Home health agencies send workers into patients' homes to provide care to some of the most vulnerable people in society — and every aspect of that operation creates insurance exposure. Workers' comp is the cost driver. Professional liability covers care errors. Abuse and molestation coverage closes the gap that GL excludes. Non-owned auto covers the accident that happens between patient visits. Crime covers the theft that happens when no one is watching. Understanding these five distinct lines is what separates an adequate home health program from a dangerous one.
Professional Liability (Healthcare E&O)Covers claims arising from the professional healthcare services provided by home health aides, certified nursing assistants, licensed practical nurses, and registered nurses. Medication errors, failure to follow a care plan, pressure ulcer development from inadequate repositioning, falls during assisted transfers, and inadequate documentation of patient status are the most common professional liability claims in home health. Claims-made form is standard — retroactive date continuity must be preserved at every renewal.
Workers' CompensationThe single highest-cost line for most home health agencies. Home health workers have one of the highest WC injury rates of any industry — musculoskeletal injuries from patient lifting and transfers, slip and falls at patient homes, needlestick injuries, exposure to bloodborne pathogens, and violence from cognitively impaired patients. WC classification for home health workers (8835 — visiting nurse) carries a very high experience modifier. Correct classification and aggressive return-to-work programs are critical for managing this cost.
Abuse and Molestation LiabilityHome health workers are alone with vulnerable patients in private homes — often elderly, cognitively impaired, or physically dependent individuals who may not be able to report mistreatment. Abuse and molestation liability covers claims of physical, sexual, or emotional abuse by caregivers. This coverage is excluded from standard GL policies and must be specifically added. It is not optional for any agency sending workers into patients' homes.
General LiabilityCovers bodily injury and property damage caused by home health workers at patient locations — a caregiver who breaks a patient's valuables, causes a small fire in the patient's kitchen, or damages the patient's home during care activities. GL also covers the agency's office premises liability for visitors, vendors, and staff at the main office.
Non-Owned Auto LiabilityHome health workers drive personal vehicles to patient homes. If a caregiver causes an accident while traveling between patient visits, the agency can be named in the lawsuit on a respondeat superior theory. Non-owned auto provides liability coverage for the agency's vicarious exposure when employees use personal vehicles on agency business. This is a critical gap that many home health agencies carry without coverage.
Crime / Employee DishonestyHome health workers have unsupervised access to patients' homes, personal belongings, financial documents, medication supplies, and in some cases financial accounts. Theft from patients — cash, jewelry, prescription medications, financial documents — is a persistent loss category in home health. Crime coverage with employee dishonesty protection and client property coverage is essential for any agency sending workers into private homes.
Employment Practices Liability (EPLI)Home health agencies typically employ a predominantly female workforce with high turnover, irregular scheduling, and frequent disputes over hours and scheduling. EPLI covers harassment, discrimination, wrongful termination, and wage-and-hour claims from home health employees. The staffing model of home health — independent contractor vs employee classification — also creates EPLI exposure from misclassification claims.
ACORD 125 — Commercial Insurance ApplicationPrimary submission document for home health accounts. Capture type of services provided (skilled nursing, therapy, companion/personal care, or all), whether the agency is Medicare/Medicaid certified, number of active patients, number of caregivers (W-2 employees vs 1099 contractors), and total annual revenue.
ACORD 126 — Commercial General Liability SectionRequired for GL and professional liability. Must accurately describe all services — skilled nursing services create very different exposure than companion care or personal care services. Medicaid waiver programs and Medicare-certified agencies face higher underwriting scrutiny than private-pay only agencies.
ACORD 130 — Workers Compensation ApplicationRequired for WC. Home health workers are classified under 8835 (visiting nurse) or 8832 (hospital — all employees) depending on jurisdiction. The WC premium for home health is among the highest of any service industry. Accurate payroll by classification and prior loss experience for 5 years is required for any meaningful market comparison.
→What services does the agency provide — skilled nursing, physical/occupational/speech therapy, home health aide, personal care, companion care, or a combination?
→Is the agency Medicare-certified? Medicaid-certified?
→Does the agency accept private-pay patients only, or does it bill insurance and government payers?
→How many active patients does the agency currently serve?
→How many caregivers are employed — W-2 employees vs 1099 independent contractors?
→Do caregivers use personal vehicles to travel between patient homes?
→Does the agency have a formal background check process for all new hires?
→Does the agency carry workers' comp for all W-2 employees?
→What is the annual gross revenue?
→Does the agency provide services to pediatric patients, dementia patients, or patients with behavioral health diagnoses?
→Has the agency had any professional liability claims or regulatory complaints in the last 5 years?
→Has the agency had any reports of caregiver misconduct, theft from patients, or abuse allegations?
→Does the agency have a written care plan system and documentation protocols?
→What states does the agency operate in?
→Is the agency accredited by CHAP, ACHC, or The Joint Commission?