You are based in Texas, but your client went into labor early while traveling in California. You hop on Zoom to support them. A complication arises. Now, a California lawyer is arguing you were “practicing” in California without a license, and your Texas insurance policy excludes work outside your domicile state.
Key Takeaways
- The “Territory” Clause: Most policies cover you in the “United States,” but state licensing laws override this.
- Jurisdiction Risk: If you are sued, it will likely be in the client’s state (California). Does your policy cover defense costs in a different state?
- Telehealth/Tele-doula Definitions: Ensure your policy explicitly covers “Telehealth” or “Virtual Services.”
- Recording Liability: If you record the Zoom call, you are creating a medical record. HIPAA rules apply.
The “Why” (The Trap): The State Lines Issue
Medical professionals (Midwives/Doctors) generally cannot practice across state lines without a license in that state.
Doulas are unregulated in most places, but if a state (like Oregon or others considering licensure) regulates doulas, and you beam in virtually, you might be breaking the law. Insurance policies often exclude “Illegal Acts.” If practicing virtually in that state is deemed “unlicensed practice,” your insurance walks away.
The Investigation: Virtual Coverage
I checked policy wording for “Territory” and “Virtual Services.”
1. The Standard “Coverage Territory”
- My Analysis: Most policies define territory as “The United States, Puerto Rico, and Canada.”
- The Catch: This means the policy is valid, but it doesn’t grant you legal permission to work there.
2. CM&F Telehealth Clause
- My Analysis: They have adapted well to 2026 tech. They often include “Telehealth” within the scope, provided you are compliant with the laws of the state where the patient is located.
3. International Virtual Support
- My Analysis: Supporting a client in Europe/Bali?
- Verdict: Almost certainly NOT covered. Most US policies stop at the border.
Comparison Table: Virtual Risks
| Scenario | Covered? | Risk Factor |
| Client in same state (Virtual) | Yes | Low |
| Client in different US state | Yes (usually) | Medium (Jurisdiction laws) |
| Client International | No | High |
[IMAGE: Map of US showing states with pending Doula licensure legislation]
Step-by-Step Action Plan
- Check the “Territory” Definition: Read your policy. Ensure it covers “Anywhere in the USA.”
- Governing Law Clause: In your contract, add a clause: “This agreement is governed by the laws of the State of [Your Home State].” This attempts to force any lawsuits to happen on your home turf.
- Disclaimer on Zoom: Remind clients that virtual support is limited. You cannot see the whole room or clinical signs.
- Cyber Liability: If you are purely virtual, consider “Cyber Liability” insurance in case your Zoom is hacked or data is breached.
FAQ Section
Can I be a virtual doula for a client in the UK?
Your US insurance likely won’t cover a lawsuit filed in a UK court. You would be personally exposed.
Is texting considered “Virtual Support”?
Yes. Every text is a record of care. If you text “That sounds normal,” you are offering an opinion.
What if the internet cuts out during the birth?
Include a “Technology Failure” waiver in your contract. You aren’t liable for Comcast going down.