GITNUXREPORT 2026

Medical Malpractice Insurance Industry Statistics

Medical malpractice insurance costs vary widely by specialty, state, and the impact of local laws.

Rajesh Patel

Team Lead & Senior Researcher with over 15 years of experience in market research and data analytics.

First published: Feb 13, 2026

Our Commitment to Accuracy

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Statistic 1

In 2022, total incurred losses for medical malpractice insurers reached $5.2 billion, up 4.3% from 2021.

Statistic 2

Average malpractice payout per claim was $348,000 in 2022, with severity rising 5.1% YoY.

Statistic 3

85% of paid medical malpractice claims in 2022 resulted in settlements rather than trials.

Statistic 4

Frequency of malpractice claims per 100 physicians fell to 1.8 in 2022 from 2.1 in 2019.

Statistic 5

Total payouts for malpractice claims hit $4.7 billion in 2021, stabilizing into 2022.

Statistic 6

Birth injury claims accounted for 12% of total payouts, averaging $700,000 per case in 2022.

Statistic 7

30% of malpractice claims closed without payment in 2022, down from 35% pre-pandemic.

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Surgery-related claims made up 25% of all filings, with $1.1 billion in payouts in 2022.

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Misdiagnosis claims rose 8% in 2022, comprising 35% of total claims volume.

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Average defense costs per claim reached $45,000 in 2022 for insurers.

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1 in 5 claims involved emergency departments, with payouts averaging $420,000 in 2022.

Statistic 12

Delayed diagnosis claims surged 10% post-COVID, totaling $900 million in payouts 2022.

Statistic 13

Only 2% of malpractice claims went to trial in 2022, with plaintiffs winning 22% of those.

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Anesthesia claims dropped to 1.5% of total, averaging $250,000 payouts in 2022.

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Nursing errors contributed to 15% of hospital claims, $650 million paid out in 2022.

Statistic 16

Median payout for physicians was $275,000 in 2022, skewed by large verdicts.

Statistic 17

Cancer misdiagnosis led to highest severity at $450,000 average payout in 2022.

Statistic 18

Claims alleging improper medication totaled 18%, $500 million in 2022 payouts.

Statistic 19

40% of claims took over 2 years to resolve in 2022, inflating costs.

Statistic 20

Obstetrics claims averaged $631,000 in payouts, 15% of total dollars in 2022.

Statistic 21

Total US medical malpractice market size was $12.4 billion in direct premiums written in 2022.

Statistic 22

The industry grew 3.2% CAGR from 2018-2023, reaching $13.1 billion by 2023 estimates.

Statistic 23

Top 5 insurers held 55% market share in 2022, led by The Doctors Company at 18%.

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Combined ratio for malpractice insurers improved to 98.5% in 2022 from 102% in 2021.

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Number of malpractice insurers declined 12% to 45 active writers in 2022.

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Policy count grew 1.4% to 210,000 physician policies in 2022.

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Investment income for insurers rose 15% to $2.1 billion in 2022, aiding profitability.

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Hospital segment premiums totaled $4.8 billion in 2022, 38% of market.

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Self-insured entities covered 25% of market exposure in 2022.

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Premium per capita for malpractice insurance was $37 in US 2022.

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Industry assets exceeded $45 billion in 2022 for malpractice lines.

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New entrants captured 3% market share via captives in 2022-2023.

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Direct losses incurred were 42% of premiums in 2022 market-wide.

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Physician segment dominated with 52% of premiums at $6.5 billion in 2022.

Statistic 35

Reinsurance ceded 18% of premiums, stabilizing market in 2022.

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Florida market size was $850 million in 2022, 7% of national.

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Overall growth projected at 2.8% annually to 2027, reaching $15.2 billion.

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New York premiums written totaled $1.2 billion in 2022, largest state market.

Statistic 39

In California, market contracted 1% to $700 million in 2022 due to MICRA.

Statistic 40

Texas malpractice premiums written were $450 million in 2022 post-reforms.

Statistic 41

In 2022, the average medical malpractice insurance premium for physicians in the United States was $16,000 annually, representing a 2.5% increase from 2021 due to rising claim costs.

Statistic 42

Nationwide, orthopedic surgeons paid an average of $48,000 in malpractice premiums in 2022, the highest among specialties, driven by high litigation risks.

Statistic 43

In Florida, physician malpractice premiums averaged $28,400 in 2022, 45% above the national average due to tort reform limitations.

Statistic 44

General surgeons saw malpractice premiums rise 4.1% to $35,200 on average in 2023 across the US.

Statistic 45

New York physicians faced average premiums of $42,000 in 2022, influenced by high jury awards in the state.

Statistic 46

OB/GYN specialists paid $50,100 average premiums in 2022, up 3% year-over-year amid birth injury claims.

Statistic 47

Emergency medicine doctors averaged $32,500 in malpractice insurance costs in 2022 nationally.

Statistic 48

Radiologists' average premiums dropped 1.2% to $24,800 in 2022 due to lower claim frequency.

Statistic 49

In Texas, post-2003 tort reforms, average premiums fell 45% to $15,200 by 2022 for physicians.

Statistic 50

Neurosurgeons paid the highest premiums at $68,400 average in 2022, reflecting procedure risks.

Statistic 51

Pediatricians averaged $11,200 in premiums in 2022, among the lowest due to fewer suits.

Statistic 52

Anesthesiologists saw premiums stabilize at $29,500 in 2022 after safety improvements.

Statistic 53

In Pennsylvania, premiums averaged $22,100 in 2022, down 30% since 2002 reforms.

Statistic 54

Cardiologists paid $31,800 average in 2022, up 2.8% from prior year.

Statistic 55

Internal medicine premiums averaged $14,500 in 2022 nationally.

Statistic 56

In California, MICRA cap limits kept premiums at $18,900 average for physicians in 2022.

Statistic 57

Psychiatrists had low premiums of $8,200 average in 2022 due to minimal physical harm claims.

Statistic 58

Average hospital malpractice premiums reached $1.2 million per bed in 2022 for large facilities.

Statistic 59

Dentists' malpractice premiums averaged $4,500 in 2022, stable year-over-year.

Statistic 60

In Illinois, premiums for high-risk specialties exceeded $100,000 in 2022 pre-reform.

Statistic 61

Family practitioners paid $12,300 average in 2022 nationally.

Statistic 62

Premiums for nurse anesthetists averaged $15,000 in 2022, rising with scope expansion.

Statistic 63

In Nevada, premiums dropped 60% post-2002 reforms to $14,500 by 2022.

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Ophthalmologists averaged $22,000 in premiums in 2022.

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Overall US physician premiums increased 1.8% to $16,400 in 2023 projections.

Statistic 66

Regional variations showed Northeast premiums 40% above South in 2022 averages.

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In the Midwest, average premiums were $14,200 in 2022, 15% below national.

Statistic 68

Southern states saw 25% higher claim frequency than West in 2022 data.

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Pennsylvania premiums averaged $21,500, down 28% since MCARE reforms.

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Nevada's premiums per physician were $13,800 in 2022, lowest post-reform.

Statistic 71

Illinois had highest payouts per capita at $52 in 2022.

Statistic 72

West Coast states averaged $17,900 premiums, stable due to caps.

Statistic 73

Southeast claim severity 12% above national average in 2022.

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New Jersey premiums $38,200 average, influenced by urban density.

Statistic 75

Georgia saw 18% premium drop to $16,500 post-2005 reforms in 2022.

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In Louisiana, premiums averaged $25,400, high despite reforms.

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Midwest hospitals paid 20% less than Northeast peers in 2022.

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Colorado premiums $12,100 average, low tort state benefits.

Statistic 79

Michigan's market stabilized at $19,800 average after caps.

Statistic 80

Urban vs rural premium gap widened to 35% in 2022 nationally.

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Ohio premiums $15,900, moderate due to balanced reforms.

Statistic 82

In reform-heavy states like Texas, claims dropped 55% since 2003 by 2022.

Statistic 83

Tort reform states had 22% lower premiums than non-reform in 2022.

Statistic 84

Telemedicine claims rose 15% in urban areas vs 8% rural in 2022.

Statistic 85

Loss ratios for malpractice insurers averaged 78% in 2022, improving from 85% in 2020.

Statistic 86

Adoption of AI in claims processing reduced costs 12% for top insurers in 2023.

Statistic 87

Tort reform in 15 states since 2010 lowered premiums 18% by 2022.

Statistic 88

Decline in jury trials to 1.5% of claims in 2022, favoring settlements.

Statistic 89

ESG investing grew to 22% of insurer portfolios in 2022 malpractice sector.

Statistic 90

Cybersecurity claims emerged, 5% of new filings in 2022 hospitals.

Statistic 91

Patient safety initiatives cut claim frequency 9% from 2018-2022.

Statistic 92

Bundled payment models reduced malpractice exposure 14% in pilots 2022.

Statistic 93

Rise in vicarious liability claims up 7% amid staffing shortages 2022.

Statistic 94

Dam caps upheld in 80% of state courts post-2022 rulings.

Statistic 95

Telehealth malpractice policies surged 40% in coverage uptake 2022.

Statistic 96

Inflation adjusted payouts rose 6% in 2022 despite stable frequency.

Statistic 97

Group practices saw 25% lower premiums than solo in 2022 trends.

Statistic 98

Predictive analytics cut loss ratios 5 points for adopters in 2022.

Statistic 99

COVID-related claims peaked at 3% of total then fell 50% by late 2022.

Statistic 100

Enterprise risk management adoption rose to 65% of hospitals by 2022.

Statistic 101

Statute of limitations extensions in 8 states increased filings 11% 2022.

Statistic 102

No-fault compensation pilots in 3 states reduced litigation 20% 2022.

Statistic 103

Wellness programs correlated with 16% fewer claims in participating orgs 2022.

Statistic 104

Blockchain for claims records piloted, cutting disputes 22% in tests 2022.

1/104

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Forget what you think you know about doctor's salaries, because before they even see a patient, a typical US physician pays over $16,000 annually just for the right to practice, a cost that skyrockets to a staggering $68,400 for neurosurgeons and is profoundly shaped by geography, specialty, and the enduring impact of tort reform.

Key Takeaways

In 2022, the average medical malpractice insurance premium for physicians in the United States was $16,000 annually, representing a 2.5% increase from 2021 due to rising claim costs.
Nationwide, orthopedic surgeons paid an average of $48,000 in malpractice premiums in 2022, the highest among specialties, driven by high litigation risks.
In Florida, physician malpractice premiums averaged $28,400 in 2022, 45% above the national average due to tort reform limitations.
In 2022, total incurred losses for medical malpractice insurers reached $5.2 billion, up 4.3% from 2021.
Average malpractice payout per claim was $348,000 in 2022, with severity rising 5.1% YoY.
85% of paid medical malpractice claims in 2022 resulted in settlements rather than trials.
Total US medical malpractice market size was $12.4 billion in direct premiums written in 2022.
The industry grew 3.2% CAGR from 2018-2023, reaching $13.1 billion by 2023 estimates.
Top 5 insurers held 55% market share in 2022, led by The Doctors Company at 18%.
Regional variations showed Northeast premiums 40% above South in 2022 averages.
In the Midwest, average premiums were $14,200 in 2022, 15% below national.
Southern states saw 25% higher claim frequency than West in 2022 data.
Loss ratios for malpractice insurers averaged 78% in 2022, improving from 85% in 2020.
Adoption of AI in claims processing reduced costs 12% for top insurers in 2023.
Tort reform in 15 states since 2010 lowered premiums 18% by 2022.

Medical malpractice insurance costs vary widely by specialty, state, and the impact of local laws.

Claims and Payouts

In 2022, total incurred losses for medical malpractice insurers reached $5.2 billion, up 4.3% from 2021.
Average malpractice payout per claim was $348,000 in 2022, with severity rising 5.1% YoY.
85% of paid medical malpractice claims in 2022 resulted in settlements rather than trials.
Frequency of malpractice claims per 100 physicians fell to 1.8 in 2022 from 2.1 in 2019.
Total payouts for malpractice claims hit $4.7 billion in 2021, stabilizing into 2022.
Birth injury claims accounted for 12% of total payouts, averaging $700,000 per case in 2022.
30% of malpractice claims closed without payment in 2022, down from 35% pre-pandemic.
Surgery-related claims made up 25% of all filings, with $1.1 billion in payouts in 2022.
Misdiagnosis claims rose 8% in 2022, comprising 35% of total claims volume.
Average defense costs per claim reached $45,000 in 2022 for insurers.
1 in 5 claims involved emergency departments, with payouts averaging $420,000 in 2022.
Delayed diagnosis claims surged 10% post-COVID, totaling $900 million in payouts 2022.
Only 2% of malpractice claims went to trial in 2022, with plaintiffs winning 22% of those.
Anesthesia claims dropped to 1.5% of total, averaging $250,000 payouts in 2022.
Nursing errors contributed to 15% of hospital claims, $650 million paid out in 2022.
Median payout for physicians was $275,000 in 2022, skewed by large verdicts.
Cancer misdiagnosis led to highest severity at $450,000 average payout in 2022.
Claims alleging improper medication totaled 18%, $500 million in 2022 payouts.
40% of claims took over 2 years to resolve in 2022, inflating costs.
Obstetrics claims averaged $631,000 in payouts, 15% of total dollars in 2022.

Claims and Payouts Interpretation

While the number of doctors getting sued is thankfully dropping, the ones who do get sued are facing more expensive and complex cases, particularly around misdiagnosis, which now drives both the volume and severity of a legal landscape where settlements overwhelmingly rule the day.

Market Size and Growth

Total US medical malpractice market size was $12.4 billion in direct premiums written in 2022.
The industry grew 3.2% CAGR from 2018-2023, reaching $13.1 billion by 2023 estimates.
Top 5 insurers held 55% market share in 2022, led by The Doctors Company at 18%.
Combined ratio for malpractice insurers improved to 98.5% in 2022 from 102% in 2021.
Number of malpractice insurers declined 12% to 45 active writers in 2022.
Policy count grew 1.4% to 210,000 physician policies in 2022.
Investment income for insurers rose 15% to $2.1 billion in 2022, aiding profitability.
Hospital segment premiums totaled $4.8 billion in 2022, 38% of market.
Self-insured entities covered 25% of market exposure in 2022.
Premium per capita for malpractice insurance was $37 in US 2022.
Industry assets exceeded $45 billion in 2022 for malpractice lines.
New entrants captured 3% market share via captives in 2022-2023.
Direct losses incurred were 42% of premiums in 2022 market-wide.
Physician segment dominated with 52% of premiums at $6.5 billion in 2022.
Reinsurance ceded 18% of premiums, stabilizing market in 2022.
Florida market size was $850 million in 2022, 7% of national.
Overall growth projected at 2.8% annually to 2027, reaching $15.2 billion.
New York premiums written totaled $1.2 billion in 2022, largest state market.
In California, market contracted 1% to $700 million in 2022 due to MICRA.
Texas malpractice premiums written were $450 million in 2022 post-reforms.

Market Size and Growth Interpretation

While doctors fret over premiums, insurers are quietly turning a tidy profit, suggesting the real malpractice might be in how little we pay for peace of mind versus how much they make providing it.

Premium Trends

In 2022, the average medical malpractice insurance premium for physicians in the United States was $16,000 annually, representing a 2.5% increase from 2021 due to rising claim costs.
Nationwide, orthopedic surgeons paid an average of $48,000 in malpractice premiums in 2022, the highest among specialties, driven by high litigation risks.
In Florida, physician malpractice premiums averaged $28,400 in 2022, 45% above the national average due to tort reform limitations.
General surgeons saw malpractice premiums rise 4.1% to $35,200 on average in 2023 across the US.
New York physicians faced average premiums of $42,000 in 2022, influenced by high jury awards in the state.
OB/GYN specialists paid $50,100 average premiums in 2022, up 3% year-over-year amid birth injury claims.
Emergency medicine doctors averaged $32,500 in malpractice insurance costs in 2022 nationally.
Radiologists' average premiums dropped 1.2% to $24,800 in 2022 due to lower claim frequency.
In Texas, post-2003 tort reforms, average premiums fell 45% to $15,200 by 2022 for physicians.
Neurosurgeons paid the highest premiums at $68,400 average in 2022, reflecting procedure risks.
Pediatricians averaged $11,200 in premiums in 2022, among the lowest due to fewer suits.
Anesthesiologists saw premiums stabilize at $29,500 in 2022 after safety improvements.
In Pennsylvania, premiums averaged $22,100 in 2022, down 30% since 2002 reforms.
Cardiologists paid $31,800 average in 2022, up 2.8% from prior year.
Internal medicine premiums averaged $14,500 in 2022 nationally.
In California, MICRA cap limits kept premiums at $18,900 average for physicians in 2022.
Psychiatrists had low premiums of $8,200 average in 2022 due to minimal physical harm claims.
Average hospital malpractice premiums reached $1.2 million per bed in 2022 for large facilities.
Dentists' malpractice premiums averaged $4,500 in 2022, stable year-over-year.
In Illinois, premiums for high-risk specialties exceeded $100,000 in 2022 pre-reform.
Family practitioners paid $12,300 average in 2022 nationally.
Premiums for nurse anesthetists averaged $15,000 in 2022, rising with scope expansion.
In Nevada, premiums dropped 60% post-2002 reforms to $14,500 by 2022.
Ophthalmologists averaged $22,000 in premiums in 2022.
Overall US physician premiums increased 1.8% to $16,400 in 2023 projections.

Premium Trends Interpretation

Even as surgeons and obstetricians are priced like luxury cars due to the high-octane risk of their work, the real national story is a patchwork quilt of premiums, stitched together by the threadbare fabric of each state's tort laws, where a doctor's paycheck is increasingly measured by their zip code and specialty rather than their skill alone.

Regional Variations

Regional variations showed Northeast premiums 40% above South in 2022 averages.
In the Midwest, average premiums were $14,200 in 2022, 15% below national.
Southern states saw 25% higher claim frequency than West in 2022 data.
Pennsylvania premiums averaged $21,500, down 28% since MCARE reforms.
Nevada's premiums per physician were $13,800 in 2022, lowest post-reform.
Illinois had highest payouts per capita at $52 in 2022.
West Coast states averaged $17,900 premiums, stable due to caps.
Southeast claim severity 12% above national average in 2022.
New Jersey premiums $38,200 average, influenced by urban density.
Georgia saw 18% premium drop to $16,500 post-2005 reforms in 2022.
In Louisiana, premiums averaged $25,400, high despite reforms.
Midwest hospitals paid 20% less than Northeast peers in 2022.
Colorado premiums $12,100 average, low tort state benefits.
Michigan's market stabilized at $19,800 average after caps.
Urban vs rural premium gap widened to 35% in 2022 nationally.
Ohio premiums $15,900, moderate due to balanced reforms.
In reform-heavy states like Texas, claims dropped 55% since 2003 by 2022.
Tort reform states had 22% lower premiums than non-reform in 2022.
Telemedicine claims rose 15% in urban areas vs 8% rural in 2022.

Regional Variations Interpretation

While tort reform clearly tames the cost beast in places like Texas, the enduring wild cards of geography, urban density, and regional legal cultures ensure that a doctor's financial risk still depends heavily on their zip code, not just their skill.

Trends and Reforms

Loss ratios for malpractice insurers averaged 78% in 2022, improving from 85% in 2020.
Adoption of AI in claims processing reduced costs 12% for top insurers in 2023.
Tort reform in 15 states since 2010 lowered premiums 18% by 2022.
Decline in jury trials to 1.5% of claims in 2022, favoring settlements.
ESG investing grew to 22% of insurer portfolios in 2022 malpractice sector.
Cybersecurity claims emerged, 5% of new filings in 2022 hospitals.
Patient safety initiatives cut claim frequency 9% from 2018-2022.
Bundled payment models reduced malpractice exposure 14% in pilots 2022.
Rise in vicarious liability claims up 7% amid staffing shortages 2022.
Dam caps upheld in 80% of state courts post-2022 rulings.
Telehealth malpractice policies surged 40% in coverage uptake 2022.
Inflation adjusted payouts rose 6% in 2022 despite stable frequency.
Group practices saw 25% lower premiums than solo in 2022 trends.
Predictive analytics cut loss ratios 5 points for adopters in 2022.
COVID-related claims peaked at 3% of total then fell 50% by late 2022.
Enterprise risk management adoption rose to 65% of hospitals by 2022.
Statute of limitations extensions in 8 states increased filings 11% 2022.
No-fault compensation pilots in 3 states reduced litigation 20% 2022.
Wellness programs correlated with 16% fewer claims in participating orgs 2022.
Blockchain for claims records piloted, cutting disputes 22% in tests 2022.

Trends and Reforms Interpretation

While a wave of data-driven initiatives and tort reforms have modestly improved the industry's balance sheet, insurers are navigating a new frontier of digital and staffing risks, proving that the art of managing medical liability remains as complex as medicine itself.