Doctors Hear Fewer Suits, Pay More, White Says

Malpractice premiums have remained flat for physicians, but that stability does not mean claims are getting cheaper to resolve. The industry is experiencing a divergence where claims frequency has hit a 53-year low, yet severity is rising well ahead of inflation. The Doctors Company President Robert White says this pattern is creating a misleading sense of security. He argues that the cushion holding rates down is running out, and early signs suggest the decline in frequency is ending.

The arithmetic behind the verdicts

White explains the mechanics of the market. While only seven percent of malpractice cases reach trial, the defense wins six of every seven. The remaining one percent becomes the benchmark for every comparable case that settles outside of court. A single plaintiff’s verdict resets the settlement value for others. This mechanism means one large loss can disproportionately impact the entire industry.

Nuclear verdicts, defined as awards above $10 million, are landing with greater frequency. They now occur roughly once a week across the country. The trend is not uniform. Georgia recorded 11 such verdicts in 2025 alone, while Illinois leads since 2015 with 58 cases. States like New York, Florida, Pennsylvania, and California also see significant numbers. This geographic spread suggests the phenomenon is not isolated to a single jurisdiction.

Some awards exceed even these massive sums. White describes “thermonuclear verdicts” above $100 million. The largest medical liability award on record reached $963 million in Utah, decided by a judge rather than a jury. The average payment reported on behalf of physicians reached $514,000 per closed report in 2025, up about 20 percent since 2022. Carriers will not know whether today’s rate is correct for three to five years.

Where the risk is highest

White identifies specific high-risk specialties. Cardiovascular, orthopedic, general surgery, and obstetrics carry the most exposure. He notes that plaintiffs’ lawyers are investing significant resources to litigate these cases. They are not pursuing this effort for nothing, and the cost will eventually filter back to the premiums practices budget against.

White expects increases of 1 percent to 3 percent nationally over the next few years. While this might sound modest, it represents a reversal of the previous stability. The early warning signs include severity trending up roughly 5 percent a year.

White also points to artificial intelligence as the emerging exposure worth watching. Choosing a malpractice carrier is often treated as a financial transaction. White suggests it is also a reputational decision. The carrier’s name never reaches the data bank, but the physician’s does. The choice of insurance provider becomes a public signal of a doctor’s standing within the medical community.