To ensure procedures that seem like harmless aesthetic treatments don't turn into costly cosmetic surgery nightmares for liability insurers, underwriters need to keep their eyes open and ask questions, according to two experts.

Indeed, there's more to underwriting medi-spa risks than just trying to understand what services they provide, said Nancy Huddlestun, assistant vice president and senior underwriter for General Star Management Co. in Chicago, and Kathleen Johnson, senior claims attorney for Deerfield, Ill.-based Shand Morahan & Co.

“It's going that one step further and asking, who is doing the laser? Who exactly is doing the microdermabrasion? Who exactly is administering botox injections?” warned Ms. Johnson during a presentation at the Professional Liability Underwriting Society international conference last year.

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