Without Proper Retroactive Coverage, Past Treatment May Come Back to Haunt You
By Namwook Cho
AAC, CM&F, HPSO, and MIEC Should Be Compared by Policy Structure and Financial Strength—not Premium Alone
As economic conditions become more challenging, an increasing number of acupuncturists are asking, “Can I switch to a less expensive malpractice insurance company?”
There is nothing wrong with comparing premiums. If you can obtain the same protection for less money, there is little reason to pay more.
The problem is that many practitioners do not fully understand the insurance they currently have. Some do not know whether their policy is written on an Occurrence or Claims-Made basis. Others with Claims-Made coverage do not know their Retroactive Date.
Before comparing prices, practitioners should first understand these basic elements of their coverage.
A Cheaper Policy Could Leave Past Treatment Uninsured
With an Occurrence Policy, coverage generally depends on whether the policy was in effect when the treatment occurred. Even if the practitioner later cancels the policy, a claim involving treatment performed during that insured period may still be covered under the terms of that policy.
Claims-Made coverage works differently. Generally, the policy must be active when the claim is made, and the treatment giving rise to the claim must have occurred on or after the Retroactive Date stated in the policy.
When a Claims-Made policy is continuously renewed with the same insurer, the existing Retroactive Date normally continues, making coverage for prior treatment relatively straightforward.
The issue becomes more complicated when changing insurance companies.
Whether past treatment remains protected depends largely on whether the new insurer agrees to recognize the practitioner’s existing Retroactive Date.
Consider an acupuncturist who has maintained Claims-Made coverage since 2021 and switches to a less expensive policy in 2026. If the new policy establishes a Retroactive Date beginning in 2026, a lawsuit filed in 2027 involving treatment performed in 2023 may not be covered by the new insurer.
One way to avoid this gap is through Prior Acts Coverage, sometimes referred to as Nose Coverage. This allows the new insurer to recognize an earlier Retroactive Date.
If Prior Acts Coverage is unavailable, the practitioner may need to consider purchasing Extended Reporting Period coverage, commonly called Tail Coverage, from the previous insurer.
Managing this transition independently can be more difficult than it appears. Even practitioners who are fluent in English may not be familiar with confirming Retroactive Dates, Prior Acts Coverage, Nose Coverage, and Tail Coverage and coordinating the actual transfer between insurers.
Terminology and procedures also vary among companies, and some insurers may direct practitioners to complete certain changes through an insurance agent.
For acupuncturists who have practiced only two or three years or who work part-time and maintain a relatively small patient volume, changing insurers may be less complicated. Even in those cases, however, practitioners should understand the basic characteristics of the company and policy they are considering.
Which Insurance Company Is Best?
Acupuncturists frequently ask, “Which company is the best?”
There is no single answer.
Financial strength and policy type are important, but practitioners should also determine whether the policy fits their specific clinical services, business structure, and practice setting.
AAC (American Acupuncture Council)
One of AAC’s primary advantages is its focus on the acupuncture profession.
Its underwriting carrier, Allied Professionals Insurance Company, received an upgraded AM Best Financial Strength Rating of A (Excellent) in June 2026.
AAC offers both Claims-Made and Occurrence options. It also offers a program under which qualifying practitioners who maintain Claims-Made coverage for an extended period may eventually transition to Occurrence coverage.
For acupuncturists providing a range of traditional services, including acupuncture and herbal medicine, AAC is one option worth comparing.
CM&F
CM&F has provided professional liability insurance programs for healthcare professionals for more than 100 years. Its acupuncture professional liability program is underwritten by MedPro Group.
MedPro Group carries an AM Best rating of A++ (Superior), giving the program a strong financial foundation.
Because the acupuncture coverage is offered on an Occurrence basis, it may appeal to practitioners who want to avoid future Tail Coverage concerns or who practice at multiple locations.
HPSO
Healthcare Providers Service Organization, or HPSO, is a professional liability insurance program administered by Aon Affinity and underwritten by CNA-affiliated insurance companies.
Its acupuncture Professional Liability coverage is structured on a Claims-Made basis, and practitioners may apply for Prior Acts Coverage.
The financial strength of a major insurer is one advantage. However, careful management of the Retroactive Date is particularly important when transferring coverage from another carrier.
Practitioners who provide cosmetic procedures or other specialized treatments should also confirm that those specific services fall within the policy’s actual scope of coverage.
MIEC
MIEC is a medical professional liability insurer established in 1975 and currently offers its Acupuncture Select program.
According to publicly available 2025 financial information, MIEC reported approximately $460 million in Net Admitted Assets and approximately $228 million in Policyholder Surplus. It carries an AM Best rating of A- (Excellent).
Acupuncture Select is written on a Claims-Made basis, but one notable feature is the inclusion of prepaid Tail Coverage.
For practitioners considering the potential long-term cost of Tail Coverage, this structure may be worth comparing with other options.
Ask More Than “Which Company Is Cheapest?”
A lower premium is not a disadvantage. When two policies truly provide equivalent protection, the less expensive policy is obviously attractive.
The key question is whether the coverage is actually equivalent.
When I review a policy for an acupuncturist considering a change of insurers, I look at the Declaration Page before looking at the premium.
The most important items include the Policy Type, Retroactive Date, Coverage Limits, named insureds and business entities, practice locations, and the types of procedures being performed.
Additional caution is especially important for practitioners who have previously changed insurance companies, employ staff or Independent Contractors, practice at multiple locations, or provide services beyond conventional acupuncture, including herbal medicine, cosmetic acupuncture, Microneedling Therapy System (MTS), or other specialized procedures.
Before changing insurers, practitioners should compare their current Declaration Page with the proposed renewal or replacement quotation.
If you can save several hundred dollars while preserving equivalent protection, changing insurers may make perfect sense.
But saving a few hundred dollars should never come at the cost of losing protection for several years of prior clinical care.
Malpractice insurance is not simply about shopping for the cheapest company. It is about structuring coverage so that your past and present clinical practice remain continuously protected.
Policy Review and Inquiries:
Hani Times Insurance Services
insurance4acu@gmail.com
Disclaimer: Insurance company ratings, policy structures, and coverage information are based on information reviewed as of August 2026. Actual policy terms and state-specific requirements may vary. Practitioners should review the most current policy documents before purchasing, renewing, or changing coverage.
Namwook Cho(L.Ac., California P&C License No. 4491041)
