton Fraser has supported aesthetic practitioners when things haven’t gone to plan. We have handled thousands of claims, complaints, complications, consent failures, and concerns about their cover.
One thing is clear: behind every claim is a situation that can be stressful for both the practitioner and their patient, but also an opportunity to learn and help reduce the risk of similar problems happening again.
As we mark our 30th anniversary, we’re drawing on three decades of experience to explore where practitioners can encounter difficulties and what you can do to better protect yourself, your patients and your business. From choosing appropriate training to documenting consent and keeping your insurance up to date, the lessons are relevant whether you’re starting out or running an established clinic.
To inform this discussion, our claims team has reviewed a snapshot of 2,226 claims recorded between 1 October 2016 and 1 October 2026.
Alongside the team’s practical insights, this 10-year view offers a useful starting point for understanding where claims occur, how practitioners get caught out and when it might be time to review your processes.
What does the claims data show?
The report groups claims into eight categories, covering both treatments and wider business risks.
Figures represent the share of claims recorded in this snapshot, rather than claims costs or Hamilton Fraser’s complete claims history.
Dermal fillers and lasers together accounted for 42% of claims in this dataset. That makes them significant areas for practitioners to consider when reviewing their training, consultation processes and documentation.
The percentages do not show the likelihood of a claim arising from an individual treatment. Without figures for the number of procedures performed or practitioners insured, a higher share of claims cannot establish that one treatment is riskier than another.
The categories also need context. ‘Surgery claims’ includes business interruption, contents and buildings; it should not be read as the percentage involving surgical complications.
What has changed over the last decade?
Emma Bracchi, Hamilton Fraser’s Claims Lead, identifies the increase in business interruption claims following government lockdowns as the standout change. These contributed heavily to the surgery claims category during the COVID-19 pandemic.
This highlights the importance of looking at your whole business when reviewing risk, including your premises, equipment and ability to keep operating.
Emma says the treatment-related claims picture has otherwise been fairly consistent. Skin boosters, biostimulators and polynucleotides are becoming more popular, but the team has received relatively few claims involving these treatments to date.
Consultations and consent remain central
Rushed or inadequate consultations can contribute to claims. Patients need to understand the proposed treatment, while practitioners need to listen carefully to their expectations and assess whether the procedure is appropriate.
“Informed consent is vital to any defence of a claim,” says Emma. “The practitioner needs to listen and note all of the patients wants and needs, as this is the key part in delivering the correct treatment.”
A patient requesting a particular treatment does not necessarily make it the right option. Emma stresses that practitioners are responsible for explaining alternatives when another approach may be more suitable.
Give patients space to ask questions and address misunderstandings before treatment. Recording that discussion helps demonstrate what was explained and understood.
Training needs to go beyond the certificate
Emma identifies poor technique and insufficient training as factors that can contribute to claims.
“If the treatment is not performed correctly, this can lead to increased swelling, bruising, longer-lasting side effects and recovery time,” she says.
When choosing training, Emma advises examining the depth of the course, the techniques covered and whether it prepares you for the treatment you intend to offer.
“Please do not just pick the cheapest price; do a comparison of the modules and what is being taught,” Emma advises. “Do your research.”
Product sourcing deserves attention too
The products you use also need careful consideration. Grey-market products, off-label use and unlicensed substances raise different questions about sourcing, suitability and insurance cover. They should not be treated as interchangeable issues.
Before introducing a product or changing how you use it, check its provenance and discuss the proposed treatment with your insurer. Keep a record of the supplier, product and batch details in the patient file.
The claims snapshot does not identify the proportion of claims involving product-related issues, but product checks remain an important part of reviewing your practice.
Looking ahead to 2027
As aesthetic practice develops, new services bring new questions about risk. AI tools used in assessment and documentation, longevity and functional medicine services, and regenerative treatments such as exosomes all warrant careful review before being introduced.
These are areas to consider when planning your services, rather than trends established by this claims report. Check the evidence, training requirements, applicable rules and insurance position, and review how any new service will affect your consultation and record-keeping processes.
Five practical lessons for your clinic
1. Keep a complete record of the patient journey
Your records should capture the consultation, the patient’s expectations, treatment decisions and subsequent communication.
“Note everything that is discussed,” says Emma. “Note when emails and calls are taken and ensure that photos are kept in the patient file.”
Completed medical questionnaires, relevant consent forms, treatment notes and post-care instructions should also sit within the patient file.
2. Review your cover throughout the year
New treatments, increased turnover and additional machines can all prompt a need to review your insurance.
“Reviewing your policy cover should be done throughout the year,” says Emma. “You need to make sure that any new treatments you offer are covered on the policy, do not just assume they will be covered under your existing policy.”
Check whether changes to turnover or equipment values require an update too.
3. Read the policy conditions
Understanding your cover includes knowing what your policy asks you to do. Emma warns that failing to meet a condition can affect whether a claim is met.
Take time to read the conditions and ask your insurer to explain anything unclear.
4. Give consultations enough time
Allow time to explain the procedure, consider alternatives and check understanding. A signed consent form supports the record, but the conversation remains essential.
Patients need information they can understand and use to make their decision.
5. Notify your insurer early when a concern arises
If a patient raises a concern or you become aware of a possible claim, check your policy’s notification requirements and contact your insurer promptly.
Seeking guidance early gives the claims team an opportunity to explain the next steps and help you respond appropriately.
If you’ve added treatments, invested in equipment or changed the services you offer, now is a good time to review your cover. Contact our team on 0800 63 43 881 to check that your cosmetic insurance reflects the procedures you perform and the risks associated with your work, or visit our website to get an online quote.
