By Greg Freeman
The number of reported license protection adverse incidents and claims made against counselors to the Board of Professional Counselors has nearly doubled in the last five years, according to a report from Healthcare Providers Service Organization (HPSO), a division of Aon Affinity. The report indicates that 4,080 reported license protection adverse incidents and claims were made against counselors in the 2024 dataset, compared to 2,082 in the 2019 dataset.
HPSO highlights these key findings from the report:
- Top counselor licensure complaints. Allegations related to sexual misconduct, failure to maintain professional standards, and breach of confidentiality represented 34.6% of all license defense matters.
- Evaluation of professional liability claims costs. The average total incurred amount for a professional liability claim involving a counselor rose to $157,492 — an increase of nearly 40% since the 2019 dataset.
- Key allegations. Professional liability claims asserting counseling relationship violations remained the top allegation category in the 2024 dataset (52.3%), which reflects prohibited sexual and/or romantic relationships as well as other non-professional interactions.
- Analysis by counselor specialty and location. Notably, claims in which counseling was rendered via telebehavioral health increased from 0% in the 2019 dataset to 3.9% in the 2024 dataset. Furthermore, claims involving telebehavioral health tended to be some of the most severe compared to other counseling locations — such as group practice and individual practice settings — with an average total incurred of $317,516.
- Assessment of subpoena assistance matters. Subpoena assistance matters refer to situations where counselors are subpoenaed to provide a deposition or court testimony and/or subpoenaed to produce counseling records. Since the 2019 report, the total number of subpoena assistance matters has more than doubled, increasing from 2,535 to 5,935, or 134%. Child custody matters are the most frequent reason that counselors are subpoenaed to testify in court or produce counseling records, representing 48.6% of all underlying matters.
The report is available online at: https://www.hpso.com/Resources/Legal-and-Ethical-Issues/Counselor-Professional-Liability-Exposure-Claim-Report-3rd-Edition?utm_source=partner-toolkit&utm_medium=news-release&utm_campaign=klpr-counselor-claim-report-toolkit-news-release.
The overall average is driven by more claims closing at a higher amount and fewer claims closing at a lower amount, says Jennifer Flynn, CPHRM, risk manager with Nurses Service Organization. There was a significant increase in the number of claims with a paid indemnity greater than or equal to $500,000, she notes.
“We had claims closing at what we consider policy limits. In most states, that’s a million dollar policy, and even claims closing at that $750,000 to $999,000 bucket, where we had not seen claims closed at those policy limits in the previous data set, that’s really driving the average total incurred amount,” she says. “Many of those claims are against an individually insured counselor, but we also see the percentage of private practice-related claims has increased.”
Documentation is key to reducing these costs, Flynn says. Many counselors do not realize that they have a professional obligation to maintain consistent documentation records, she says.
“Inadequate documentation can severely hurt the defense of a liability lawsuit, as well as possibly leading to disciplinary action if we find that the counselor’s records are not contemporaneous, objective, truthful, and professionally appropriate,” Flynn says. “Good documentation can guard against miscommunication and misunderstanding. It can guard against the lengthy litigation process. It can demonstrate to the court your competency as a as a counselor.”
Flynn says an attorney once told her that of all the people who look at medical records, the most important reader is actually the counselor, but in the future.
It may take a client one to two years to bring a claim and another three and a half years to litigate that claim, so that documentation is going to be the one thing that helps the clinician answer questions through reconstruction, Flynn says.
“You’re not just giving simple conclusions in your testimony, but you’re citing your measurable observations that are in the record,” she says. “When you think of the counselor putting their clinical decision-making rationale and any actions they took in the record, whether or not the they’re successful in that defense, it will be the justification as to why they made those decisions.”
Source
- Jennifer Flynn, CPHRM, Risk Manager, Nurses Service Organization, Fort Washington, PA. Telephone: (215) 773-4513. Email: [email protected]
Greg Freeman has worked with Relias Media and its predecessor companies since 1989, moving from assistant staff writer to executive editor before becoming a freelance writer. He has been the editor of Healthcare Risk Management since 1992 and provides research and content for other Relias Media products. In addition to his work with Relias Media, Greg provides other freelance writing services and is the author of seven narrative nonfiction books on wartime experiences and other historical events.
The number of reported license protection adverse incidents and claims made against counselors to the Board of Professional Counselors has nearly doubled in the last five years, according to a report from Healthcare Providers Service Organization, a division of Aon Affinity. The report indicates that 4,080 reported license protection adverse incidents and claims were made against counselors in the 2024 dataset, compared to 2,082 in the 2019 dataset.
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