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US Medical Malpractice Insurance Analysis

Goals

To provide an analysis of the US medical malpractice insurance market, including the total number of doctors individually covered and sources for claim investigation, to help the client validate an idea for a new company.

Early Findings

US Medical Malpractice Insurance

  • There is no federal law in place requiring doctors to carry medical malpractice insurance, however, multiple states have requirements for this in place. Thirty-two states “require no medical malpractice insurance and have no minimum carrying requirements.” Of the remaining 18 states, some of them require a minimum level of malpractice insurance by-doctor (or employer), and some require “medical professionals to have some insurance to qualify for liability reforms in their state.”
  • These states do not require malpractice insurance and have zero minimum requirements for practitioners: “Alabama, Alaska, Arizona, Arkansas, California, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kentucky, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington and West Virginia.”
  • Seven states require healthcare practitioners / doctors to “maintain a minimum level of malpractice insurance: Colorado, Connecticut, Kansas, Massachusetts, New Jersey, Rhode Island, and Wisconsin.” These levels vary significantly depending on the state.
  • Other states, like “Indiana, Nebraska, New Mexico, New York, Pennsylvania, and Wyoming,” have malpractice insurance requirements related to “state liability reforms.” These states require doctors to carry this minimal level of insurance should be wish to participate in state programs “designed to help physicians deal with claims.”
  • Notably, many hospitals (or other employers) often require doctors to carry insurance (or be on their group plan) to work there or to work in certain situations. For example, visiting physicians are often required by the hospitals in which they serve to carry their own malpractice insurance. Another example is doctors working with healthcare plans; some plans require their plan doctors to carry insurance.
  • All self-employed doctors, as well as those working in the multiple states that require it, should purchase their own medical malpractice insurance. Additionally, doctors who work only part-time or who work via alternative medical modes (like through telemedicine, for example) also should carry their own medical malpractice policy.
  • Although some doctors are covered by this insurance through their employers, if they do side jobs (like locum tenens or telemedicine, as examples), they may need additional individual insurance to cover them, as the employer policy may not have provisions for these types of other work.
  • Additionally, specific types of practitioners must carry malpractice insurance, including “surgeons, physicians, chiropractors, anesthesiologists, nurses, and pharmacists.”

Practitioners with Malpractice Insurance

  • Many organizations, including the National Practitioner Data Bank collect data on the total paid in claims per year and by claim type (and other categories), however, the total number of doctors carrying medical malpractice (medical professional liability) insurance does not appear to be tracked for the whole of the US. The National Association of Insurance Commissioners (NAIC) does not appear to publicly publish these statistics, either.
  • Notably, a brief search into state-level figures found that states do not typically publish the total number of practitioners covered by this type of insurance, either. Washington, for example, publishes a detailed annual report on their state’s medical malpractice insurance market and claims. Although the report includes a wide variety of statistics on things like percentage of premium-by-carrier-type and total number of claims and payouts, nowhere in the report is the total number of insured persons listed.
  • However, estimates of these figures may be available through each of the major players in the professional liability insurance market, including companies like Berkshire Hathaway Group, Doctors Co Group, and CNA Insurance Group. Note, these would only be very rough estimates, and would only be available if each company publishes this type of information, which is not likely.

Medical Malpractice Claims Database

  • The National Practitioner Data Bank (NPDB) is the place to find all information related to medical malpractice claims in the US. Individual health care practitioners and organizations can both have accounts and use this database. Note, there is a small charge per-query, and the public use data file associated with the database is updated only quarterly (not in real-time). The public use data file is downloadable, and may include all information on all claims, though this was not confirmed.
  • The database can be filtered for claims by either map or graph view, and by state, year, practitioner type, report type, and action type. The NPDB’s Analysis Tool shows that there were 60,207 medical malpractice claims in 2018, and there have been 41,904 so far in 2019.

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