Do you practise acupuncture, homeopathy, osteopathy or naturopathy? If you provide one of the seven recognised complementary therapies in Portugal, the law requires you to hold professional liability insurance. But even if it weren't mandatory, the protection this insurance offers is too important to ignore.
In Portugal, complementary and alternative therapies were regulated by Law No. 71/2013 and Law No. 45/2003. This legislation officially recognises seven practices — Acupuncture, Phytotherapy, Homeopathy, Traditional Chinese Medicine, Naturopathy, Osteopathy and Chiropractic — and requires all practitioners to hold professional liability insurance.
Why therapists need this insurance
Complementary therapies work directly with people's bodies and wellbeing. Even with the best training and intentions, unforeseen situations can arise:
- An allergic reaction to a prescribed herbal remedy
- An injury during an acupuncture session or body manipulation
- Worsening of a pre-existing condition that was not detected during the initial assessment
- An injury during an osteopathic or chiropractic manipulation
- A drug interaction that was not identified
In these cases, the therapist may be held civilly liable for damages caused — whether physical, moral or financial. Without insurance, compensation costs and legal defence come directly out of your own pocket.
What Portuguese law requires
Law No. 71/2013, which regulates complementary therapies, establishes in Article 10.º, paragraph 1, that practising these activities requires professional liability insurance. (Article 5.º of the same law governs a separate subject — the degree-level qualification needed to access the profession — and is not the source of the insurance requirement.) The regulation the law itself delegates that requirement to is Portaria n.º 200/2014, which sets a minimum insured capital of €150,000 per annuity and per claim. Holding that insurance is a condition for the issuance of the professional licence by ACSS (Central Administration of the Health System).
The seven therapies covered are:
- Acupuncture — use of needles and energy medicine techniques
- Phytotherapy — treatment through medicinal plants and herbal preparations
- Homeopathy — therapeutic system based on the principle of similitude
- Traditional Chinese Medicine — holistic approach including acupuncture, Chinese herbal medicine and tuina
- Naturopathy — health promotion through natural methods and prevention
- Osteopathy — manual therapy focused on the musculoskeletal system
- Chiropractic — manual and manipulative treatment centred on the spine and musculoskeletal system
Although yoga is not formally included in the list under Law No. 71/2013, many instructors work as wellness and sports professionals and are equally exposed to liability risks — particularly in the context of classes involving physical contact, postural adjustments and work with vulnerable populations. The same applies to Pilates and Tai Chi instructors and to massage and spa therapists, none of whom are on the regulated list either.
What the policy should cover
Not all liability insurance policies are the same, and a generic policy rarely covers the specificities of complementary therapies. A good policy for therapists should include:
- Professional liability for acts, errors or omissions in therapeutic practice
- Premises liability (for those with their own clinic or treatment space)
- Legal defence and court costs
- Cover for bodily, material and moral harm caused to patients/clients
- Cover for products used or recommended (relevant in phytotherapy and homeopathy)
Recommended sums insured
The statutory minimum is €150,000 per claim and per annuity, set by Portaria n.º 200/2014 for practitioners holding the ACSS (Administração Central do Sistema de Saúde — Central Administration of the Health System) professional licence, the cédula profissional. The solutions we place start from €250,000, because that legal floor covers a bodily-injury claim poorly once compensation, expert assessment and defence costs are added together over a process that can run for years. Consider a higher sum insured for:
- Clinics or centres with multiple therapists
- Practices working with at-risk populations (elderly, pregnant women, children)
- Manipulation techniques with higher exposure
The annual cost of an adequate policy is generally modest for the exposure it covers — the exact figure depends on the sum insured, the activity declared and the insurer's acceptance.
Common mistakes we see with our clients
At Adler & Rochefort, we regularly work with therapists and complementary health practitioners. The most common mistakes we encounter are:
- Taking out a generic liability policy that excludes therapeutic acts
- Not correctly declaring the activity carried out, which can invalidate the policy in the event of a claim
- Ignoring premises liability cover when you have your own clinic
- Not updating the policy when adding new therapies to your range of services
- Not checking whether the policy covers home visits or multiple locations
How to choose the right insurance
Choosing the right insurance should start with a detailed analysis of your activity: which therapies you practise, where you see clients, what type of clients you serve, and the specific risks of your practice. With that information, it's possible to find a policy that offers real protection — not just a document to meet legal requirements.
At Adler & Rochefort, we analyse your situation free of charge and compare the best options on the market for your specific activity. Contact us and protect your practice with the peace of mind you deserve.
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