What 30 Years of Claims Have Taught Me About Managing Risk in Aesthetics

This year marks 30 years since Hamilton Fraser first began providing medical malpractice insurance to the aesthetics sector. Looking back over three decades of claims experience, it’s fair to say that almost everything about our industry has changed.

When we first started, the market was much smaller. Treatments were less advanced, patients had fewer sources of information, and complaints tended to be relatively straightforward. Today, practitioners are running practices in a sector that is shaped by social media, advanced technologies, evolving regulation, AI and increasingly informed consumers.Yet despite all of these changes, one thing continues to stand out: most claims are not solely about the treatment itself.

Of course, clinical mistakes can and do happen. But when we review claims, we repeatedly find that communication, consent and expectation management play just as significant a role in determining whether a dissatisfied patient becomes a formal complaint or claim.

In many cases, the treatment outcome may have been clinically appropriate, but the patient’s expectations were never fully aligned with what could realistically be achieved. Sometimes risks were discussed but not properly documented. Occasionally, aftercare advice was given verbally but not recorded. These small gaps can become significant when a complaint is made months later. Our claims data reflects how the sector continues to evolve. Between 2024 and 2025, the number of claims reported to Hamilton Fraser increased by 12.1%, rising from 281 to 315. At the same time, the number of dissatisfaction cases reported fell from 66 to 48.

One explanation is that practitioners are becoming more proactive at addressing concerns before they escalate. Another is that patients are becoming more confident in pursuing formal routes when they feel their concerns have not been adequately addressed. We’re also seeing a new trend emerge: the rise of AI-assisted complaints.

Increasingly, complaints arrive looking professionally drafted, complete with references to legislation, regulatory guidance and legal terminology. In many cases, patients have used AI tools such as ChatGPT to help structure and strengthen their correspondence.

This doesn’t mean the complaint is necessarily more valid. AI cannot create evidence where none exists. However, it can make a complaint appear more sophisticated and intimidating to the practitioner receiving it.

As AI becomes more widely used by both patients and practitioners, good record-keeping becomes even more important. Clear consultation notes, robust consent processes and documented discussions around risks and expectations provide an objective record of what actually took place.

So what have 30 years of claims taught me?

First, never underestimate the importance of managing expectations. Patients who understand both the benefits and limitations of treatment are less likely to feel disappointed later.

Second, document everything. If a discussion isn’t recorded, it becomes much harder to demonstrate what was said if a complaint arises months or years later.

Third, view complaints as part of professional practice rather than a sign of failure. Even excellent practitioners can receive complaints. What often matters most is how those complaints are handled.

And finally, remember that while treatments, technologies and patient behaviours will continue to evolve, the fundamentals of risk management remain remarkably consistent.

Good communication. Informed consent. Professional standards. Comprehensive records.

After 30 years, those remain the strongest forms of protection any practitioner can have.

If you’d like to talk through how your cover supports you when a complaint or claim arises, our team is here to help. Get in touch on 0800 63 43 881 or visit hamiltonfraser.co.uk.