The Synthesis Project

Understanding Medical Malpractice Insurance

A Primer

As a result of rapidly rising medical malpractice insurance premiums, reduced availability of coverage, and financially distressed liability insurers, many states have passed tort reforms. This synthesis examines the medical malpractice “crisis” and the effect of state tort reforms.

Evidence shows that caps on non-economic damages reduce the average size of malpractice awards by 20 to 30 percent and have a modest impact on malpractice insurance premium growth.

There is also evidence that the most severely injured patients are disproportionately affected by caps, however. Other state reforms such as changes to joint-and-several liability, statutes of limitations, or attorney contingency fees have had little impact. Studies do not support the notion that overall physician supply has decreased, nor that there is a relationship between malpractice cost and physician supply.

There is “good evidence” that doctors “often” engage in defensive medicine, ordering referrals, medications and tests to protect themselves from liability, but the impact of this practice is difficult to quantify.

The Synthesis Project

An RWJF initiative to produce user-friendly briefs and reports that synthesize research findings on perennial health policy questions. These products give policy-makers reliable information and new insights to inform complex policy decisions.

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Charts from the report

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Charts from Understanding Medical Malpractice Insurance

  1. Figure 1: State approaches to medical malpractice insurance regulation
  2. Figure 2: Average liability premiums for OBGYNs in select crisis and non-crisis states, 1993-2002
  3. Figure 3: Measuring insurers%u2019 financial performance
  4. Figure 4: Measurement issues in analyzing trends in claim severity and claims frequency
  5. Figure 5: Amount of average paid claim, 1991-2003
  6. Figure 6: Trends in per-capita frequency of paid malpractice claims, 1991-2003

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