What Does Locum Insurance Cover?

A member of your clinical team is suddenly unable to work. You need cover for their sessions, patients still need appointments and, somehow, the rota needs to keep moving.

This is the point where locum insurance earns its keep.

But what does locum insurance actually cover?

The obvious answer is sickness and injury. Yet the cover available can go considerably further than that.

Depending on the level selected, Practice Cover's policy can include support for compassionate leave, jury service, regulatory suspension and even some of the practical costs that follow an accident.

So, let's unpack what that means for a healthcare practice.

First, a quick reminder: what is locum insurance?

Locum insurance is designed to protect a practice against the financial impact of an insured person's absence.

Rather than being personal income protection for the clinician, the core benefit is paid to the insured practice when an insured person can't carry out their usual occupation following a covered event.

Under Practice Cover's policy wording, Level 1 can provide a Weekly Benefit where an insured person is certified as “not fit to work” due to illness, accidental bodily injury or neonatal care leave. The payment starts once the applicable deferment period has passed and is subject to the policy's benefit period and other terms.

If you're new to the subject, it's worth reading our What Is Locum Insurance? guide first. If you already know the basics, read on.

The heart of the cover: illness and accidental injury

For most practices, this is the big one.
A GP develops an illness and can't run their normal clinics. A dentist suffers an injury that prevents them from treating patients. A veterinary surgeon has an accident and needs several weeks away from work.

Those aren't just staffing problems. They can quickly become financial ones too.

Under the policy's Level 1 cover, an insured person must be unable to carry out their usual occupation because of illness or accidental bodily injury. The policy defines that occupation around the essential duties disclosed when applying for the insurance, or subsequently notified and accepted.

Once a valid claim is established and the deferment period has ended, the Weekly Benefit can be paid for the continuing absence.

That benefit continues until the first applicable stopping point, such as the insured person returning to work or the benefit period expiring. Where relevant, it can also end if the insured person ceases to be employed by the insured practice.

In plain English? The cover is there to help the practice weather an absence that lasts longer than the initial waiting period.

And what about neonatal care leave?

There's an important addition to the core cover: Neonatal Care Leave.

Under the current policy wording, this can be treated in a similar way to sickness and accident absence for reimbursement purposes.

There are conditions. For example, evidence is required that the baby was admitted to neonatal care within 28 days of birth for at least seven consecutive days, and the relevant absence must fall within 68 weeks of the child's birth.

It's quite a specific benefit, but that's precisely why it's worth knowing about. Practice absence doesn't always arrive in the form we'd expect.

What happens when someone starts coming back to work?

Recovery isn't always an on/off switch.

Someone can be well enough to return to the practice without being ready for their normal hours or full clinical duties. Going from weeks of absence straight back into a packed surgery isn't always realistic.

Following a valid Level 1 claim, there are provisions for a return on reduced hours where recommended by the treating doctor. Under the Fit Note provision, benefit can continue at a proportionate rate for up to 35 working days, subject to the policy terms.

Alternatively, where a doctor recommends a phased return to some or all of the person's usual duties, the policy provides for benefit at a reduced rate of 50% for up to 35 working days, or until the person returns to all their duties, whichever happens first. The Fit Note and phased-return provisions don't apply simultaneously.

It's a good example of why it's worth looking beyond the words “sickness cover”. Real absences and real recoveries can be messier than that.

Level 2: where the cover gets broader

Practice Cover's policy is structured in levels, and Level 2 adds benefits to the Level 1 protection.

This starts moving the conversation beyond straightforward illness and injury.

Depending on the circumstances and policy terms, Level 2 includes cover relating to:

• compassionate leave;
• jury service;
• medical expenses;
• revalidation;
• suspension from duty;
• coma; and
• funeral expenses following a qualifying accidental death.

A few of those deserve a closer look.

Compassionate leave

Healthcare professionals have families too, of course. If a qualifying family member requires care because of an accident, illness or neonatal care leave and this causes the insured person to take compassionate leave, the policy can provide the Weekly Benefit for up to four weeks, subject to its conditions.

The policy defines a family member as a spouse, civil partner, common-law partner, child, parent or sibling.

For a small practice, even a few weeks can make a sizeable difference.

Jury service

Being perfectly healthy doesn't necessarily mean someone can come to work.

If an insured person has to attend court for jury service and therefore can't work, Level 2 can provide the Weekly Benefit, subject to conditions including the insured person submitting the appropriate claims for travel, subsistence or financial loss to the court.

It's probably not the first reason anyone buys locum insurance. Still, when you're trying to fill a clinical rota, an empty chair is an empty chair.

Regulatory suspension

This is particularly relevant to regulated healthcare professions.

The Level 2 cover can respond where an insured person is suspended from duty by a regulatory body because of an event relating to discipline, health or performance, provided the relevant policy requirements are met.

The wording includes bodies such as the General Medical Council, General Dental Council and Nursing and Midwifery Council within its definition of a regulatory body, alongside other recognised bodies appropriate to the insured person's profession.

There are important restrictions here. For example, cover doesn't apply where the insured or insured person was already aware of an existing or impending investigation that could result in suspension when the relevant cover began.

Level 3 goes further again

This is where locum insurance starts looking rather different from the simple “pay for a replacement when somebody is sick” description.

Level 3 includes the Level 1 and Level 2 benefits and adds further benefits, subject to their individual terms and limits.

These include adoption leave, maternity or surrogacy leave and paternity leave benefits. The wording also provides benefits relating to dental expenses following certain accidental injuries, delayed return from holiday, domestic and childcare expenses, chauffeur costs, hospital inpatient expenses and hospital transport.

There are some healthcare-specific features too. For example, the policy includes a benefit for HIV infection resulting directly from a qualifying needlestick injury sustained in the course of the insured person's usual occupation. It also includes counselling expenses in certain specified circumstances, subject to the policy limits and requirements.

These aren't benefits every practice will need. That's rather the point. The right cover should reflect the people you're insuring and the risks your practice would struggle to absorb itself.

What doesn't locum insurance cover?

This bit matters just as much. No insurance policy covers every eventuality, and locum insurance is no different.

Practice Cover's current policy wording contains general exclusions relating to areas including certain hazardous activities, alcohol and non-prescribed drugs, war and terrorism, specified travel circumstances and pre-existing conditions.

Mental health claims also need careful attention. The wording contains an exclusion relating to psychiatric illness and mental, nervous, stress, anxiety or depression-related disorders unless the insured person is receiving care and attention from an independent UK-registered psychiatric specialist or psychiatric nurse, subject to the full policy wording.

So it's important not to reduce this to “mental health isn't covered”. The actual policy wording is more nuanced.

And that's a useful lesson generally: never judge locum insurance from a headline list of benefits alone. Read the definitions, conditions and exclusions too.

Pre-existing conditions deserve particular attention

This is one of the areas practices should understand before buying cover.

The policy defines a pre-existing condition as a sign, symptom or medical condition that existed before the policy's inception, or before the insured person was added, whether diagnosed or not, unless it was properly disclosed and expressly accepted by the insurer in writing.

When arranging cover, accurate disclosure isn't simply paperwork to get through. The policy places a duty on the insured to provide a fair presentation of the risk, including disclosing material facts. Failure to do so can affect how a claim is handled and, in some circumstances, whether the policy remains valid.

A few extra minutes spent getting the information right at the start can save a lot of uncertainty later.

Does locum insurance cover you abroad?

There is some provision for absence overseas, but it comes with specific requirements.

For qualifying illness or accidental bodily injury, the policy can pay the Weekly Benefit for the certified period or up to six weeks, whichever is shorter. Further payments require specified evidence, including a face-to-face assessment by the insured person's registered UK doctor and evidence that they've returned to the UK for that assessment.

There are also geographical exclusions, including travel to areas where the Foreign, Commonwealth & Development Office advises against all, or all but essential, travel, as well as countries specified in the policy wording.

So, yes, overseas circumstances can be covered, but don't assume they work in exactly the same way as an absence at home.

What about a recurring illness?

Here's another detail worth knowing. Suppose an insured clinician makes a valid Level 1 claim, recovers and returns to work. Then, within 13 weeks, they're signed off again because of the same original illness or accidental injury.

Under the policy wording, those periods can be linked and treated as part of the same claim. A fresh deferment period won't apply, although previous benefit payments count towards the overall benefit period.

If the later absence is caused by a new and unrelated illness or accidental bodily injury, it's treated differently and a new deferment period can apply.

It's a fairly technical distinction, but an important one when you're trying to understand how cover behaves in the real world.

The question isn't simply “what's covered?”

Perhaps the better question is: What would an unexpected absence actually cost your practice?

For one practice, the biggest concern might be paying for a replacement GP for several months. For another, it could be losing dental sessions that generate a significant part of weekly revenue. A smaller veterinary practice may simply not have enough clinical capacity to redistribute the work.

That's why the Weekly Benefit, deferment period and benefit period matter just as much as the list of insured events.

A long list of benefits looks reassuring. But the useful policy is the one that matches how your practice actually operates.

Before choosing cover, read the detail
Locum insurance can provide much broader protection than its name suggests. Practice Cover's policy can extend from the core risks of illness and accidental injury into areas such as compassionate leave, jury service, regulatory suspension and certain family-related absences, depending on the level selected.

But each benefit comes with definitions, conditions, limits and exclusions. So don't buy from the bullet points alone.

Understand who is insured, how much Weekly Benefit you've selected, how long the deferment period lasts and which level of cover appears on your Schedule. The Schedule identifies the insured person or people, selected level of cover, insured benefit and whether continuity of cover has been selected.

That's where “having insurance” becomes having insurance that actually fits the practice.