Every single week, someone in the Traveling Therapist Facebook group asks the same question: what do I do about liability insurance when I'm traveling? I'm replaying one of the most listened-to episodes on the show because this question never stops coming up.
In this episode of The Traveling Therapist Podcast, I walk through what your liability insurance actually needs to see happen for you to stay covered, what changes the second you start seeing clients outside your home country, and the questions you should be asking your provider instead of guessing. I also get into what to do when local rules get murky and what your options are if the whole thing starts to feel like too much to manage on your own.
In This Episode, We Explore…
Mentioned in the Episode:
Portable Practice Method: https://www.portablepracticemethod.com/free-training
CPH & Associates: https://cphins.com/
HPSO (Healthcare Providers Service Organization): https://www.hpso.com/
International Therapist Directory: https://internationaltherapistdirectory.com/
European Association for Psychotherapy: https://www.europsyche.org/
Connect with me:
Instagram: @thetravelingtherapist_kym
The Traveling Therapist Facebook Group: www.facebook.com/groups/onlineandtraveling/
Signup to learn more about life as a Traveling Therapist: https://www.portablepracticemethod.com/free-training
Revolutionize Your Private Practice with AI Course: www.kymtolson.kartra.com/page/ai
Bill Like A Boss Insurance Billing Community: www.kymtolson.kartra.com/page/blab
Subscribe to the Podcast:
Apple iTunes | Spotify | Google Podcast | Stitcher | Amazon | Castbox
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Transcript:
[00:00:00] hey, everybody, it's Kym here. I'm still off from recording new episodes this month because I'm traveling through Switzerland and Italy with my nephew modeling that traveling therapist life, being able to have multiple income streams and take time off when I want to and do essentially whatever I wanna do with my life, my time, and my money.
[00:00:19] So I'm replaying the episodes that got the most listens, and this is the single most asked question in my Facebook group. Every week, without fail: What do I do about liability insurance if I'm traveling?
[00:00:31] So this episode is like an answer in one place that I can just point people back to all the time 'cause I get asked this question so much
[00:00:38] I talk about which coverage actually protects you when you're practicing across state lines, what to look for in a provider like CPH & Associates, what to ask when you have a question or when you wanna find out the actual true answer. People ask the wrong question all the time, and I talk about that in this episode. And then what changes the second you leave the country
[00:01:00] So one quick note before I hand this over to you all. This episode originally aired a while back, and the insurance products and state rules do change, so of course always check it yourself. Don't just take my word for it, and treat it as your map, not your final answer to these questions that come up around liability insurance and where can you be sitting and all of that stuff.
[00:01:20] As far as I know, CPH & Associates are still supporting traveling therapists. The client just needs to be sitting in your state of licensure when you're seeing them if you want your liability insurance to cover you, at least in the United States Not the most exciting episode I ever made, probably one of the most useful ones. So have a listen
[00:02:45] Hey, everyone, and welcome back to another episode of the Traveling Therapist podcast. I'm your host, Kym Tolson, and today we're diving into a topic that I really haven't talked much about on this, on this podcast, but it comes up literally every day. There's a question about this inside of the Traveling Therapist Facebook group.
[00:03:13] I also was just developing a module inside the Portable Practice Method course that I'm getting ready to release, a beta release. I'm really excited about that, but it's a topic I have to touch on, and that's liability insurance. So every single day, somebody posts in the Facebook group and says, "What do I do about liability insurance?"
[00:03:33] So the answer is it's, it's sort of complicated, but sort of not complicated. So I wanna dive into it a little bit, talk to you about my liability insurance, which is CPH & Associates, what they told me, and then also do the disclaimer that, of course, this stuff is subject to change at all times. It's your due diligence to go and research this on yourself, get it in writing, keep a record of it with you in case anyone ever asks you, in case anything comes up where somebody is trying to take you to court or, you know, file a complaint against you.
[00:04:05] You wanna make sure you have really good liability insurance in place.
[00:04:08] So let's talk about why liability insurance is a non-negotiable for any therapist. If you have a private practice or you're starting a private practice, you probably have already learned that you're gonna need liability insurance.
[00:04:20] There's a couple out there, like the NASW offers liability insurance. There's one called CPH & Associates. That's my liability insurance. There's one, HPSO, I can't remember what it stands for, but if you Google liability insurance HPSO, you'll find it and it'll give you more information about how to get liability insurance.
[00:04:40] So, if a client files a grievance or a misunderstanding occurs, having coverage in place can save you from potential legal and financial troubles. It's also a good tool if, you know, you have compliance issues or if you're gonna work internationally. Liability insurance, they have lawyers on call. I think mine, I get two or three hours a year if I want to, through my liability insurance, just to ask a lawyer a question, so it's really important to have it.
[00:05:07] You need to protect yourself and your practice and all of that. Now, if you're insured through CPH & Associates, there is some great news for US-based therapists. I reached out to them, I sent them a message, and I just said, "Look, here's my situation. I'm gonna be practicing only in my state of licensure, which is Virginia, and I'm gonna be traveling internationally.
[00:05:29] I might be in a different location all the time. Is it okay for me to do that, and are you gonna cover me liability-wise?" And they came back and I can, you know, show it to you in writing if anybody wants to see it, but they came back to me and they said, "It's absolutely fine for you to do that as long as you are following the licensing laws of your state of licensure."
[00:05:49] So for me, the state of Virginia says the only thing they're concerned about is where the client is located at the time of the session. They have no rules or regulations about where I can be located. So CPH & Associates, all they care about is that the client is sitting in the state of licensure, 'cause that's what my laws say for my license type in my state, and there's no regulations around where I am.
[00:06:13] Now, if I'm following that guideline and the client is in the state of Virginia and they decide to take action against me, they will take action in the state of Virginia. So if I'm living in Japan and somebody decides they're gonna sue me, CPH & Associates is going to deal with the litigation basically in the state of Virginia.
[00:06:32] So I, you know, if there were any proceedings or anything, I would need to physically come back to the state of Virginia to face any charges that were brought against me to my licensing board or there's some sort of legal thing where I've got to go to court, all of that would take place in the state of Virginia, and that's the only place CPH & Associates is gonna cover that in.
[00:06:50] They're only gonna cover it if they find that I am following the rules and regulations that they set forth for me to do so. If you have any questions about that, please reach out to me. Of course, I'm not a lawyer. I don't work for an ethics board or, you know, a licensing board or anything like that. So as I said before, any of this can change at any time, and the crucial, crucial part is it's your responsibility to ensure that you understand and follow the guidelines set forth by your licensing board, and that you read your insurance policy or reach out to them, get it in writing, that it's okay for you to be located anywhere as long as your client is in the state of licensure.
[00:07:26] It's important to realize, and I say this almost in every episode in some form or fashion, it's all over the Facebook group, if you live in a state, not all states are the same. So you'll see people post in the Facebook group constantly saying things like, "Oh, it's not okay to, to practice outside of your state," or, "It's not okay to practice in this other state because of this or that."
[00:07:48] Don't listen to those first of all because half the time they're wrong. I go research it and I find that no, that's actually not correct and I have to go back and correct it. But the important thing is to ensure that you're being compliant, so you have to make sure you're checking with your licensing board about what your state allows, and then research the laws in your state, in your client's state to ensure that you meet their requirements.
[00:08:07] So what I'm saying there is you might be sitting in a different state, you might be sitting in a different country. You have to always research where you're sitting to make sure it's okay for you to give services back to your state of licensure while you're sitting in that state. For example, Texas, this is not a law anymore, Texas used to have on the books the, the, the licensing board used to say a clinician cannot even sit in the state of Texas and give services back to somebody in their state of licensure like, say, Virginia, that you're not allowed to do that unless you're licensed in Texas also, which makes no sense, but they had that on the books for quite some time.
[00:08:45] So you, and you'll still hear people saying that in the Facebook group, but it's actually not true. You need to research that stuff, but you need to do your due diligence for where you're sitting and where the client's sitting. Have that written down, have that you ask somebody, and just keep a record of that.
[00:08:59] If you're in a different country, same thing applies. Reach out to the country, whoever the licensing board is in that country that regulates psychotherapy, and make sure it's okay for you to be sitting and delivering services back somewhere else. I just cannot shout that loudly enough. This is the most confusing thing for people.
[00:09:15] Every day somebody asks this question, so I just thought, "Why not just record an episode about this so you guys know exactly how to handle it. And of course, the Portable Practice Method is coming. It's c- has all this in excruciating detail. It's got checklists and walkthroughs on how to do this, the actual script to send to your licensing board and your liability insurance, so you know exactly what to do step by step to be completely compliant.
[00:09:41] Okay, and the next thing that people always ask is, "Okay, so what if I want to see clients in another country, or if I'm living in another country and I wanna see clients within that country?" So it gets a little more complicated. One, if you're living in a country and not in the United States but you wanna see clients in that country, of course you need to research what are the licensing rules and regulations in that country.
[00:10:05] Will my credentials even transfer to that country, and can I then start to build, you know, a client base? Let's say you wanna become an expat, you wanna get residency in another country. That's a whole totally different issue, and it is possible, but your liability insurance back in the United States is not gonna cover you if you do that.
[00:10:24] It's not an international type policy, so CPH & Associates, H- even through the NASW, they're not gonna cover you internationally. Some things you can do about that. If you are like, "Gosh, yeah, I don't even wanna see clients in the US anymore. I wanna be an expat therapist. I wanna see clients around the world" it, it is okay because, first of all, your state of licensure has no jurisdiction over what you do outside of your state of licensure, so they're only concerned about that.
[00:10:52] So what you have to do in that case is move outside of the United States and think globally around how to protect yourself if you're gonna be seeing clients. So, here are some, some ideas and thoughts around that, and of course, disclaimer, you've gotta do your own research around this to make sure it's accurate and up to date and will help you in your specific situation.
[00:11:13] First thing you can do, local professional associations. You can reach out to counseling or therapy associations in the country where your client resides or of the place where you plan to practice before you even go, like I said before. And oftentimes these organizations, they can recommend or they even themselves will provide liability insurance options tailored to mental health professionals.
[00:11:36] It really depends on the country. Some countries have no regulations around providing any kind of mental health services at all, so a lot of people just call themselves therapists in some countries, and they're able to see their clients, and they don't really worry about You know, licensure regulations and liability and being sued and that sort of thing because there's no license to begin with.
[00:11:57] So in some countries, you may not even have to worry about it. That's at your own risk, of course, but just something to consider and to take into account. And then you can look for insurance providers based in the country you're targeting. They ty- they typically will offer professional indemnity insurance, which covers liability for providing therapy services.
[00:12:17] So you can look into that or even a business insurance that covers liability. Look into something like that. You can really, like, go down the Google rabbit hole or as I like to, ChatGPT now has an amazing search engine that will conglomerate all that information, give you resources, and even give you who to contact if you need help.
[00:12:35] I find that it's a lot better than trying to use Google to find some of this stuff. It's getting very accurate and gives great guidance around this stuff You can explore other international insurance options. So there's something called global insurance providers, companies like Clements Worldwide and Allianz, with a Z, offers professional liability insurance for individuals practicing across multiple countries.
[00:13:00] And I, I haven't researched this myself, but I've been told this, that some international professional organizations like the International Therapist Directory or the European Association for Psychotherapy provide access to liability insurance as a membership benefit. So, these are directories that have membership benefits around that.
[00:13:19] Again, I've never researched that personally, but somebody did tell me that. And then of course, as I was saying before, you wanna make sure you're complying with local laws and requirements, so licensing and registration. Many countries require you to register or obtain temporary licensing to practice legally or even remotely, so ensure that you're meeting these requirements before you're seeking insurance.
[00:13:39] If you're gonna get international insurance, there's going to be caveats or places in the policy that you need to pay attention to, to make sure that you're being compliant and that your insurance is actually gonna cover you if there is some sort of suit brought against you in, in a different country.
[00:13:56] While you're doing all this, you've gotta take into account and pay attention to what does your liability insurance say around ensuring that your telehealth tools comply with local laws, like in the United States it's HIPAA, in Europe it's the GDPR, in Canada it's the PIPEDA, or in other countries there might be other ones that I'm not remembering right now, but those are the main ones, HIPAA, GDPR, PIPEDA.
[00:14:21] If you're in a different country and using liability insurance that's international and following rules like in New Zealand, you need to check out what the privacy laws and rules are around that to make sure you're complying and using tools and software that meet those requirements or, you know, your insurance might be null and void if somebody tries to bring a suit against you.
[00:14:40] So these are just a lot of things to think about when you're trying to practice with a portable practice or moving around a lot or just seeing clients that are sort of outside of the box and not back in your state of licensure for United States therapists Just some other thoughts around that. If you are trying to secure local liability insurance and it proves challenging for you, think it through and maybe consider focusing on expat clients.
[00:15:05] Provide therapy maybe to individuals from your home country, like back in the United States. I tell people all this time, you don't have to complicate it that much. CPH & Associates is, is fine as long as you're following your licensure laws. It's okay just to not have to, like, see clients. Maybe you decide you wanna live in Belgium.
[00:15:22] You don't have to see clients in Belgium because you can do telehealth back in your state of licensure and it's fine, and your liability insurance is probably gonna cover you if you use one of the major ones that are okay with you being located anywhere. Another thing you can do, I hear people talking about this in the Traveling Therapists Facebook group, there are international counseling, like, group conglomerates that offer services around the world.
[00:15:45] You can reach out to them, you can become an employee for them. They will normally have some sort of like huge umbrella liability insurance policy that will protect you that way if you're not feeling comfortable doing it on your own. So that's something else to think about. This is for, this is obviously for the traveling therapists that wanna be international, maybe not feel comfortable, but wanna work un- under the umbrella of an organization that's gonna protect you that way Another thing you can do always is legal protections.
[00:16:12] Consult with an international attorney to draft agreements that limit your liability in jurisdictions without coverage. If you've, if you're finding you're in a country, you wanna see clients in that country, and you can't find any sort of liability, meet with a lawyer, have him draft up some protections for you, have the client sign it just in case.
[00:16:33] It doesn't hurt to just protect yourself that way. Other things you might wanna consider to protect yourself is emergency protocols, so have clear plans for handling a crisis, including referrals to local resources. So, if you are, you know, decide you're gonna get licensed in 15 states in the United States and you're gonna live, you know, over in Australia somewhere, you need to know what the local resources are to protect yourself.
[00:16:57] You don't want a client who all of a sudden is suicidal on a telehealth call in another country, and you have no idea how to get them help. That's opening yourself up for liability, so you need to make sure that you research that stuff and have a ton of good information about that. There's a Wikipedia page, I can't think of the actual web address here, but if you type in like Wikipedia 911 in all countries, there's this huge list of emergency phone numbers in almost every single country, a way to like reach out in case of an emergency.
[00:17:29] So familiarize yourself with that, local resources, how to get help if your client's in trouble and you're having a telehealth session. Finally, make sure you document everything. Keep detailed records of all your communications with your clients, with your licensing board, with your liability insurance.
[00:17:47] Keep it all in one place in case you ever need to pull up on something and say, "Yeah. Well, I talked to this lawyer. This lawyer said I could do this, this, and this. Here's how he told me to write my consents. Here's the signature where my client signed the consent. You know, here's the licensing law in this country.
[00:18:03] Here's what my liability insurance says." You wanna be able to just put your finger on that stuff and have it with you digitally stored somewhere in case anything comes up and you need to protect yourself. So, make sure you do that. Stay flexible. Consider offering non-clinical services. Coaching really helps take away a lot of this liability if you don't wanna worry about licensing rules and regulations and liability insurance and all of that, you can always do coaching.
[00:18:31] I'm a coach. I help people become coaches. I have 15 income streams. I only see a few clients these days, and the more that the insurance companies and all of these places start to kinda clamp down on where we can practice, like most of you probably know, Blue Cross Blue Shield is really cracking on down cracking down on where the clinician can be located during the session.
[00:18:52] SimplePractice, a couple other EHRs have these, and, and Alma, you know, I love Alma. I love them so much, but they're starting to have regulations around where the clinician can be located at the time of service because Blue Cross Blue Shield is dictating this. So- You've gotta be really careful, and if it all starts to seem just, like, too overwhelming, consider coaching.
[00:19:12] You, you, as a therapist, have tons of skillsets, and you could probably be an awesome coach if you wanted to be, if you wanted to not worry about this stuff. So, reach out to me if you need help with setting up your coaching business. I have six-week packages where I can walk you through the whole thing, how I set it up, how I manage all of that stuff.
[00:19:28] So it's totally doable if this is seeming too overwhelming. And then the last little tip is networking. Engage with other internationally practicing therapists for recommendations and advice. So, the Traveling Therapist group is great for that. We've got-- I think we've got, like, 20 or 30 chat threads for different countries.
[00:19:47] You can come over there and just talk to people that are already living in these other countries. Ask them, "How are you doing this?" And there's a wealth of knowledge over there to, to help you, to walk you through it. There's also expat groups out there that you can join for each country to get more information around that.
[00:20:03] And the Portable Practice Method, my course, has got all of this in, like I said, excruciating detail with a ton more resources than I've even talked about today. But I just wanted to touch on this literally because it comes up almost every day in some form or fashion in the Traveling Therapists Facebook Group, so I thought I would record this.
[00:20:23] I can share this episode now when I have this question come up in the group. And of course, if you're listening to this and you have resources, please reach out to me. I love to add resources to the show notes of these episodes, just so I can point people back to them really quickly, say, "Look, here's all the resources for this stuff," or, "Here is an international liability insurance that people in Europe are using.
[00:20:45] Use this. Reach out to them. Get liability insurance." So, there's tons of ways to do this. Let me know if you have questions, and thanks for listening