Medical malpractice claims at 17-year low

JEFFERSON CITY, Mo. -- Fewer medical malpractice claims were filed and paid in 2003 than in any year since Missouri's laws on personal injury lawsuits were revised in 1986, the state Insurance Department said Friday.

"The Missouri malpractice insurance environment is sound," insurance director Scott Lakin said in a statement. "The insurers' problems have clearly passed, but policyholders, especially physicians, are left with high rates -- perhaps much too high -- and too few options for coverage."

The Insurance Department compared 2003 statistics to those from other years since 1986, when a state law imposed a cap on malpractice awards for non-economic damages in injury cases.

Based on reports from companies that sell medical malpractice insurance in Missouri, the department said new claims against physicians fell 13.8 percent last year to 664, while new claims against all health-care providers fell 16.4 percent to 1,369.

At the same time, however, medical malpractice insurers spent 44 percent more on legal expenses in Missouri last year than in 2002, the department said, adding that the companies on average spent more than one-third of their premiums to contest patients' claims.

The top three physicians' insurers in Missouri posted profits last year and raised rates between 19 percent and 82 percent, the department said. Under Missouri law, the insurance department does not approve medical malpractice rates.

The report was issued a day after legislative negotiators reached agreement on a bill revising Missouri's rules for trying injury lawsuits, which supporters say would help control the cost of medical malpractice insurance. Opponents say the measure would hurt people's right to sue without really helping doctors.

According to the report, the cost of malpractice coverage for all health care providers rose 12.9 percent last year in Missouri, compared to 21.6 percent nationally. For physicians alone, premiums rose 18 percent in Missouri last year, the department said.

The report said the average payment per claim fell slightly to $207,068 last year, but average payments in cases involving doctors rose 9.1 percent, mostly for economic damages -- such as lost wages -- and for future medical costs. The median settlement was $111,250.

In cases that went before juries, the number of awards that reached the state's cap on non-economic damages such as pain and suffering fell from 13 in 2002 to six last year, when the cap was set at $557,000, the department said. Total payments exceeded $1 million in 13 cases, according to the report.

Some legislators want to lower the cap on non-economic damages, which was set in 1986 at $350,000 but allowed to rise with inflation. The compromise bill drafted Thursday would set it at $400,000 permanently, with a new $200,000 cap on non-economic damages for malpractice committed in emergency rooms or trauma care.

The department said 23 cases in Missouri would have been affected last year if non-economic damages had been capped at $350,000. Total damages in those cases would have been reduced by $4.4 million, the department said.