Buy-online malpractice from Berkshire Hathaway Specialty Insurance
The best carrier strength and buy-online experience in the category for individual clinicians — occurrence or claims-made to $1M/$6M with defense outside limits — but no med-spa entity product and no published pricing.
Berxi is the direct-to-customer, buy-online insurance division of Berkshire Hathaway Specialty Insurance Company, a carrier rated A++ by AM Best and AA+ by S&P — the strongest paper in this category. Its core products are individual medical malpractice for clinicians (nurse practitioners, physician assistants, RNs, therapists and other allied health professionals), dental malpractice, professional liability/E&O for service businesses, and a general liability product rolling out nationwide in 2026.
Malpractice policies are available in both occurrence and claims-made forms, with typical limits ranging from $500K/$1M up to $1M per claim/$6M aggregate, defense costs paid outside the limits, and a consent-to-settle posture ('we don't settle claims unless you say yes'). The entire experience is digital: quote, buy and download proof of coverage in minutes, with same-day effective dates. Berxi claims customers save 15–20% versus broker-sold equivalents by cutting out commissions. It is a provider-focused program: it insures the individual clinicians who work in med spas, not the med spa entity itself.
Ideal customer
NPs, PAs, RNs and other licensed clinicians who inject, laser or supervise in med spas and want their own individual malpractice policy on top-rated paper — not med spa owners seeking entity/business coverage, which Berxi does not offer as a dedicated product.
Berxi is what happens when the strongest balance sheet in insurance decides to sell malpractice the way software is sold. It operates as a division of Berkshire Hathaway Specialty Insurance Company — rated A++ by AM Best and AA+ by S&P, ratings we verified on Berxi's own site — and its pitch is direct: cut out the broker, quote online in minutes, and start coverage the same day. For the clinicians who actually deliver med-spa medicine — nurse practitioners, physician assistants, RNs and allied health professionals — that combination of paper quality and purchase speed is rare.
The policy terms are genuinely strong rather than merely cheap. Typical malpractice limits run from $500K per claim/$1M aggregate up to $1M per claim/$6M aggregate, in both occurrence and claims-made forms. Defense costs are paid outside the limits, so legal fees don't erode the money available for settlement, and Berxi maintains a consent-to-settle posture — it won't settle a claim over the clinician's objection, which matters for licence protection and reputation. An E&O line and a general liability product (rolling out nationwide in 2026) round out the shelf.
Carrier strength is the headline: in a category populated by surplus lines programs and association pools, buying from a Berkshire Hathaway company is a different tier of counterparty. The buying experience is the second differentiator — quote, bind and download proof of coverage in minutes, with any-day effective dates, and Berxi claims average savings of 15–20% versus broker-sold equivalents thanks to the direct model (a company figure, but directionally credible given the removed commission).
Berxi is provider-focused, and med spa owners should be clear-eyed about what that means. There is no dedicated med-spa entity product: the program insures individual clinicians, not the business, its medical director arrangement, or its premises in a packaged way. An owner still needs entity general liability and, typically, entity-level professional liability arranged elsewhere. Pricing is also opaque until you quote — there is no rate card, and no fixed public figure for aesthetics work specifically — and aesthetic procedures (injectables, laser) may be subject to eligibility questions during underwriting, so clinicians should answer scope-of-practice questions precisely and confirm the quoted policy actually contemplates their med-spa duties. Finally, the Berxi brand has no verifiable third-party consumer rating aggregate we could confirm, so we have left ratings empty; the AM Best rating applies to the parent carrier's financial strength, not to service reviews.
For the NP running a med spa's injectable program, the PA moonlighting across clinics, or the RN who wants her own malpractice policy rather than relying solely on an employer's, Berxi is one of the best options available: top-rated paper, policyholder-friendly terms and a ten-minute purchase. For the med spa as a business, it is a complement rather than a solution — cover your providers here if the quotes land well, and place entity coverage through a med-spa-specialist broker.
By Med Spa Vendor Hub Editorial Team. Last reviewed July 1, 2026. Independent editorial review — how we score.
No published rate card — premiums are quoted online in minutes by profession, state and risk profile. Berxi claims average savings of 15–20% versus broker-sold policies via its direct model. No fixed public figure for aesthetics/med-spa clinicians specifically.
Individual malpractice
Custom quote
annual or monthly
Occurrence or claims-made; limits from $500K/$1M up to $1M/$6M; defense outside limits.
Pricing is researched from public sources and verified periodically; confirm current rates with the vendor.
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