Pediatric Therapy and Pediatric Dental Practices: Check Your Abuse and Molestation Coverage Before You Move or Grow

Independent pediatric therapy centers and pediatric dental practices are growing right now. I hear about it every week. Owners are moving into bigger buildings, adding providers, and opening second locations.

If that is where you are, congratulations. Growth in pediatric care is a good thing for the families you serve.

Growth is also the exact moment to check a coverage most practice owners never read. It is called abuse and molestation liability, and some insurers call it sexual misconduct liability. I know it is a heavy subject. I am raising it because the time to understand how your policy treats it is before you sign a new lease or hire your next provider, not after an allegation.

What the exclusion usually says

Here is the uncomfortable part. Many general liability and professional liability policies either exclude abuse and molestation claims entirely or cover them only up to a much lower limit, called a sublimit. Either way, the protection you think you have may not be the protection you actually have.

The wording matters too. A common standard exclusion can apply to anyone in your care, custody or control, which is language broad enough to reach the children and patients you serve every day. These exclusions can also reach claims about negligent hiring, supervision, investigation, or reporting, so the exposure is not limited to the act itself.

An industry explainer from AmWINS does a good job of walking through how these exclusions and sublimits work across different policy types. I would encourage you to read their article on how abuse and molestation exclusions impact insurance coverage before you talk to your agent, because it will help you ask better questions.

One court said outpatient therapy counted as care

You might be reading that care, custody or control language and thinking it only applies to residential facilities. A court has said otherwise.

In Valley Forge Insurance Co. v. Carson Center for Human Services, the U.S. Court of Appeals for the First Circuit held that a child receiving regular outpatient therapy was in the provider's care, so the exclusion applied. You can read the opinion itself on govinfo.gov.

I am not a lawyer and this is not legal advice, but the takeaway for practice owners is simple. Do not assume outpatient care falls outside that language. Ask instead of assuming.

Three questions to ask your agent

This is where it gets practical. Pull out your policy, call your agent, and ask three questions.

First: is abuse and molestation coverage excluded, sublimited, or covered? Sometimes it is added by an endorsement to your existing policy. Sometimes it lives on a separate policy altogether. You want a clear answer in writing, not a general reassurance.

Second: what is the limit? If there is a sublimit, find out what it is and how it sits alongside the rest of your liability coverage. Limits are one of those details that matter enormously at claim time and not at all until then.

Third: if the coverage is claims-made, what is the retroactive date? Claims-made policies only cover claims based on when the care was provided relative to that retroactive date, so an old date can leave earlier years uncovered. If you have been practicing for years under policies that changed, this is worth a careful look.

Ask these questions about every policy you carry, because the answer can differ between your general liability, your professional liability, and anything else you own. If you are not sure where to start, my guides on what a PT practice policy should cover and my dental practice insurance guide will help you see how the pieces fit together.

Why a move or new hires is the moment

Why am I writing about this now, in an article about moving and growing?

Because growth changes the paperwork. New leases, and sometimes school contracts or payer contracts, ask for specific coverage by name, and abuse and molestation liability is increasingly one of those line items. If a contract requires it and your policy excludes it, you want to discover that during negotiation, not at signing.

Growth also changes your people. More providers means more hiring, and more hiring means more supervision. The exposure does not come from your existing team. It comes from the simple reality that any practice serving children carries this risk, and adding staff adds screening and oversight responsibilities. That is exactly when coverage and risk management both deserve a fresh look.

If your growth includes a move, it is also worth reviewing the rest of your coverage, not just this piece. My overview of physical therapy practice insurance and my page on dental practice insurance cover the other policies a growing practice should have on its radar.

Risk management that helps

Coverage is only half of this. The other half is the everyday practices that protect the children in your care and give your team clarity.

Start with background checks and reference checks on everyone who works with patients, and make them part of your hiring process, not an occasional step.

Then write down your supervision expectations. Many pediatric practices use open-door policies or two-adult rules where practical, meaning no adult is alone with a child behind a closed door. Every practice is different, so think through what is workable in your space and put it in writing.

Have a clear reporting procedure, so any concern, however small it seems, has an obvious path to the right person. And train your team on it. People act on what they have rehearsed, not on what is in a binder nobody opens.

None of this is legal advice, and I am not suggesting any specific procedure is required in your state. These are simply the habits strong pediatric practices tend to build, and they pair well with the coverage questions above.

A last word before you sign anything

Policy wording varies a lot on this subject, so the only answer that counts is the one in your policy. Read yours, or better yet, let me read it with you.

If you are moving, adding providers, or signing a new contract, send me your current policies and I will review them with you. We can go through what is excluded, what is sublimited, and what questions to ask. You can reach me through my contact page. It is a calm, no-pressure conversation, and it is one I am glad to have before you sign the lease rather than after.