Domiciliary Care Insurance, Explained Properly

Domiciliary care insurance is a packaged business policy for agencies and carers who deliver personal care in clients' own homes. The core is public liability (commonly £5m or £10m), employers' liability (a legal minimum of £5m once you employ anyone) and treatment or medical malpractice cover for hands-on care tasks, with abuse cover, professional indemnity and legal expenses around it. A self-employed carer can insure public liability from a few pounds a month; a CQC-registered agency typically pays from several hundred to a few thousand pounds a year, priced on wage roll and turnover.

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Independent information, not advice

This site explains how domiciliary care insurance works and links to a regulated comparison service. It does not arrange, recommend or sell insurance.

£5m
Statutory minimum employers' liability
£2,500
Potential fine per day without employers' liability
£10m
Public liability limit commonly offered
15
Standards in the Care Certificate

What Is Domiciliary Care Insurance?

Domiciliary care insurance is not one policy. It is a bundle of covers assembled for the specific risks of sending carers into private homes, and the bundle is different for a sole trader than for a registered agency.

What counts as domiciliary care

Domiciliary care, also called home care or care at home, means personal and practical support delivered in the client's own home rather than in a residential setting. Washing, dressing, toileting, medication prompts, meal preparation, companionship and live-in care all fall within the description.

In England the Care Quality Commission (CQC) treats personal care as a regulated activity under the Health and Social Care Act 2008. That single fact drives most of the insurance conversation, because a regulated provider is expected to evidence cover that a cleaner or a befriending service would never be asked for.

What the policy actually is

A domiciliary care insurance policy is a business combined policy. Public liability, employers' liability and treatment (medical malpractice) cover form the core. Professional indemnity, abuse and molestation cover, legal expenses, personal accident, loss of client keys and office contents are added as sections or extensions.

Specialist brokers such as Everywhen (formerly Towergate), Howden and Gallagher arrange most agency policies through care schemes underwritten by insurers including Aviva and Markel. Direct products from providers such as Surewise and PolicyBee serve self-employed carers with simpler needs.

Who needs domiciliary care insurance

CQC-registered home care agencies, franchisees of national care brands, supported living providers, live-in care companies and self-employed carers working directly for families all need some version of this cover. So does anyone employing a personal assistant through a direct payment.

The right package depends on three questions: do you employ anyone, do your staff carry out clinical or hands-on treatment tasks, and do you hold a local authority or NHS contract. Each yes adds a cover section and usually raises the limit the contract demands.

Is it a legal requirement?

Employers' liability is. The Employers' Liability (Compulsory Insurance) Act 1969 requires any employer in Great Britain to hold at least £5 million of cover, and the Health and Safety Executive can fine an uninsured employer up to £2,500 for every day without it. Most insurers write the limit at £10 million as standard.

Public liability, treatment cover and abuse cover are not statutory. In practice they are contractual: commissioning contracts, franchise agreements and the CQC's expectation that a provider is financially viable make them unavoidable for any agency that wants to trade, and commissioners will ask for the certificates.

What Does Domiciliary Care Insurance Cover?

Each section responds to a different kind of claim. Knowing which section a scenario falls under is the quickest way to spot a gap in a quote.

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Public liability insurance

Public liability covers your legal liability for injury to a third party or damage to their property arising from your work. A carer who leaves a tap running, knocks a client's parent down the stairs or scorches a worktop creates a public liability claim.

Limits of £1 million, £2 million, £5 million and £10 million are all sold. Local authority framework contracts commonly specify £5 million and larger commissioners £10 million, so check the tender paperwork before choosing a limit.

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Employers' liability insurance

Employers' liability pays compensation and legal costs when an employee is injured or made ill through their work. Back injuries from moving and handling, needlestick injuries, dog bites and road accidents between calls are the typical domiciliary care claims.

The cover applies to bank staff, zero-hours workers, apprentices and volunteers in most wordings, not only to salaried employees. The certificate must be displayed or made available to staff.

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Treatment and medical malpractice cover

Treatment cover, often labelled medical malpractice, responds when a client is injured by the care itself: a medication error, a pressure sore that develops through poor repositioning, a fall during a hoist transfer, or a PEG feed or catheter task carried out incorrectly.

Standard public liability wordings exclude treatment risks, which is why a generic business policy is unsuitable for care. Insurers ask which delegated healthcare tasks staff perform and who trains and signs them off.

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Abuse and molestation cover

Abuse cover responds to allegations of physical, sexual, emotional or financial abuse against a client by a member of staff. Defence costs are the main value, since an allegation must be investigated and defended even when it proves unfounded.

The cover is commonly sub-limited, often at £1 million or £2 million, written on a claims-made basis, and conditional on enhanced DBS checks, safeguarding training and a written safeguarding policy being in place before the policy starts.

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Professional indemnity

Professional indemnity covers financial loss caused by negligent advice, care planning or assessment rather than physical injury. A flawed needs assessment, a breach of confidentiality or a lost care record can each produce a claim under this section.

Some care schemes fold professional indemnity into the treatment section; others sell it separately from around £340 a year for £1 million of cover. Read the schedule to see which arrangement applies to you.

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Legal expenses, keys, personal accident and office

Legal expenses cover employment tribunal defence, contract disputes and regulatory investigations, including CQC enforcement action. Loss of keys cover pays to replace locks when a carer loses a client's keys.

Personal accident pays a fixed benefit if a carer is injured, useful for self-employed carers with no sick pay. Office contents, business interruption and cyber cover protect the base, the rota system and the client records.

How Much Does Domiciliary Care Insurance Cost?

Premiums range from pocket money for a lone self-employed carer to a meaningful line in an agency's accounts. The rating factors are the same at every scale.

Typical premiums in 2026

Some direct providers advertise public liability for a self-employed carer from around £5 a month, with treatment cover and personal accident pushing a fuller sole-trader package to roughly £100 to £300 a year. Professional indemnity on its own is quoted from about £340 a year for £1 million.

A CQC-registered agency should expect a combined policy in the hundreds of pounds a year at start-up, rising into the thousands as wage roll grows, because employers' liability is rated on payroll.

What drives the price

Wage roll is the dominant factor, followed by turnover, the number of service users, the split between personal care and clinical tasks, live-in versus visiting care, and claims history. Nurse-led or complex care with ventilated or tracheostomy clients attracts a treatment loading.

Insurers also price the safeguards. Enhanced DBS checks on every carer, Care Certificate completion, documented moving and handling training and a registered manager in post all support a lower rate.

Excess, limits and claims-made wordings

Public liability excesses on care policies are typically a few hundred pounds; treatment and abuse sections often carry a higher excess. A higher voluntary excess lowers the premium but should never exceed what the business can pay when a claim lands.

Treatment, professional indemnity and abuse cover are usually written on a claims-made basis: the policy in force when the claim is reported responds, not the policy in force when the care was given. Cancelling cover without run-off leaves past work uninsured.

Cheapest versus best

The cheapest domiciliary care insurance quote is usually cheap because it omits treatment cover, sub-limits abuse cover to a token amount, or excludes clients with specific conditions. For a business that must evidence cover in a tender, that saving is illusory.

The best policy is the one whose limits match the highest figure in your contracts, whose treatment section lists the tasks your staff actually perform, and whose insurer has a care claims team. Compare on those three points first and premium second; most comparison routes offer a free quote.

CQC Registration, DBS Checks and What Insurers Ask For

Regulation and insurance are intertwined. Underwriters rate the same evidence the regulator inspects, so a provider that is ready for CQC is usually ready for a quote.

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CQC registration in England

The Care Quality Commission registers any provider carrying out personal care in England. The application names a registered manager, submits a statement of purpose, evidences financial viability and requires DBS checks on the nominated individual and manager. CQC publishes a target of around ten weeks to decide a complete application; providers frequently report longer.

Trading without registration when it is required is a criminal offence. Insurers ask whether registration is in place or pending, and some care schemes write cover for pre-registration start-ups so that certificates exist for the application itself. CQC fees are banded by the number of service users.

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Scotland, Wales and Northern Ireland

The Care Inspectorate registers care at home services in Scotland, with staff registered through the Scottish Social Services Council. Care Inspectorate Wales (CIW) regulates domiciliary support under the Regulation and Inspection of Social Care (Wales) Act 2016.

In Northern Ireland the Regulation and Quality Improvement Authority (RQIA) registers domiciliary care agencies. Insurance requirements are broadly the same across all four nations, but a UK-wide provider needs the policy's territorial limits and the statement of purpose to name every nation it serves.

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DBS checks and the barred list

Care workers in regulated activity with adults need an enhanced Disclosure and Barring Service (DBS) check including a check of the adults' barred list. Since December 2024 an enhanced check costs £49.50, and the DBS Update Service costs £16 a year to keep a certificate portable between employers.

Abuse cover is conditional on these checks. An insurer can decline an abuse claim where the carer concerned was deployed before a certificate was returned, so any carer working under a pending check needs a documented, signed-off risk assessment.

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Skills for Care and the Care Certificate

Skills for Care, the workforce development body for adult social care in England, publishes the Care Certificate: fifteen standards covering duty of care, safeguarding, infection control, moving and handling, medication awareness and basic life support. New carers are expected to complete it within their first twelve weeks.

Skills for Care reports around 1.7 million filled posts in adult social care, with domiciliary care carrying the highest turnover of any setting. Insurers treat a documented induction and supervision programme as evidence that claims are being managed at source.

How to Compare Domiciliary Care Insurance

Quotes for care businesses are rarely like-for-like. These three comparisons resolve most of the confusion.

Self-employed carer versus registered agency

A self-employed carer contracted directly by a family is usually not carrying out CQC-regulated activity, because the regulation attaches to the organisation that arranges the care. Public liability, treatment cover and personal accident on a direct product are normally enough, and employers' liability is unnecessary unless the carer takes on staff.

An introductory agency that matches carers with families should confirm its status with CQC. A registered agency that employs or supplies carers needs the full package, and its policy should extend to self-employed carers it deploys, since the client will sue the agency rather than the individual.

Domiciliary care car insurance

Carers driving between calls in their own car need business use added to their personal motor policy. Social, domestic and pleasure cover with commuting does not include driving to multiple client addresses, and an accident on the way to a call can be repudiated on that basis.

Carrying a client to an appointment without charging a fare is generally accepted under class 1 business use, but insurers vary and some require a specific extension. Agencies should check every carer's certificate at induction and annually, and record the checks.

Who underwrites the market

Aviva does not sell a domiciliary care policy direct to the public. Aviva, Markel, Zurich and Hiscox underwrite care schemes that specialist brokers distribute, which is why searches for an Aviva product lead to broker pages. The Homecare Association also negotiates member benefits with named brokers.

When comparing, ask which insurer sits behind the scheme and whether that insurer has a dedicated care claims team. A broker's experience in the care sector matters more here than in most business insurance lines.

Exclusions, Conditions and Common Mistakes

Care liability policies are conditional. The conditions are where claims are lost, and most of them are avoidable with paperwork.

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Tasks outside the treatment schedule

The treatment section lists the healthcare tasks the insurer has agreed to cover. Adding insulin administration, stoma care or ventilator management without telling the insurer leaves those tasks uninsured, even though the rest of the policy remains in force.

Review the schedule whenever a care package changes. Complex care contracts should be notified before the first visit, not at renewal.

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Cancelling or lapsing cover

Because treatment, indemnity and abuse sections are claims-made, cancelling a policy also cancels cover for work already done. A claim about care given two years ago will not be paid if there is no policy on the day it is reported.

A provider winding down should buy run-off cover, commonly for six years, rather than simply letting the policy expire.

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Underdeclared wage roll and activities

Employers' liability and treatment cover are rated on declared payroll and declared activities. A declaration that understates either is a misrepresentation, and the insurer can reduce a settlement in proportion or, in a serious case, avoid the policy.

Declare bank staff, self-employed carers on the rota and any live-in or nursing work. Declare the honest figure and adjust at renewal.

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Missing evidence when a claim is made

Domiciliary care insurance claims turn on records: daily care notes, medication administration records, risk assessments, training certificates and DBS dates. A claim about a fall during a transfer is defended with the moving and handling assessment and the carer's training record.

Report incidents to the insurer promptly, including allegations that seem trivial, since late notification is a standard reason for a declined claim. Keep an official incident log and copy the insurer's claims team the same day for anything involving injury or an emergency call-out.

Domiciliary Care Insurance: Common Questions

What is classed as domiciliary care?

Domiciliary care is personal and practical support delivered in a person's own home rather than in a care home or hospital. The Care Quality Commission regulates it in England as the activity of personal care, meaning help with washing, dressing, toileting, eating and medication. Meal preparation, shopping, companionship and live-in care are usually delivered alongside those tasks. Cleaning-only or befriending services without personal care fall outside CQC registration but still need public liability insurance.

How much does an indemnity policy cost in the UK?

Professional indemnity for a care provider is quoted from around £340 a year for £1 million of cover by direct providers, with higher limits and treatment risks pushing the figure up. For a registered agency the indemnity element is usually bundled into a combined care policy priced on wage roll, so the standalone figure is less useful than the total package premium. Sole-trader carers can often add indemnity to a public liability policy for a small additional premium.

What is the hourly rate for domiciliary care?

The Homecare Association calculated a Minimum Price for Homecare of £32.14 per hour for 2025 to 2026 in England, the figure it says is needed to pay carers the National Living Wage, cover travel time and leave a sustainable margin. Many local authorities commission below that rate, and privately funded care is commonly charged at between £25 and £35 an hour depending on region and complexity. Insurance is a small fraction of that hourly cost.

How much does domiciliary care insurance cost?

A self-employed carer can buy public liability cover from around £5 a month, and a fuller sole-trader package with treatment cover and personal accident typically costs £100 to £300 a year. A CQC-registered agency should budget from several hundred pounds a year at start-up, rising into the thousands as payroll grows, because employers' liability and treatment cover are rated on wage roll, turnover, service user numbers and the clinical tasks staff perform.

Do I need insurance to employ a domiciliary care worker?

Yes. The Employers' Liability (Compulsory Insurance) Act 1969 requires anyone employing staff in Great Britain to hold at least £5 million of employers' liability cover, with fines of up to £2,500 for each day without it. The duty applies to a family employing a personal assistant through a direct payment as well as to agencies. Self-employed carers engaged directly are not employees, but the line is decided by the working arrangement, not the label.

Does domiciliary care insurance cover my car?

No. Domiciliary care insurance covers liability, treatment and related business risks, not vehicles. Carers driving between clients need business use on their own motor policy, because commuting cover does not extend to travelling between multiple client addresses. Carrying clients as passengers without charging is generally acceptable under class 1 business use, but some insurers require an extension. Agencies should check and record each driver's certificate at induction and annually.

How do domiciliary care insurance claims work?

A claim starts with notification to the insurer or broker as soon as an incident or allegation is known, which is a condition of every care policy. The insurer's claims team will ask for the care plan, risk assessments, daily notes, medication records, training certificates and DBS dates for the staff involved, then investigate and either defend or settle. Treatment, indemnity and abuse claims fall under the policy in force when the claim is reported.

Compare Domiciliary Care Business Cover

Care policies differ far more in what they exclude than in what they cost. Check that treatment cover lists your tasks, that abuse cover carries a real limit, and that public liability meets the highest figure in your contracts, then compare the premium.

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This website provides general information about domiciliary care insurance and care sector regulation in the United Kingdom. It is not financial, insurance or legal advice, and it does not take account of your individual circumstances. It is not a personal recommendation to buy any particular policy.

We do not arrange, underwrite or sell insurance. Quote comparison is provided by a third-party comparison service, and this site may receive a commission for referrals. That commission does not affect the price you pay.

Policy terms, limits, exclusions and conditions differ between insurers and change over time, and regulatory requirements differ between England, Scotland, Wales and Northern Ireland. Always read the policy wording and the key facts document in full, and confirm the position with the insurer or an FCA-authorised broker before relying on any cover.