Mid-market insurance

Insurance for hospices

Reviewed by the Apex broking team · Last reviewed 2026-11-06

Hospice insurance is the combined clinical, charity and property cover a hospice buys to protect patients, staff, volunteers, shops and trustees. It matters because hospices carry hospital style clinical risk alongside a retail estate and charity governance duties.

Part of: Care home insurance

In short

A charitable hospice usually needs medical malpractice covering employed staff and clinical volunteers, employers' liability of at least £5m, public liability, abuse cover, property and business interruption for the inpatient unit and charity shops, fleet and volunteer driver motor, fundraising event liability, trustees' liability, cyber and crime. CQC registration and the duty of candour shape how clinical incidents develop. The common gaps are doctors outside the policy, volunteers not clearly insured, shops added without updating the schedule, and shared limits between clinical and trustee risk.

What insurance does a hospice need?

A charitable hospice usually needs a programme that combines a clinical provider's cover with a charity's cover. The clinical side means medical malpractice for nurses, doctors, allied health professionals and volunteers, plus employers' and public liability. The charity side means property for inpatient units and shops, business interruption, motor for community and hospice at home teams, fundraising and event liability, trustees' liability, cyber and crime.

Hospices sit between sectors. Their clinical risk resembles a small hospital, their retail estate resembles a high street chain, and their governance is a charity's. A policy designed for any one of those, on its own, tends to leave gaps. The specialist board cover is explained on our D&O for healthcare and hospice boards page.

Regulation and governance behind the risk

CQC registration. CQC guidance says the regulated activity of treatment of disease, disorder or injury applies in any setting, and gives hospices as an example. Its quick guide to regulated activities indicates hospices are unlikely to need most other regulated activities. Inspection findings and enforcement can drive both liability claims and reputational loss.
Duty of candour. Registered providers must meet the duty of candour in regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Early, documented candour after an incident shapes how a clinical claim later develops.
Charity law. Trustees carry personal duties, and the hospice usually needs trustee indemnity insurance alongside clinical cover.
NHS and commissioning contracts. Contracts for funded beds and community services commonly set indemnity requirements. Compare the contract wording with the policy limits and named insureds.

Exposures and the cover that usually responds

Exposure	Typical example	Cover that usually responds
Clinical care	Syringe driver or controlled drug error, pressure ulcer, missed deterioration	Medical malpractice covering employed staff and volunteers
Staff and volunteer injury	Back injury moving a patient, shop volunteer hurt lifting donations	Employers' liability, at least £5m under the 1998 Regulations; check volunteers are included
Visitors, families and the public	Visitor falls at the inpatient unit or a shop	Public liability
Abuse allegations	Allegation against a staff member or volunteer	Abuse cover; see abuse and safeguarding cover
Inpatient unit, day services and shops	Fire in a shop stockroom, escape of water at the unit	Property damage, including donated stock
Loss of income	Inpatient unit closed, shop income lost	Business interruption; see BI for charities
Community and retail vehicles	Hospice at home nurse in a collision, van collecting donations	Fleet motor plus business use on staff cars
Fundraising events	Participant injured at a challenge event	Event liability; see fundraising events and trustee liability
Patient data	Ransomware locks clinical records	Cyber
Governance and fraud	Regulatory investigation of trustees, misappropriated shop takings	Trustees' liability and crime

How hospice clinical cover is usually structured

Medical malpractice for hospices is commonly written on a claims made basis, which means the policy in force when a claim is first made responds, provided the incident falls after the retroactive date. That has practical consequences:

Keep the retroactive date. Changing insurer without carrying the retroactive date forward can leave older care uninsured.
Check the aggregate. Many malpractice sections have an annual aggregate limit. One serious incident involving several patients, such as a medicines error repeated over weeks, can use much of it.
Individual clinicians. Nurses and other registered professionals need appropriate indemnity for their practice. Where the hospice employs them, the hospice policy usually provides it, but bank staff, agency staff and sessional doctors need checking one by one.
Wider services. Bereavement support, complementary therapies, lymphoedema clinics and education programmes for care home staff should be described to the insurer, as some wordings treat them separately from core palliative care.

Where the hospice runs a treatment liability section rather than full malpractice, the difference in scope is worth understanding before a claim tests it.

Illustrative examples

These examples are illustrative, not real cases.

Example 1: hospice at home medication error

A community nurse sets up a syringe driver at a patient's home with the wrong dose. The family brings a claim after the patient's death. The questions are whether the malpractice policy covers care delivered in patients' homes, and whether the hospice has the incident record and candour correspondence to show what happened.

Example 2: volunteer driver

A volunteer drives a patient to day therapy in their own car and has an accident. The volunteer's personal motor policy may not cover the trip if business use is not included. A hospice policy covering volunteer drivers, or confirmed checks of their cover, avoids the hospice being drawn in.

Example 3: shop fire

A fire in a charity shop destroys stock and the floor above. The property policy responds to the building or tenant's interest and contents; business interruption responds to lost retail income. Donated stock is often valued differently from bought stock, so the basis of settlement should be agreed in advance.

What underwriters usually want to see

Bed numbers, community caseload and day services, with a description of hospice at home and any children's or young adults' services.
Clinical governance: incident reporting, medicines management and controlled drug processes, and recent CQC findings.
Who is covered: employed staff, bank staff, volunteers, and doctors on honorary or sessional arrangements, with clarity on who holds their own indemnity.
Volunteer numbers by role, induction and safeguarding checks.
Shop estate list with values, stock handling, cash handling and lone working arrangements.
Event calendar, including overseas or high risk challenge events.
Five years of claims history across clinical, liability, motor and property.

Common mistakes

Doctors outside the policy. Some doctors rely on their own or NHS indemnity for some work but not all. Confirm in writing who covers hospice duties.
Volunteers not named. Employers' and public liability wordings vary on whether volunteers count as employees or members of the public.
Shops added piecemeal. New shops, warehouses and e-commerce hubs are opened without updating the schedule or the business interruption figure.
Events assumed covered. Some events, particularly overseas treks or adventurous activities, need specific agreement or separate cover.
Treating trustee and clinical risk as one. A shared limit can be eroded by one large claim. Our charity D&O guide explains the separation.

When to review your programme

Hospices should review cover when they open a new inpatient unit or day centre, expand hospice at home, take on a new NHS contract, add shops or a warehouse, or merge with another hospice. A significant incident, CQC enforcement or a change in the clinical model is also a trigger. Hospices that own or lease property to healthcare tenants should check the healthcare property landlord position too. Related care exposures appear on our care home insurance and children's homes pages, and an insurance programme review is a structured way to test limits and wordings.

Apex arranges insurance for charitable hospices; a broker reads every enquiry.

Sources

Frequently asked

Do hospice volunteers need to be covered by the hospice's insurance?

Usually yes. Volunteers deliver care, drive patients, run shops and staff events, so injuries to and by volunteers are a real exposure. Check that employers' and public liability treat volunteers as insured, that malpractice cover extends to clinical volunteers, and how volunteer drivers using their own cars are protected.

Is a hospice regulated by CQC?

In England, hospices providing healthcare usually register with the Care Quality Commission. CQC guidance gives hospices as an example of where treatment of disease, disorder or injury applies. Registration brings inspection, the duty of candour and enforcement powers, all of which affect how clinical incidents and claims develop.

Does medical malpractice cover hospice at home services?

It can, subject to the policy terms. Some wordings are written around an inpatient site and need extending to care in patients' homes, care homes and community clinics. Confirm the territorial and location scope, and that community staff and lone working nurses are within the definition of insured persons.

What cover do hospice charity shops need?

Shops usually need property cover for buildings or the tenant's interest, contents and donated stock, public liability for customers, employers' liability for staff and volunteers, money cover and business interruption on retail income. Shops opened mid-year should be added to the schedule promptly so the sums insured remain accurate.

Mid-sized business? Have your programme reviewed

Send us your current schedules or renewal pack and we will review the whole programme and tell you plainly what to keep and what to change. No fee and no obligation. Or call 0117 325 0027.

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Apex Insurance Brokers Limited is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales, company number 07014570. This page is general information, not advice on your individual circumstances, and it does not guarantee that cover will be available or on what terms.