MPL Market Dynamics

Medical professional liability (MPL) insurance has been in a soft market cycle since 2005. Soft markets are generally characterized by coverage that is widely available, policy terms have been "loose," and price-based competition is common. 

However, in a hard market cycle, insurance becomes less available, policy conditions tighten, and premiums increase to stabilize reserves.

Due to the long-tail nature of medical malpractice claims that may take years to resolve, an insurer's long-term financial health is of utmost importance to insureds. ProAssurance was founded in response to the first hard market after it began in 1975, providing stability for our insureds during the next three hard market cycles in the 1980s, 1990s, and early 2000s.

We have created a report that outlines key drivers of the MPL market for use in your sales conversations around hard and soft market cycles and nationwide trends.

Market Dynamics 2023 slide deck - Download the PowerPoint Presentation

Timeline Sources:

February 2019 – Texas DOI appoints a rehabilitator for Capson Physicians Insurance Company – https://bit.ly/3COCqA8
June 2019 – Texas DOI orders liquidation of Capson – https://bit.ly/3ROhQUr
August 2019 – Kansas DOI appoints a rehabilitator for Physicians Standard Insurance Company – https://bit.ly/3Cr18Fj
September 2019 – Multiline commercial carrier One Beacon announces it will exit the MPL line – https://bit.ly/3IyMbEG
October 2019 – Swiss Re, a multiline commercial carrier, exits the MPL line – https://bit.ly/38MfyQE
November 2019 – Kansas DOI orders liquidation of Physicians Standard Insurance Company – https://bit.ly/3CLkIx3
August 2020 – QBE, a multiline commercial carrier, exits the MPL line – https://bit.ly/31Zpswp
October 2020 – Multiline commercial carrier Zurich exits the MPL line – https://bit.ly/3mBaZyz
November 2020 – Reports show the acquisition of WVMIC by MagMutual – https://bit.ly/3SQeUrV
February 2021 – Vermont DOI appoints a rehabilitator for Emergency Physicians Insurance eXchange RRG – https://bit.ly/2OfjxQ7
May 2021 – ProAssurance finalizes acquisition of NORCAL Group – https://bit.ly/3L2keVc
December 2021 – Coverys Syndicate 1975 announces it will be placed into run-off at the end of 2022 – https://bit.ly/38Uk8AG
March 2022 – Constellation announces acquisition of Michigan Professional Insurance Exchange – https://bit.ly/3JYvBfl
January 2023 – MagMutual Insurance finalizes acquisition of MDAdvantage Insurance – https://bit.ly/3MOdMEF
October 2023 – Constellation and Curi Holdings complete merger – https://bit.ly/3FcNck4
October 2023 – Integris Group to Acquire MedMal Direct Insurance Company – https://bit.ly/3Fowfms

Shock Verdict Sources:

$183M: Philadelphia, PA - https://www.law.com/thelegalintelligencer/2023/04/26/jury-hits-penn-medicine-with-over-180m-record-verdict/
$165M: New York, NY - https://www.insurancejournal.com/news/east/2022/10/10/688781.htm
$111M: St. Cloud, MN - https://www.startribune.com/jury-awards-111m-to-college-student-after-care-at-st-cloud-hospital-left-leg-permanently-damaged/600174695/
$97M: Iowa City, IA - https://www.thegazette.com/crime-courts/jury-awards-nearly-98-million-to-iowa-city-parents-of-newborn-left-with-brain-injury/
$82M: Tulsa, OK - https://www.morelaw.com/verdicts/case.asp?s=OK&d=171135
$80M: New York, NY - https://www.law.com/newyorklawjournal/2022/10/24/80m-medical-malpractice-jury-award-in-long-running-case-is-limited-by-accord-between-parties/
$77M: Dekalb County, GA - https://www.law.com/dailyreportonline/2022/09/02/dekalb-jurys-77m-med-mal-verdict-appears-to-set-new-georgia-record/?slreturn=20221018090823
$75M: Roswell, GA - https://radiologybusiness.com/topics/patient-care/75m-malpractice-verdict-splits-fault-between-er-doctor-radiologist
$69M: Tampa, FL - https://blog.cvn.com/jury-awards-68.6m-in-med-mal-trial-over-womans-profound-brain-injury-following-sodium-imbalance
$52M: Albuquerque, NM - https://www.globenewswire.com/news-release/2023/01/25/2595506/0/en/Albuquerque-Jurors-Issue-52-Million-Verdict-in-Insurance-Bad-Faith-Lawsuit.html
$49M: Park Ridge, IL - https://www.chicagolawbulletin.com/cook-jury-49m-medical-malpractice-abdomen-20220321
$47M: Las Vegas, NV - https://www.reviewjournal.com/crime/courts/woman-with-locked-in-syndrome-awarded-47m-in-malpractice-suit-2726235/
$45M: Chicago, IL - https://www.evidencevideo.com/45-3m-verdict-in-veterans-brain-damage-case/
$44M: Philadelphia, PA - https://www.cnn.com/2023/02/15/sport/chris-maragos-wins-medical-malpractice-case-spt-intl/index.html
$42M: Chicago, IL - https://www.corboydemetrio.com/newsroom-news-2242
$40M: Mattoon, IL - https://pantagraph.com/news/local/40-million-awarded-in-central-illinois-malpractice-suit/article_ac81fa40-ccc1-11ed-8a55-2ffa4b15c482.html#:~:text=CHARLESTON%20—%20A%2019-year-,Sarah%20Bush%20Lincoln%20Health%20Center
$35M: Mobile, AL - https://www.prnewswire.com/news-releases/35-million-verdict-against-springhill-medical-center-for-death-after-thumb-surgery-301488027.html
$35M: Evanston, IL - https://www.beckershospitalreview.com/legal-regulatory-issues/northshore-physician-to-pay-35m-settlement-in-negligence-suit.html
$34M: Springfield, MO - https://www.ky3.com/2022/03/16/greene-county-jury-awards-34-million-malpractice-verdict-case-against-coxhealth/
$34M: Towson, MD - https://www.beckershospitalreview.com/legal-regulatory-issues/jury-delivers-34m-verdict-against-maryland-hospital.html?utm_medium=email&utm_content=newsletter
$31M: Sacramento, CA - https://www.prweb.com/releases/2023/01/prweb19140012.htm
$30M: Lawrenceville, GA - https://blog.cvn.com/30m-verdict-hits-ga-hospital-doctor-in-birth-injury-med-mal-trial
$29M: Marysville, CA - https://www.trains.com/trn/news-reviews/news-wire/jury-awards-28-6-million-to-man-who-lost-legs-when-hit-by-amtrak-train/
$29M: New York, NY - https://www.cbssports.com/nfl/news/former-giants-running-back-michael-cox-wins-over-28-million-in-medical-malpractice-case/
$27M: Polk County, IA - https://www.desmoinesregister.com/story/news/health/2022/11/22/jury-awards-iowa-man-millions-after-meningitis-misdiagnosed-flu-symptoms/69668716007/
$27M: Spokane, WA - https://www.spokesman.com/stories/2022/jul/20/jury-awards-27-million-to-the-estate-of-woman-who-/
$26M: Fontana, CA - https://www.prnewswire.com/news-releases/kaiser-arbitrator-awards-injured-child-over-25-6-million-301527651.html
$26M: Wilkes-Barre, PA - https://www.timesleader.com/news/1583280/jury-awards-26-million-after-medical-malpractice-trial
$25M: Kansas City, MO - https://www.prnewswire.com/news-releases/jury-awards-injured-baby-25-4m-in-kc-metros-largest-medical-malpractice-verdict-301519306.html
$21M: Montgomery, AL - https://www.al.com/news/2022/11/alabama-jury-awards-21-million-to-mom-who-lost-newborn-after-missed-diagnosis.html
$21M: Bowling Green, KY - https://www.bgdailynews.com/news/jury-awards-21-million-in-bg-medical-malpractice-trial/article_06f577c5-c178-5b3d-8be3-d2d9385567e3.html
$21M: Dallas, TX - https://www.dallasnews.com/news/courts/2022/10/31/jury-awards-21-million-to-man-in-vegetative-state-after-leg-surgery-at-dallas-hospital/
$21M: Essex County, NJ - https://www.law.com/njlawjournal/2023/03/31/essex-county-jury-returns-20-9m-verdict-in-med-mal-suit-over-double-amputation/
$20M: Oak Lawn, IL - https://chicago.suntimes.com/2022/6/27/23184866/advocate-christ-hospital-brain-damage-jury-award
$20M: Philadelphia, PA - https://www.law.com/thelegalintelligencer/2022/09/22/jury-returns-19-7m-to-penn-medicine-patient-largest-state-medical-malpractice-verdict-in-2022/#:~:text=A%20Philadelphia%20jury%20handed%20up,Pennsylvania%20so%20far%20in%202022
$20M: Lowell, MA - https://www.boston.com/news/the-boston-globe/2023/03/28/jury-awards-20-million-to-man-who-lost-a-leg-after-hospital-missed-blood-clot/
$19M: Bayfield County, WI - https://www.wpr.org/bayfield-county-jury-awards-nearly-19m-family-medical-malpractice-lawsuit
$18M: Norman, OK - https://medicalmalpracticelawyers.com/17-5-million-oklahoma-medical-malpractice-verdict/
$18M: West Chester, PA - https://www.dailylocal.com/2022/07/22/chester-county-woman-22-wins-18-million-jury-verdict-in-breast-cancer-malpractice-case/
$18M: Charleston, WV - https://apnews.com/article/health-stroke-lawsuits-wv-state-wire-accidents-4f4632e58f1cfb1624d441743376a9a4
$17M: Canton, MI - https://milawyersweekly.com/news/2023/02/28/michigans-million-dollar-verdicts-and-settlements-for-2022/
$16M: Melbourne, FL - https://www.medscape.com/viewarticle/979680
$16M: Beaver County, PA - https://www.law.com/thelegalintelligencer/2023/03/16/western-pa-jury-awards-couple-16m-verdict-in-med-mal-case/?slreturn=20230220131943
$14M: Los Angeles, CA - https://shernoff.com/our_news/los-angeles-jury-awards-14-42-million-including-7-5-million-in-punitive-damages-to-a-woman-who-became-addicted-to-opiates-because-of-health-nets-delays-in-referrals-to-specialists/
$14M: Bethesda, MD - https://thedailyrecord.com/2022/07/27/family-wins-14-million-medical-malpractice-verdict-over-sons-botched-surgery/
$14M: Ada County, ID - https://www.idahostatesman.com/news/business/article272586104.html
$13M: Westport, CT - https://www.nhregister.com/news/article/Stamford-Hospital-ordered-to-pay-Westport-man-s-17131326.php
$13M: Bel Air, MD - https://thedailyrecord.com/2022/08/02/jury-awards-13m-in-harford-county-malpractice-case-stemming-from-2004-birth/
$12M: Orlando, FL - https://blog.cvn.com/12.35m-verdict-after-life-care-centers-of-america-found-largely-liable-for-patients-bone-deep-pressure-sore
$12M: Beaumont, TX - https://medicalmalpracticelawyers.com/11-9-million-texas-birth-injury-medical-malpractice-verdict-reduced-to-2-19-million-due-to-texas-cap-on-damages/
$11M: Miami, FL - https://www.law.com/dailybusinessreview/2022/12/14/miami-dade-jury-returns-award-of-more-than-11-million-in-nursing-home-litigation/
$11M: Crown Point, IN - https://www.nwitimes.com/news/local/crime-and-courts/jury-awards-northlake-patient-11-million-in-malpractice-lawsuit/article_e8311fdc-57f9-551b-ac3f-2b52518fb2de.html
$11M: Cobb County, GA - https://www.shampsilk.com/blog/shamp-silk-obtains-105-million-medical-malpractice-verdict
$10M: Dallas, TX - https://blog.cvn.com/texas-jury-returns-10m-medical-malpractice-verdict-for-paralyzed-patient-beating-hospitals-450k-settlement-offer