Brett Buchanan
Executive Vice President, Business Insurance
Insurance for digital health companies is fundamentally different from insurance for traditional healthcare organizations or traditional technology firms. Digital health companies operate at the intersection of clinical care, software, data, and regulatory compliance — often all at once. A single patient incident can touch medical professional liability, technology errors and omissions, cyber, and directors and officers coverage.
This cross-line complexity is what makes broker selection one of the most consequential decisions a digital health company can make. The wrong brokerage model can mean higher premiums, slower service, and coverage gaps that remain invisible until a claim arrives — and by then, the damage may already be done.
The data supports this concern. According to the CFC Digital Healthcare Report 2025, two-thirds of digital health claims now stem from sources that would not be covered under a traditional medical malpractice policy — including advertising liability, intellectual property disputes, cybercrime, and regulatory actions. Only 33% of eHealth claims involve bodily injury in the traditional sense. The remaining 67% fall across cyber and privacy, breach of contract, regulatory costs and fines, and other emerging categories.
This means the broker model that worked for a hospital system or a SaaS company may be structurally misaligned with the risk profile of a digital health company. The question is not whether your broker is competent. The question is whether your broker’s model is built for the way digital health risk actually behaves.
We have observed five dominant brokerage models serving this market. Each has a coherent rationale. Each has real strengths. And each has a failure mode that is predictable, recurring, and often discovered only at the worst possible moment — when a claim is filed.
The five brokerage models
1. The vertical specialist
What they do well: These brokers know their vertical exceptionally well. The healthcare specialist understands medical malpractice, hospital professional liability, and managed care E&O. The technology specialist understands cyber liability, tech E&O, and media liability. The life sciences specialist understands product liability, clinical trial coverage, and FDA regulatory exposure. Within their lane, these brokers are often excellent.
Where it breaks: Digital health companies routinely operate across all three domains at once. A vertically specialized broker who places your medical professional liability through healthcare markets may have no relationships with the cyber carriers that understand AI-assisted clinical tools, and no framework for how those policies interact when a single patient incident triggers both. The broker may also lack fluency in the MSO/PC corporate structures common in telehealth, where coverage coordination between the management services organization and the professional corporation is essential to avoid leaving an entity uninsured.
The bottom line: The expertise is real, but the scope is too narrow. You get strong coverage in one dimension and potential blind spots everywhere else.
2. The generalist broker
What they do well: Generalist brokers are often in the room because of a personal connection — a board member’s recommendation, a founder’s prior relationship, or a referral from an investor. They are capable of placing standard commercial lines and are often strong relationship managers. For companies in low-complexity industries, this model can work well enough. Coverage gets placed, certificates get issued, and renewals happen on schedule.
Where it breaks: Digital health is not a low-complexity industry, and generalist brokers face structural disadvantages across multiple dimensions when serving it.
Coverage overlaps and finger-pointing at claims time. A generalist broker placing cyber coverage for a telehealth company may not understand how HIPAA interacts with standard cyber policy exclusions, or that the technology E&O policy may contain a bodily injury exclusion that conflicts with the med mal policy’s technology exclusion. When a single incident triggers multiple policies placed with different carriers, the result can be predictable: each insurer points to another policy as the one that should respond. Without a broker who has reviewed the exclusion language across every form and can explain to each carrier why its policy is triggered, the company may be left mediating a dispute between its own insurers while the claim remains unresolved. This is the finger-pointing problem, and it is one of the most common failure modes in generalist-brokered digital health programs.
Reliance on wholesalers and limited market access. Generalist brokers typically lack direct appointments with the specialist carriers that underwrite digital health risk — markets such as CFC, Beazley’s Virtual Care division, or Hudson’s digital health facility. Without these relationships, they often route placements through wholesale intermediaries that add cost, reduce transparency, and create distance between the insured and the underwriter. At renewal, when terms need to be negotiated or claims experience needs to be explained, the generalist broker may not have a direct line to the decision-maker. The wholesale layer can mean slower responses, less flexibility, and a broker who is relaying messages rather than advocating directly on your behalf.
Inability to negotiate competitive pricing. Pricing leverage in specialty insurance comes from two sources: volume of similar accounts placed with a carrier, and the technical fluency to present a risk in the language the underwriter needs to see. A generalist broker who places one or two digital health accounts per year may have neither. They cannot demonstrate a track record of favorable loss experience in the space, and they may not know how to frame your MSO/PC structure, your AI-assisted clinical workflows, or your HIPAA compliance posture in a way that gives the underwriter confidence to offer competitive terms. The result can be higher cost — not necessarily because your risk is worse, but because your broker cannot present it effectively.
Fragmented placement driving unnecessary cost. Perhaps most consequentially, generalist brokers may place digital health programs across five or more separate, uncoordinated policies: a standalone med mal policy from one carrier, a tech E&O policy from another, cyber from a third, D&O from a fourth, and EPL from a fifth. Each policy carries its own minimum premium, fees, and underwriting overhead. A specialist broker, by contrast, may be able to consolidate three or more of these lines onto a single integrated policy form from a carrier that underwrites digital health as a class — reducing total premium, minimizing coverage gaps between policies, and simplifying administration. The fragmented approach does not just create risk. It can also create cost that compounds at every renewal.
The bottom line: Five separate policies may be placed without anyone reviewing the complete program for coordination, conflicts, or cost efficiency. The coverage may look legitimate on a certificate of insurance. Whether it responds to an actual digital health claim — and at what cost — is a different question.
3. The tech-forward broker with a wholesale back end
What they do well: This model has grown significantly in the insurtech era. The client experience is often excellent: a clean portal, fast certificate issuance, easy renewals, and automated benchmarking reports. For founders accustomed to modern software interfaces, this model feels intuitive and efficient. Quoting is fast. Onboarding is smooth.
Where it breaks: What the client may not see is that actual risk placement is handled by wholesale brokers — intermediaries who market standard policy forms at scale rather than building customized programs for individual risk profiles. The technology layer between you and your actual coverage placement often means no one has reviewed your complete program for coordination or gaps. When a digital health company faces a complex D&O claim or an OCR investigation triggered by a cyber incident, the critical question becomes: who is advocating for you at claims time? Wholesale brokers serve the carrier marketplace, not the insured.
The bottom line: You get a modern buying experience layered over a traditional wholesale structure. The interface may be excellent. The claims advocacy and program architecture may not be.
4. The large brokerage/silo model
What they do well: Large national and global brokers bring real advantages: deep carrier relationships, significant premium leverage, and genuine specialization within each coverage line. A dedicated cyber team, a dedicated D&O team, and a dedicated professional liability team — each staffed by experts who know their respective markets well. For large, mature enterprises with predictable risk profiles, this model can be the right choice.
Where it breaks: The structural challenge is coordination. Each coverage line is often marketed and managed independently, sometimes by different teams, to different underwriters, using different policy forms with different definitions of key terms and different exclusion language. No single person may review the complete program as an integrated system. For digital health companies — where a single incident can touch three or four coverage lines simultaneously — this silo structure can create predictable and expensive gaps.
Consider a scenario where a platform outage at a telehealth company leads to missed patient follow-ups and adverse health outcomes. The cyber policy may respond to the technology failure and data exposure. The med mal policy may respond to the patient harm. The tech E&O policy may respond to service interruption claims from enterprise clients. But if each policy was placed independently by a different team, there is a meaningful risk that exclusion language in one conflicts with the coverage assumptions of another — and no one identified the conflict because no one was looking at the whole picture.
The bottom line: You get deep expertise by line, but no one is engineering the program as a system. Each policy may be individually strong. Whether they work together when it matters most is a question that can go unasked.
5. The digital health specialist
What they do well: A purpose-built digital health practice operates at the intersection of healthcare, technology, and clinical decision-making — the exact intersection where digital health companies live. Before going to market, the specialist broker designs the complete coverage architecture: reviewing every policy for exclusion conflicts, shared-limit risks, and definition mismatches across carriers. The goal is a program where every policy is aligned with the others.
This model pairs program architecture with direct relationships to underwriters who have built dedicated digital health books — carriers that understand AI-assisted care models, MSO/PC structures, telehealth regulatory frameworks, and the emerging liability exposures around GLP-1 platforms, remote patient monitoring, and software as a medical device. The result can be better terms, faster quotes, and underwriters who understand your actual risk profile rather than mapping it to a standard industry classification that does not reflect what you do.
The specialist broker also understands the lifecycle of a digital health company in a way that matters for coverage design. The insurance needs of a Series B telehealth startup scaling from 50 to 500 employees are fundamentally different from those of a post-IPO digital therapeutics company managing a public company D&O tower. A broker who has guided companies through these transitions can anticipate coverage needs before they become urgent — structuring the program today so it scales without requiring a complete rebuild at each inflection point.
The bottom line: You get a broker whose practice is built around the risk profile of companies like yours. Not a generalist stretching into digital health. Not a single-vertical specialist missing part of the picture. Not a technology layer over a wholesale back end. And not a siloed enterprise structure that never reviews the complete program as one integrated system.
How the five models compare
The following comparison evaluates each brokerage model across the capabilities that matter most when insuring a digital health company. No model is without merit — but the differences become consequential when a claim arrives.
