Rising Medical Professional Liability Claims and Premiums: What Healthcare Leaders and Physicians Need to Know
Medical professional liability (MPL) insurance has re-emerged as a critical issue across the healthcare industry after more than a decade of relative stability. New research and reporting from the American Medical Association (AMA) and Becker’s Hospital Review point to a sustained rise in both malpractice claims severity and insurance premiums nationwide. Together, these trends are creating renewed concern among physicians, hospital systems, insurers, and healthcare administrators regarding the long-term impact on patient access to care, provider recruitment, and financial sustainability.
Recent analyses published by the AMA and summarized by Becker’s Hospital Review indicate that the healthcare industry may be entering a period reminiscent of the “hard market” conditions experienced in the early 2000s, when malpractice insurance costs escalated dramatically and coverage availability tightened. While current conditions have not yet reached those historical extremes, the trajectory has prompted increased attention from policymakers, physician advocacy groups, and medical liability carriers.
Let’s look at the emerging trends in medical liability claims and premiums, the driving factors behind rising verdicts and insurer losses, and the broader implications for healthcare organizations and physicians.
A Seven-Year Rise in Medical Liability Premiums
According to research released by the AMA in April 2026 and reported by Becker’s Hospital Review, medical liability insurance premiums increased nationwide for the seventh consecutive year in 2025. This marks the longest sustained period of premium growth since the early 2000s.
Although the AMA noted that the current market has not yet reached the severity of prior malpractice crises, the organization warned that continued increases could negatively affect patient access to care. In the past, physicians facing higher operating expenses chose to reduce high-risk services, relocate to states with more favorable liability environments, retire earlier, or avoid certain specialties altogether.
Several key findings from the AMA’s research illustrate the scope of the trend:
- Physicians in 36 states experienced at least one premium increase in 2025.
- Eleven states reported premium increases of 10% or greater.
- Pennsylvania, Kentucky, Florida, Illinois, and New York experienced some of the most significant increases.
- States with liability caps and other tort reform protections have historically experienced slower premium growth and more predictable insurance markets.
High-Risk Specialties Continue to Face Greater Exposure
The AMA report also confirmed that certain specialties continue to face disproportionately high liability exposure. Obstetrics and gynecology (OB/GYN) and general surgery remain among the specialties with the highest malpractice premiums nationwide.
These specialties inherently involve higher-acuity care, greater procedural complexity, and elevated risk of severe patient outcomes, all of which contribute to larger claim severity and higher insurance costs. In many regions, liability costs for these specialties can represent a substantial portion of physician overhead expenses.
Additionally, physician age and career duration appear closely linked to malpractice exposure. The AMA found that nearly 45.2% of physicians age 55 and older had been sued at least once during their careers, compared to only 11% of physicians under age 45. Among older OB/GYNs and general surgeons, nearly three in four had experienced at least one claim.
While the overall percentage of physicians sued during their careers declined modestly from 34% in 2016 to 28.7% in 2024, insurers remain increasingly concerned about the severity—not merely the frequency—of claims.
The Rise of “Nuclear Verdicts”
One of the most significant contributors to rising medical liability premiums is the dramatic increase in so-called “nuclear verdicts,” generally defined as jury awards exceeding $10 million. In recent years, some malpractice awards have even surpassed $100 million.
According to reporting published by the AMA, the average of the top 50 medical malpractice verdicts in the United States reached $56 million in 2024, up from $32 million in 2022 and $48 million in 2023.
These escalating verdicts are having a direct effect on insurers’ loss ratios and reserve calculations. As claims severity rises, insurers must adjust premiums upward to account for the increasing cost of future payouts.
Importantly, this trend is not necessarily tied to worsening quality of care or higher negligence rates. Rather, experts point to broader societal and legal dynamics that are reshaping jury behavior and litigation strategies.
Social Inflation and Changing Jury Attitudes
A central theme identified by AMA legal experts is the concept of “social inflation,” which refers to claim costs rising faster than general economic inflation.
The Corporatization of Healthcare
The increasing corporatization of healthcare may also be contributing to higher litigation risk. AMA legal counsel Wes Cleveland noted that many patients no longer feel personally connected to individual physicians due to large health systems, staffing models, and fragmented care delivery.
As healthcare becomes more transactional and less relationship-driven, patients may perceive providers as representatives of large institutions rather than trusted personal caregivers. This dynamic can influence juror perceptions as well as plaintiffs’ litigation strategies.
Shifting Juror Perspectives
The AMA also highlighted evidence that juries increasingly seek to compensate plaintiffs even in cases where negligence may not be clearly established.
In addition, large financial figures have become normalized in modern society due to media coverage of celebrity contracts, corporate settlements, and major commercial verdicts. As Cleveland observed, multimillion-dollar awards may no longer seem extraordinary to jurors accustomed to hearing about $100 million athlete contracts and other large financial transactions.
These changing attitudes can make it more difficult for defense counsel and insurers to manage jury expectations during malpractice trials.
Litigation Strategies Driving Larger Awards
The AMA article also identified several litigation techniques increasingly used by plaintiffs’ attorneys that may contribute to larger verdicts and settlements.
The “Reptile Theory”
One widely discussed strategy is known as the “reptile theory,” a courtroom tactic designed to appeal to jurors’ survival instincts and fears regarding public safety.
Rather than focusing narrowly on whether a physician met the applicable standard of care in a particular case, plaintiffs’ attorneys frame the alleged conduct as a broader threat to community safety. By emphasizing hypothetical risks to the public, attorneys attempt to motivate jurors emotionally rather than analytically.
The AMA noted that some states, including Florida and Texas, have begun enacting legislation intended to limit or counter these tactics.
Anchoring
Another common tactic is “anchoring,” in which plaintiffs request extremely large damages awards to influence jurors’ perception of appropriate compensation.
Behavioral research has demonstrated that jurors often rely heavily on the first numerical figure introduced during trial deliberations. As a result, even if jurors ultimately award less than the requested amount, the final verdict may still be substantially larger than it otherwise would have been.
The AMA cited research from Harvard Law School and Boston University School of Law supporting the psychological impact of anchoring on jury decisions.
States including Utah and Georgia recently passed tort reform measures aimed at limiting the use of anchoring arguments during trials.
Physician Intimidation and Settlement Pressure
The AMA also raised concerns about aggressive settlement tactics directed at physicians personally. Some plaintiffs’ attorneys allegedly threaten physicians with potential exposure of personal assets if claims exceed insurance policy limits.
Although legal experts note that successfully pursuing physicians’ personal assets is often difficult in practice, the emotional and psychological impact of these threats can be substantial.
This pressure may encourage earlier settlements and contribute to overall claim costs.
Implications for Healthcare Organizations
The resurgence of MPL concerns has important implications for hospitals, physician groups, and healthcare systems.
Financial Planning and Risk Management
Organizations should anticipate continued pressure on liability insurance costs and incorporate rising premiums into long-term financial planning. Enhanced enterprise risk management strategies, robust clinical documentation practices, and proactive patient safety initiatives may become increasingly important.
Physician Recruitment and Retention
High-liability environments can significantly affect workforce stability. Specialties already facing staffing shortages—such as OB/GYN and surgery—may become even more difficult to recruit and retain if liability pressures continue escalating.
Access to Care
Historically, hard malpractice markets have contributed to reduced patient access in high-risk specialties and underserved regions. Rural communities may be particularly vulnerable if providers limit services or relocate due to liability costs.
Legislative and Policy Considerations
The AMA continues advocating for medical liability reform measures that include protections for physician assets, limitations on non-economic damages, controls on courtroom tactics, and pre-litigation review panels.
Healthcare leaders should closely monitor evolving state legislation and tort reform initiatives that may influence insurance market stability.
The medical professional liability landscape is undergoing a significant shift driven by rising claims severity, escalating jury awards, and steadily increasing insurance premiums. Although claim frequency may not be increasing dramatically, the financial impact of individual cases has grown substantially due to social inflation, changing jury attitudes, and evolving litigation strategies.
The research and reporting published by the American Medical Association and Becker’s Hospital Review underscore the importance of proactive risk management, strong physician-patient relationships, and thoughtful public policy reforms aimed at preserving access to care while maintaining accountability within the healthcare system.
As the healthcare industry navigates these challenges, organizations that prioritize patient safety, communication, documentation, and physician support will likely be better positioned to manage liability exposure in an increasingly complex legal and financial environment.
Medical Liability Alliance, and the HSG companies can help with MPL insurance coverage in Missouri, Illinois, Kansas, and Arkansas. Serving physicians, hospitals, and facilities for 30 years! If you have any questions or want more information, contact Monte Shields at mshields@hsg-group.com or call (573) 545-5927.
Sources and Acknowledgments:
This article was developed using reporting and research published by the American Medical Association (AMA) and Becker’s Hospital Review, including articles authored by AMA staff and Becker’s reporter Mackenzie Bean.