According to NPDB data, the state of New York had the highest total medical malpractice payments, totaling $7.025 billion – followed by Pennsylvania, with $3.416 billion. North Dakota had the lowest amount, totaling $28.35 million. New York has the highest average cost of medical malpractice coverage and the worst tax-friendliness. The average annual premium is $7,500. Neurosurgery has the highest malpractice insurance rate, with 53.1 claims per 1,000 physician-years. It also had the highest mean payment from paid claims at $469,222.
Malpractice Rates by State
New York had the highest number of malpractice cases from 1990 to 2023, totaling $7.025 billion in payments. High rates tend to be in states with patient-friendly laws and high populations. West Virginia is an outlier with over $1.5 billion in payouts. Its juries have favored plaintiffs. Texas has the lowest payout.
The top four specialties sued are plastic surgeons, general surgeons, orthopedists, and urologists. Sixty-two percent of specialists and 52 percent of primary care physicians face claims. OB/GYN malpractice is high risk for birth and delivery.
Between 2009-2018, malpractice reports decreased 18.5 percent to 11,429. The average payout was $309,908. Payments were lowest in 2010 at $3.66 billion and highest in 2015 at $4.01 billion. From 2009-2018, $38.5 billion was paid out. Thirty states have reforms with damage caps, including Arkansas and California.
Best and Worst States for Malpractice Laws
Best states for laws are California, Colorado, Kansas, and Texas with reasonable caps on non-economic damages. Litigation has decreased, and premiums remain low. Both Iowa and Minnesota have inexpensive liability insurance, while North Dakota has the lowest malpractice payouts per capita.
Insurance Coverage and Limits
Malpractice insurance covers lawyers’ fees and settlements, but policies have limits and exclusions. Affected states have the most adverse actions, payments, and payouts. Most are East Coast states. New York ranked first for payments but second to last for adverse actions.