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Insurance for osteopathy and chiropractic in Germany: practice, liability and income

Osteopathy is not a regulated profession of its own in Germany. Whoever offers it does so as a doctor, as a Heilpraktiker (state licensed non medical practitioner) or as a physiotherapist with extra training, and that decides what your professional liability must cover. If you trained as an osteopath or chiropractor in the UK, the US or elsewhere, your title alone does not allow you to treat patients here. Spinal manipulation rarely goes wrong, but when it does, it is serious. And your hands are your income. This page covers practice, liability and income.

Insurance for osteopaths and chiropractors in Germany

The question almost everyone asks first

Can I practise in Germany with my foreign osteopathy or chiropractic degree?

Not on that basis alone. Treating illness without a German medical licence counts as practising medicine and needs a permit under the Heilpraktiker Act. Only then can you insure yourself as a Heilpraktiker with osteopathy and chiropractic named in the policy. We check the wording line by line, in English.

What goes wrong in this trade

  1. 01

    Cervical manipulation

    Rare but serious: after a thrust to the neck a patient reports dizziness and paralysis.

  2. 02

    Missed condition

    Back pain is treated osteopathically, but the cause is a slipped disc or a tumour. The claim: referred to a doctor too late.

  3. 03

    Infants and children

    Treating infants is viewed critically and is not covered by every policy.

  4. 04

    Informed consent

    Without documented information about risks you can be liable even if the treatment itself was correct.

  5. 05

    Your own health

    Thumbs, wrists, back: hands on therapists are out of work at once after overuse or an accident.

  6. 06

    Advertising

    Health claims on your website can lead to warning letters under the Therapeutic Products Advertising Act (Heilmittelwerbegesetz).

Risk radar
Liability 4Fire and water 2Theft 2Cyber 3Downtime 4Health 5

Compared with other trades, 1 low to 5 high.

The insurance you need

Essential

Professional indemnity

Covers claims from treatment; your professional basis and every technique you use must be named in the policy.

Strongly advised

Business liability

For falls in the practice and damage to rented rooms, often part of the professional liability policy.

Business legal expenses

Including criminal defence if prosecutors investigate negligent bodily harm after a treatment.

Business contents

Treatment tables, furniture and equipment against fire, water and burglary.

Depends on the business

Cyber insurance

For online booking and digital patient records with health data.

What it costs: example prices

Professional liability depends on your professional basis: doctors pay considerably more than Heilpraktiker, and chiropractic with thrust techniques often carries a surcharge.

InsuranceExampleTypical range
Professional indemnityOsteopath with Heilpraktiker permit, single practice, €3 million combinedabout €150 to €400 a year
Professional indemnityChiropractic with spinal manipulation, €5 millionabout €300 to €800 a year
Business contentsPractice equipment worth €30,000about €100 to €300 a year
Occupational disability€2,000 monthly benefit, age 35, healthyabout €900 to €1,800 a year

For comparison: A year of professional liability for an osteopathic single practice costs about as much as two to four treatments.

Guide prices from our quoting practice, as of October 2026, excluding insurance tax.

Doctors practising osteopathy insure it under their medical liability;

we obtain the exact quote for you.

Sources of the price examples

Our suggestions: three packages

01

Solo practice

For: Osteopath with Heilpraktiker permit in own or rented rooms

  • Professional indemnity
  • Occupational disability

Together about €1,100 to €2,200 a year, mostly income protection

Request this package

02

Practice

For: Two to four therapists with reception

  • Professional indemnity
  • Business liability
  • Business contents
  • Business legal expenses
  • Occupational disability

Together about €1,800 to €3,500 a year

Request this package

03

Centre

For: Centre for osteopathy, chiropractic and physiotherapy with online booking

  • Professional indemnity
  • Business liability
  • Business contents
  • Business legal expenses
  • Cyber insurance

Together about €2,500 to €6,000 a year, excluding income protection

Request this package

The worst day in an osteopathy practice

Six things that really happen to osteopaths and chiropractors, here all on one Wednesday. Click through and see who pays.

Damage so far€86,000
  1. After a cervical manipulation a patient feels dizzy and is taken to hospital.

    €40,000 · Paid by: Professional indemnity

  2. A patient slips getting off the table and breaks a wrist.

    €6,000 · Paid by: Business liability

  3. Prosecutors open an investigation after the morning's complaint.

    €4,000 · Paid by: Business legal expenses

  4. A burst pipe upstairs floods the treatment room.

    €9,000 · Paid by: Business contents

  5. The online booking system is hacked and patient data leaks.

    €12,000 · Paid by: Cyber insurance

  6. Your thumb joint is inflamed: three months without treating.

    €15,000 · Paid by: Occupational disability

Which package would you have had?

Paid by insurance: €0
Out of your own pocket: €86,000

Illustrative amounts before any excess.

What is paid depends on the policy terms.

Practical tips from your broker

  1. Have your professional basis and every technique named in the policy: osteopathy, chiropractic, thrust techniques, treating infants.
  2. If you work both as a physiotherapist and as a Heilpraktiker, you need cover for both activities.
  3. Document history, screening for red flags and consent in writing, especially before cervical manipulation.
  4. Avoid promises of cure in advertising and on your website.
  5. Choose an income protection policy whose job description reflects your hands on work.
  6. Check whether your association offers group cover and compare it with individual policies.

Why NAMMERT for your business

We read the job description

Whether you practise as a physiotherapist, Heilpraktiker or doctor, we check that your policy covers exactly what you do.

Several insurers compared

Norman Nammert, as an insurance broker, compares policies for health professionals and lays out techniques and exclusions side by side.

In English

We explain German terms and policy wordings in English, so you know what you are signing.

Brokering since 1989

A family business with short lines. Our advice costs you nothing; the insurer pays our commission.

Frequently asked questions

Questions and answers

Is professional liability compulsory for osteopaths in Germany?

There is no law specific to osteopathy, because it is not a regulated profession.

Panel doctors must be insured under § 95e SGB V.

For Heilpraktiker and physiotherapists it is not required by law,

but associations, landlords and partners almost always ask for proof.

Can I practise with a foreign osteopathy degree?

Practising medicine without a German medical licence requires a permit under § 1 of the

Heilpraktiker Act.

A foreign degree in osteopathy or chiropractic does not replace it.

What does professional liability cost?

With a Heilpraktiker permit about €150 to €400 a year,

with chiropractic and thrust techniques usually €300 to €800.

These are guide prices from our quoting practice.

Is chiropractic covered?

Only if it is named in the policy.

Some insurers charge extra for spinal manipulation or ask for proof of training.

Am I covered for accidents at work?

Your employees are usually covered by the BGW,

the Berufsgenossenschaft (statutory accident insurer) for health services.

Whether you are covered yourself depends on your activity and its statutes;

private accident or income protection insurance closes the gap.

NAMMERT insurance broker

Request quotes for Osteopathy

The recommended covers are ticked.

Change what does not fit; we compare quotes, in English.

1Who is it for?
2Which insurance?

Choose as many as you like. For each one, the details an insurer needs for a quote appear below.

Personal

Business

3Details

Occupational disability insurance (Berufsunfähigkeitsversicherung)

For example data analyst in an office, or civil engineer with site visits

We discuss details personally for an anonymous enquiry

For example how long you plan to stay in Germany, self-employment, existing policies

Business liability insurance in Germany (Betriebshaftpflicht)

For example electrical installation in homes, café with outdoor seating, online shop for furniture

For example work at clients' sites, own products, exports to the US, parent company abroad

Professional indemnity insurance in Germany (Berufshaftpflicht)

For example tax adviser with payroll, freelance software developer,

architect for residential buildings

For example current policy abroad, clients in the US, side activities,

expiry date of existing cover

Business legal expenses insurance in Germany (Firmenrechtsschutz)

For example plumbing business, tax practice, online shop for electronics

Existing disputes cannot be insured, but knowing about them helps us advise you

Business contents insurance in Germany (Inhaltsversicherung)

For example café with bakery, accounting firm, car repair shop

At purchase price, 0 if no stock

For example flood cover, customer property, tools in vehicles, loss of income

4Your current policy
5How can we reach you?

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Your broker: Norman Nammert, trading as NAMMERT.

Insurance broker licensed under section 34d(1) of the German Trade Regulation Act.

Broker register no. D-C08Q-TOSD4-37.

NAMMERT Assekuradeur GmbH is a separate company.

It does not arrange your contract.

Statutory disclosure (German) · Updated