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How Does CQC Rating Impact Insurance for Healthcare Providers?

How Does CQC Rating Impact Insurance for Healthcare Providers?

In today’s evolving healthcare landscape, the relationship between CQC ratings and insurance for healthcare providers has become increasingly significant. With the insurance market experiencing shifts, exacerbated by the challenges brought on by the Covid-19 pandemic, it’s crucial for healthcare providers to understand how their CQC ratings can influence their insurance coverage. Here at the HLTH Group, we’re committed to providing insights and guidance to help healthcare providers navigate these complexities.

Pre-Covid Insurance Landscape:

Before the pandemic, the insurance market for care homes and domiciliary care providers was relatively niche but offered a range of products from various brokers and insurers. Underwriters assessed risks based on business activities, financials, property, loss history, and crucially, the latest CQC inspection reports. Providers with “Good” or “Outstanding” ratings generally found it easier to secure favourable terms, while those rated “Requires Improvement” or “Inadequate” faced increased scrutiny and potentially higher premiums.

Post-Covid Insurance Landscape:

The Covid-19 pandemic has brought unprecedented challenges to the healthcare sector, significantly impacting the insurance landscape. Insurers, already grappling with profitability issues in the care sector due to liability claims, are now facing heightened concerns about the frequency and severity of claims related to Covid-19. Challenges include allegations of negligence in areas such as PPE provision, testing, funding, and hospital discharge protocols.

Reinsurers, essential for spreading risk in the insurance industry, are increasingly hesitant to cover liabilities in high-risk sectors like healthcare, leaving insurers to shoulder more significant burdens themselves. Consequently, some insurers are exiting the market, while others are becoming more selective in accepting new business. This reduced appetite for risk means providers may face limited options for coverage and potentially higher premiums.

Impact of CQC Ratings:

In this changing landscape, CQC ratings continue to play a crucial role in insurance assessments. Insurers scrutinise inspection reports more closely, looking for trends, action plans, and evidence of improvement. Providers with favourable ratings may find it easier to secure coverage, while those with lower ratings may face challenges and increased premiums.

Benefits of Care Consultancy:

Utilising a care consultancy, such as the HLTH Group, can provide significant benefits for healthcare providers seeking insurance coverage. Consultants offer independent reviews, assist with regulatory improvements, and demonstrate a commitment to risk management. For providers already utilising consultancy services, sharing this information with your insurance broker can lead to access to additional markets, discounts, or enhanced coverage.


As healthcare providers navigate the evolving insurance landscape, understanding the relationship between CQC ratings and insurance coverage is essential. By proactively managing risks, investing in regulatory compliance, and leveraging the expertise of care consultancies such as the HLTH Group, providers can enhance their insurability and navigate challenges more effectively.

Remember, in today’s hard market, insurers may be less likely to offer discounts upfront. However, investing in risk management and consultancy services can position providers more favourably, potentially influencing underwriters’ decisions and ensuring continued access to essential insurance coverage.