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Understanding Insurance Claims in Care Homes: Top Risks and Mitigation Strategies

Insurance claims are an inevitable part of running a care home. However, understanding the most common claims and their impact on your operations can help you implement strategies to reduce risks and protect your care home.

We work closely with care providers to manage risks and minimise claims. Here, we explore the top types of claims care homes face, their effect on insurance, and how proactive risk management can help mitigate them.

Top Insurance Claims in Care Homes

1. Slips, Trips, and Falls

One of the most frequent claims involves residents, visitors, or staff injuring themselves due to slippery floors, uneven surfaces, or poorly lit areas. These incidents can lead to liability claims and serious reputational damage.

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2. Property Damage

Claims for damage to buildings, furniture, or equipment often result from fires, water damage such as storms and floods, and burst pipes. Such events can disrupt operations and result in costly repairs.  

3. Staff Injury Claims

Care home staff often work in physically demanding roles, leading to claims related to injuries such as lifting incidents or attacks by residents.

4. Resident Lack of Care Claims (clinical negligence)

Allegations of neglect or injury during care provision, whether founded or not, can result in complex and costly liability claims including legal defence costs.

5. Theft and Vandalism

Incidents involving stolen personal items or vandalism can lead to both material loss and loss of trust among residents and families.

The Impact on Insurance

Frequent or high-value claims can significantly impact your care home insurance:

  • Increased Premiums: A higher frequency of claims often results in insurers raising premiums.
  • Reduced Coverage: Insurers may impose stricter conditions or exclude specific risks from your policy.
  • Reputation Risks: A record of claims can make insurers view your care home as high-risk, potentially limiting your coverage options.
  • Lack of choice of and negotiation: Some insurers may not want to offer terms and there could be less of a bargaining power to negotiate discounts.
Mitigating Risks in Care Homes

Proactive risk management is key to reducing the likelihood of claims and their impact. Here’s how care providers can take control:

Conduct Regular Risk Assessments

Identifying potential hazards, from wet floors to faulty equipment, is essential. Address these risks promptly to minimise their likelihood.

Staff Training

Equip staff with training on health and safety, manual handling, and incident response. Empowered, knowledgeable staff are better prepared to prevent accidents.

Maintain Property and Equipment

Regular maintenance checks on buildings and essential equipment like lifts, hoists, and alarms can prevent costly breakdowns or accidents.

Enhance Resident Safety

Introduce measures like anti-slip flooring, grab rails, and motion-activated lighting. For higher-risk residents, consider using wearable fall detection devices or bed sensors.

Establish Clear Documentation

Maintain thorough records of risk assessments, staff training, and safety checks. These documents can support your case in the event of a claim and reassure insurers of your proactive approach.

Communicate with Insurers

Work with your insurer or broker to ensure your coverage meets your needs. Highlight any new measures you’ve implemented to manage risks and negotiate better terms.

Supporting Care Homes  

We help care providers navigate the complexities of insurance claims and risk management. From identifying top risks to implementing effective mitigation strategies, our experts are here to support your care home every step of the way.

Want to reduce insurance claims and protect your care home? Contact us today to learn how we can help you create a safer environment for residents and staff.

Also, why not take advantage of a free audit risk review for all care businesses to assess your current risk and offer mitigation advice?

Call us on 01273 424904 of email me directly to book in you free audit.

Together, we can safeguard your care home’s future.
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