Understanding Insurance Needs for Nature Informed Therapists
- Chesapeake Mental Health Collaborative
- Jul 21, 2024
- 5 min read
Updated: Sep 2
As a Nature-Informed Therapist, sorting out liability coverage can feel… murky. Different policies protect different risks, and gaps often hide in the fine print. One widespread myth is that “if I only do outdoor sessions occasionally, my general liability will cover it.” Reality: coverage depends on what your policy says you do, not how often you do it.
This guide clarifies the core coverage types, common exclusions that affect outdoor work, and a concrete checklist you can use with your broker to close gaps—before you’re on the trail with clients.
The Three-Legged Stool (Plus a Fourth "Stabilizer)
Insurance needs for Nature Informed Therapists can be likened to a three-legged stool, where each leg represents a different type of insurance essential for comprehensive coverage:
1) Professional / Malpractice Liability (E&O)
What it’s for: Allegations tied to your professional services (e.g., negligence in assessment, treatment, advice, scope-of-practice issues).
Key limit: Per-claim and aggregate (often separate from GL).
Watch for: Coverage must apply whether therapy occurs indoors or outdoors.
2) General Liability (GL / CGL)
What it’s for: Premises/operations liability—slips, trips, falls, property damage—not the professional advice itself.
Critical caution: Many GL policies carry a Participant Exclusion (sometimes labeled “Athletic or Recreational Participants”). If clients are considered participants in an activity (hike, forest bathing, nature walk), their injuries may be excluded—even if you do it only once.
3) Outdoor / Participant Liability (Outfitter & Guide or Special Event Endorsement)
What it’s for: Bodily injury to participants during organized outdoor activities.
Why you need it: This fills the gap when GL excludes participants. It’s often structured as:
A dedicated Outfitter & Guide policy, or
A Special Event or Outdoor Program endorsement for specified activities/dates.
4) Participant Accident Medical (the Stabilizer)
What it’s for: No-fault medical benefits for participants (a goodwill, first-dollar buffer).
Why it helps: Keeps minor injuries from escalating into liability claims and supports participant care.
“Occasional” Isn’t a Coverage Strategy
Insurers underwrite what you disclose as your operations. If your policy lists “office-based counseling” but you guide hikes or run retreats, a claim may be denied regardless of frequency. The fix isn’t doing less—it’s classifying accurately and endorsing appropriately.
Common Gaps for Nature-Based Work (and How to Plug Them)
Participant Exclusion on GL
Fix: Add Participant Liability via an Outdoor/Guide policy or event endorsement.
Outdoor activity carve-outs
Higher-risk or water-adjacent activities (kayaking, swimming, boating, scrambling, ropes, climbing, overnight camping) are frequently excluded.
Fix: Endorse or place with a carrier that specifically covers your activities. When in doubt, list them all.
Professional-services exclusion (on GL)
Normal: GL won’t cover “therapy” as a service (that’s your malpractice).
Implication: Injuries from the activity must be covered by GL with participants included or by an outdoor policy.
“Outdoor fitness/wellness” policies vs. therapy
Some group/aggregator policies cover the physical activity only and exclude psychological services.
Fix: Keep malpractice in place for clinical work; use the outdoor policy to cover the activity risk. Confirm both carriers will coexist cleanly.
Abuse/Molestation coverage
Often excluded unless separately added.
Fix: Add a dedicated Sexual Misconduct/Abuse coverage part with appropriate limits and risk-control requirements.
Additional Insureds & COIs
Parks/landowners typically require Certificates of Insurance naming them Additional Insured, with primary & noncontributory wording and waiver of subrogation.
Fix: Ensure your policy can issue these endorsements quickly.
Transportation exposures
Staff using personal cars or rentals to transport participants ≠ automatically covered.
Fix: Add Hired & Non-Owned Auto (and Commercial Auto if you own a van).
Retreats & International trips
Multi-day programs increase risk complexity; foreign venues add jurisdictional issues.
Fix: For retreats, consider Special Event or Outfitter & Guide solutions; for international, add Foreign GL and Travel/Accident Medical (and, where appropriate, Foreign Voluntary Workers’ Comp).
Practical Risk Controls (They Matter to Underwriters)
Informed consent + assumption of risk that specifically references outdoor activities
Participant screening (fitness, medical considerations, medications, allergies)
Staff training (WFA/WFR where appropriate), ratios, route plans, weather thresholds
Emergency Action Plan (communications, evacuation, nearest care, incident reporting)
Gear & PPE (footwear guidance, hydration, sun/heat/cold protocols)
These won’t replace insurance—but they can improve insurability and claim outcomes.
If You Use an Outdoor “Umbrella” Policy (e.g., fitness/wellness aggregators)
Confirm it allows naming landowners as Additional Insureds with required wording.
Verify it doesn’t conflict with your malpractice (no “other insurance” surprises).
Check excluded activities (watercraft, swimming, scrambling, overnights, altitude, winter conditions).
Ensure the territory (domestic/international) and participant age ranges match your programs.
Note: Some popular outdoor/fitness policies have historically excluded psychological/mental-health services; that’s why malpractice remains non-negotiable for therapy and supervision, while participant/outdoor coverage handles the activity risk.
What to Ask Your Broker (Copy/Paste Checklist)
Please confirm in writing that:
Our Professional/Malpractice policy covers therapy delivered outdoors.
Our GL either (a) covers participants in outdoor activities or (b) we have a dedicated Participant/Outfitter & Guide solution for them.
Abuse/Molestation coverage is included with adequate limits.
We can issue COIs naming landowners/park authorities Additional Insured with primary & noncontributory wording and waiver of subrogation.
We have Hired & Non-Owned Auto (and Commercial Auto if applicable).
For retreats (domestic/international), we have appropriate Special Event/Outfitter & Guide and, if abroad, Foreign GL and Travel/Accident Medical.
Any activity-specific exclusions (water, ropes, climbing, camping, international) are disclosed, and solutions are proposed.
Who actually sells this stuff? (good options for solos & small groups)
Malpractice (Professional Liability) for mental-health clinicians
HPSO (underwritten by CNA) – large national program for counselors/therapists.
CPH & Associates – long-running, therapist-focused program.
American Professional Agency (APA, Inc.) – broad behavioral-health appetite (MFTs, counselors, psychologists).
Psychologists: The Trust is a go-to option.
General Liability / Business Owner’s Policy (BOP) for private practices
The Hartford, Travelers, CNA, Chubb – mainstream carriers with solid BOPs for clinics and offices.
Hiscox, NEXT, biBERK (Berkshire Hathaway), State Farm (through agents) – small-business friendly, often fast online quotes.
Philadelphia Insurance (PHLY) – good for practices with training/events or higher foot-traffic exposure.
Tip: ask for a BOP (bundles GL + business property + loss of income) and price Hired & Non-Owned Auto, Abuse/Molestation, and the ability to issue Additional Insured COIs on demand.
Outdoor / Participant Liability (guided hikes, forest bathing, retreats)
PHLY – Guides & Outfitters / Great Outdoors
K&K Insurance – Outfitters & Guides
Markel – Outfitter/Guide programs
Alternative Balance – Sports & Recreational Fitness Services
(These fill the participant-injury gap when standard GL excludes “participants.”)
Documentation That Pays Off
Keep a program file for each outing/retreat: itinerary, roster, screening notes, waivers, EAP, staff credentials, incident logs, and issued COIs.
Review coverage annually or when you add new activities (e.g., kayaking, international treks).
Train your team on when to report an incident—early notice preserves coverage options.
Bottom Line
If you run a business, carry General Liability (GL). It covers premises/operations injuries and property damage—not your clinical advice.
If you practice mental health, carry Professional Liability/Malpractice. It covers claims about your assessment, treatment, and advice (indoors or outdoors).
Will GL cover outdoor sessions? Sometimes—but not automatically. It depends on your policy:
Many GL policies have a Participant Exclusion (clients on hikes/forest bathing = “participants”).
If your operations are classified only as office-based counseling, outdoor activities may be outside scope.
Some carriers exclude specific activities (watercraft, ropes, overnights, etc.).
If excluded: add Participant Liability via an Outfitter & Guide / Outdoor Program endorsement or a Special Event policy, and consider Participant Accident Medical. Keep malpractice for the therapeutic piece.
Broker one-liner to confirm:
“Do we (1) have malpractice for therapy delivered outdoors, and (2) have GL that covers participants in our outdoor activities—or the right outdoor/guide endorsement if not?”
Disclaimer: This article is for informational purposes only and is not legal or insurance advice. Coverage varies by carrier and policy form. Consult a qualified broker and/or attorney about your specific operations and jurisdictions.