What Home Health Care Insurance Claims Cost (and How to Prevent Them)
Every day, roughly 11,400 Americans turn 65 years old, a milestone that can compel them to think about long-term care - especially as many live into their 80s and beyond. With growing numbers of those seniors preferring to age in place, the need for home care and home health care insurance is ever-growing.
Yet complex medical care inside private homes can pose serious risks, from slips and falls to theft and caregiver negligence. While liability insurance for home health care is essential, not all providers face the same exposures, making adaptability just as important.
Philadelphia Insurance Companies (PHLY) has long provided tailored, comprehensive professional liability insurance for home health care agencies and personal caregivers so that they can focus on care instead of claims. Along the way, we’ve learned that both risks and opportunities abound in a market that’s expected to reach $176.3 billion by 2032.
The High Price of Inadequate Home Health Care Insurance
Roughly 11,500 home health care agencies serve the market, but they face a whopping 80% employee turnover rate. Improper vetting and training can mushroom into expensive claims, making the costs of not carrying home health care insurance potentially catastrophic.
During the 15+ years PHLY has served and monitored the home health care industry, we’ve witnessed many costly judgments. They include:
A claim involving a home health aide who was helping their client use the restroom when the client fell, fracturing their hip and subsequently requiring around-the-clock care. An investigation determined the caregiver didn't follow patient handling procedures and was insufficiently trained for lifting patients in tight spaces. The claim resolution: $187,329.
A claim based on the improper care of a hospice patient whose estate alleged the patient was ignored by their caregiver as they endured intense pain and nighttime hallucinations during their final weeks of life. The resulting claim was resolved for $390,125.
A claim involving a wheelchair-bound client who was left unattended in a bathroom and fell when trying to pick up a washcloth. The home health care aide, who was in the kitchen at the time, was alleged to be negligent. The ultimate claim cost: $293,675.
Smart Risk Management For Home Care Agencies
These claims illustrate the critical importance of risk management in home health care. Beyond ensuring a client’s quality of life, proper preparation, training, and monitoring can also prevent costly accidents and negligence. Agents who work with home health care agencies and caregivers should emphasize these risk management strategies:
Background checks. Agencies should conduct thorough pre-employment screenings that include driving records, professional licensures, training, criminal background, and sex offender registries.
Transportation safety protocols. To avoid auto liability claims, agencies that transport clients should implement for caregivers a robust onboarding process that includes vetting auto insurance cards, vehicle safety, and driving history.
Comprehensive training. Home care aides should undergo thorough initial training (as well as regular refreshers) around patient handling, transfer techniques, and specialized treatments such as wound care and ventilator management.
Home safety assessments. Falls are the most frequently reported patient mishap in home health care. During client admission, agencies should assess the home for hazards such as inadequate lighting, slip-and-fall risks, and improper equipment for client transfers.
Detailed reporting systems. Home health caregivers benefit from establishing clear guidelines around reportable events, from medication errors and equipment failures to falls, patient complaints, and unexplained injuries. When incidents do happen, timely follow-up with the patient and/or their family is critical.
The PHLY Difference: A Longtime Leader in Home Care Agency Insurance
PHLY’s flexible Home Health Care Insurance Package is designed to meet both niche-specific exposures and insurance needs for agencies and family/companion caregivers alike, whether skilled or non-skilled. Our policy can be tailored for home care agencies, medical directors, or physicians, but companion care insurance is also an integral part of our coverage.
Policy highlights include:
General Liability, Professional Liability, and Abuse & Molestation coverage on a first-dollar basis, with separate limits of insurance for each line of coverage
Comprehensive General Liability - limits to $1M per occurrence/$3M aggregate
Defense costs outside policy limits
Coverage for medical directors
Primary and vicarious medical malpractice coverage for physicians
Business income loss arising out of civil authority at your client premises
Coverage for theft, disappearance, destruction of client property, and employee forgery
Hired and Non-Owned Auto coverage, including for volunteers
In addition, PHLY offers a suite of extensive resources and services to help our home health care policyholders manage risk and exposures. These include:
Safety program development
On-demand and web-based training
Defensive driving training and telematics via PHLYTRAC
Discounted background checks
At PHLY, we’re proud of our 96% overall customer satisfaction rate, one we uphold throughout dozens of offices nationwide. We’re ready to give you a competitive quote on customized home health care insurance that you can share with potential clients.
To learn more, call our new business team today at 800-873-4552 or email Vice President Tony Canci at Anthony.Canci@phly.com.