Insurance for Chiropractors
Chiropractic care is hands-on, and so are its claims: an adjustment a patient says went too far, a burn from a heat modality, a fall from the table. We request chiropractor malpractice insurance and the clinic coverages around it for California doctors of chiropractic, and the insurer decides after reviewing your techniques, staff and claims record.
Chiropractor malpractice insurance and the adjustment claim
Spinal manipulation sits at the center of chiropractic malpractice. A review of U.S. jury verdict data covering 48 chiropractic cases from 1988 to 2018 found that 93.8% involved allegations about spinal manipulation, with over-aggressive manipulation the most frequent complaint at 33.3%. Two-thirds of the cases alleged a neurological spine injury, and 87.5% of those involved surgery. A herniated C5-C6 disc was the injury alleged most often, at 32.4%, and seven cases (14.6%) alleged a stroke.
The same review shows why the defense budget matters. The defense won 70.8% of those cases, yet plaintiff verdicts averaged about $658,000 and settlements about $597,000. A malpractice policy pays for that defense and for covered damages up to its limit. We request chiropractor malpractice insurance from insurers that write chiropractic risks, and each one weighs your techniques, patient volume and history before it decides on terms.
Licensed under the Chiropractic Initiative Act
The Board of Chiropractic Examiners licenses California chiropractors under the Chiropractic Initiative Act, a voter-approved law outside Division 2 of the Business and Professions Code, but Civil Code 3333.2(j)(1) still names them as health care providers. That brings chiropractic claims under the MICRA caps raised by AB 35: Milliman’s table shows $470,000 for injuries other than death and $650,000 for wrongful death on claims resolved in 2026.
The Board also learns about money paid on claims. B&P 800 has it keep a central file on each licensee that records judgments and settlements over $3,000 for injury or death caused by negligence. The insurer files that report within 30 days, and a chiropractor with no professional liability insurance for the claim files it personally (B&P 801 and 802). Before any suit, CCP 364 requires the patient to send 90 days’ notice, and that letter is the moment to call your insurer.
Scope of practice under 16 CCR 302
Section 302 of Title 16 spells out what the license allows. A chiropractor may manipulate and adjust the spine and other joints and the related muscle and connective tissue, and as part of chiropractic treatment may use air, cold, diet, exercise, heat, light, massage, rest, ultrasound, water and physical therapy techniques. X-ray and thermography are for diagnosis only, and diagnostic ultrasound is limited to neuromusculoskeletal diagnosis.
The same section rules out surgery or penetrating tissue, obstetrics, dentistry, optometry, drugs included in materia medica, lithotripters, fetal ultrasound and mammography, and it bars advertising “physical therapy” without a PT license. Underwriters price the work you actually do, so list every technique and modality on the application and ask how the policy answers a complaint that calls a service outside the license.
Chiropractic professional liability: claims-made, occurrence and tail
Chiropractic professional liability insurance comes on two triggers. An occurrence policy covers incidents that happened while it was in force, no matter when the patient files. A claims-made policy covers claims made while it is active, which is why a chiropractor who retires, sells the clinic or moves to a new insurer needs tail coverage, an extended reporting period, to keep earlier adjustments protected. Ask which trigger each quote uses and what the tail would cost; our guide to occurrence vs claims-made policies walks through both.
Board complaints, probation and patient disclosure
A Board of Chiropractic Examiners complaint can arrive with or without a lawsuit. Ask whether a quote includes license defense and what amount it provides. Probation has its own consequence: under SB 1448, the Patient’s Right to Know Act, chiropractors placed on probation by orders on or after July 1, 2019 for certain causes, including sexual misconduct with a patient, must tell each patient about the probation before the first visit, in a separate signed document. Read how your policy wording handles sexual misconduct allegations, and ask whether that coverage is excluded or capped at a lower amount.
Associate chiropractors, staff and the ABC test
Labor Code 2783(b) exempts physicians, dentists, podiatrists, psychologists and veterinarians from California’s ABC test for worker classification, and chiropractors are not on that list. An associate chiropractor paid on a 1099 therefore carries classification risk, which our guide to employees vs independent contractors in California explains; the state Labor Commissioner’s office answers classification questions. Hiring front-desk staff or massage and rehab aides brings workers’ comp with it, because Labor Code 3700 requires every employer except the state to carry it.
The clinic: tables, the lobby and patient files
A patient who slips in the lobby is a general liability matter, but a fall from the treatment table during an adjustment can be argued as either treatment or premises. Ask each insurer how its malpractice and general liability forms divide those claims, and consider a business owner’s policy that bundles liability with cover for tables, X-ray equipment and the office itself.
Patient files need protection too. Under Civil Code 56.36, a negligent release of medical information lets each affected patient recover $1,000 in nominal damages without proving harm, and the clinic faces penalties of up to $2,500 per violation. That exposure is what cyber insurance is meant to handle.
What chiropractor insurance costs
Insureon publishes national medians for chiropractors buying through its marketplace, updated October 19, 2026: $55 a month ($654 a year) for professional liability at $1 million per occurrence and $3 million aggregate, $36 a month ($437 a year) for general liability, $74 a month for a business owner’s policy, $54 a month for workers’ comp and $79 a month for cyber. Insureon reports that malpractice median for healthcare professionals as a group, chiropractors included. Most of its customers have fewer than five employees, $50,000 to $200,000 or more in revenue and five years or less in business. Treat them as a marketplace’s published medians for solo and very small chiropractic clinics, not a Mithril1 quote; busier clinics pay well above them.
Malpractice is rated per chiropractor, and workers’ comp follows the payroll of the staff around them. Take a clinic with an owner and one associate, each on a policy at the $654 median, plus a business owner’s policy and workers’ comp at their medians: about $1,308 for malpractice, $888 for the BOP and $648 for workers’ comp, roughly $2,844 a year before cyber.
Expect more for high patient volume, added modalities, more associates or aides, higher limits and past claims or Board discipline. Expect less for a solo practice, a clean record, a higher deductible and careful records of consent and treatment.
A few useful answers
Common questions
Does chiropractor malpractice insurance cover a stroke claim after a neck adjustment?
An allegation that an adjustment caused a stroke is a treatment claim, the kind a chiropractic malpractice policy is written to answer, and the insurer decides how the policy applies once the claim comes in. Stroke allegations appeared in 14.6% of the cases in one review of U.S. jury verdict data, so describe your cervical work accurately on the application.
Do the MICRA caps apply to chiropractors?
They do. Civil Code 3333.2(j)(1) counts people licensed under the Chiropractic Initiative Act as health care providers, so the noneconomic damages caps AB 35 raised apply to chiropractic negligence claims.
Can I pay an associate chiropractor as a 1099 contractor?
Chiropractors are not among the professions Labor Code 2783(b) exempts from the ABC test, so a 1099 associate has to pass all three prongs to stay a contractor. Check the arrangement with the state Labor Commissioner’s guidance before you sign.
What happens to my coverage when I retire or sell the clinic?
On an occurrence policy, adjustments made while it was in force stay covered. On a claims-made policy, a claim filed after it ends falls outside it unless you buy an extended reporting period; price the tail before you set a date.
Can I get chiropractic professional liability insurance through Mithril1?
You can, when an insurer accepts your clinic’s application. We request quotes for malpractice and for the clinic’s liability, property, cyber and workers’ comp, and each insurer decides after reviewing your techniques, staff and claims record.