# 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.

Quelle/Source: https://www.nammert.com/en/business-insurance-osteopathy-and-chiropractic.php  
Updated: 2026-10-14

## 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.

## At a glance

- **Compulsory:** No insurance requirement specific to osteopathy; panel doctors (Vertragsärzte) need professional liability of at least €3 million per case under § 95e of Social Code Book V
- **Professional law:** Anyone practising medicine without a medical licence needs a permit under § 1 of the Heilpraktiker Act; training and the profession of osteopath are not regulated by law
- **Biggest risk:** Injuries from manipulation of the cervical spine and claims that a serious condition was missed
- **Basic cover from:** about €150 a year of professional liability for a single practice with a Heilpraktiker permit, a guide price from our quoting practice
- **Often forgotten:** Every method must be named in the policy: chiropractic, thrust techniques and treating infants are not always included

## What goes wrong in this trade

- **Cervical manipulation:** Rare but serious: after a thrust to the neck a patient reports dizziness and paralysis.
- **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.
- **Infants and children:** Treating infants is viewed critically and is not covered by every policy.
- **Informed consent:** Without documented information about risks you can be liable even if the treatment itself was correct.
- **Your own health:** Thumbs, wrists, back: hands on therapists are out of work at once after overuse or an accident.
- **Advertising:** Health claims on your website can lead to warning letters under the Therapeutic Products Advertising Act (Heilmittelwerbegesetz).

**Risk radar** (Compared with other trades, 1 low to 5 high.): Liability 4, Fire and water 2, Theft 2, Cyber 3, Downtime 4, Health 5

## The insurance you need

- **Professional indemnity** (Essential): Covers claims from treatment; your professional basis and every technique you use must be named in the policy. https://www.nammert.com/en/insurance-broker-professional-indemnity.php
- **Occupational disability** (Essential): No hands, no income; self employed therapists have little statutory protection. https://www.nammert.com/en/insurance-broker-occupational-disability.php
- **Business liability** (Strongly advised): For falls in the practice and damage to rented rooms, often part of the professional liability policy. https://www.nammert.com/en/insurance-broker-business-liability.php
- **Business legal expenses** (Strongly advised): Including criminal defence if prosecutors investigate negligent bodily harm after a treatment. https://www.nammert.com/en/insurance-broker-business-legal-expenses.php
- **Business contents** (Strongly advised): Treatment tables, furniture and equipment against fire, water and burglary. https://www.nammert.com/en/insurance-broker-business-contents.php
- **Cyber insurance** (Depends on the business): For online booking and digital patient records with health data. https://www.nammert.com/en/insurance-broker-cyber-insurance.php

## 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.

| Insurance | Example | Typical range |
| --- | --- | --- |
| Professional indemnity | Osteopath with Heilpraktiker permit, single practice, €3 million combined | about €150 to €400 a year |
| Professional indemnity | Chiropractic with spinal manipulation, €5 million | about €300 to €800 a year |
| Business contents | Practice equipment worth €30,000 | about €100 to €300 a year |
| Occupational disability | €2,000 monthly benefit, age 35, healthy | about €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._

- [German federal law portal: § 1 Heilpraktikergesetz](https://www.gesetze-im-internet.de/heilprg/__1.html)
- [German federal law portal: § 95e SGB V](https://www.gesetze-im-internet.de/sgb_5/__95e.html)
- [Association of Osteopaths in Germany (VOD)](https://www.osteopathie.de/)

## Our suggestions: three packages

- **Solo practice** (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
- **Practice** (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
- **Centre** (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

## 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.

- 08:30: After a cervical manipulation a patient feels dizzy and is taken to hospital. (€40,000, Paid by: Professional indemnity)
- 10:15: A patient slips getting off the table and breaks a wrist. (€6,000, Paid by: Business liability)
- 12:00: Prosecutors open an investigation after the morning's complaint. (€4,000, Paid by: Business legal expenses)
- 14:30: A burst pipe upstairs floods the treatment room. (€9,000, Paid by: Business contents)
- 16:45: The online booking system is hacked and patient data leaks. (€12,000, Paid by: Cyber insurance)
- 18:20: Your thumb joint is inflamed: three months without treating. (€15,000, Paid by: Occupational disability)

**Damage so far:** €86,000

## Practical tips from your broker

- Have your professional basis and every technique named in the policy: osteopathy, chiropractic, thrust techniques, treating infants.
- If you work both as a physiotherapist and as a Heilpraktiker, you need cover for both activities.
- Document history, screening for red flags and consent in writing, especially before cervical manipulation.
- Avoid promises of cure in advertising and on your website.
- Choose an income protection policy whose job description reflects your hands on work.
- 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.

## FAQ

### 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.

### Do I need legal expenses cover?

It is useful, because complications often lead to a criminal investigation as well. Professional liability pays damages, not your defence lawyer.

## Request quotes

We obtain quotes and come back with a comparison, free of charge. You can write in English. https://www.nammert.com/en/business-insurance-osteopathy-and-chiropractic.php#anfrage

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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.

NAMMERT Assekuradeur GmbH, Karl-Marx-Straße 4, 15711 Königs Wusterhausen, +49 3375 29 12 77, info@nammert.com. Wikidata: Q141141479.