Malpractice payouts and malpractice insurance: Evidence from Texas closed claims, 1990-2003

Using medical malpractice claims with payments of 25,000 or more that closed in Texas from 1990 to 2003, this study quantifies physicians' insurance limits and examines the connection between policy size and payments on claims. It finds that most physicians had less than 1 million (nominal) in coverage, that real policy size declined, that settlements at the policy limits were common, that payment size was stable or falling, and that payments above the policy limits were rare. It also finds that physicians rarely made out-of-pocket payments, suggesting the policy limits often cap recoveries, and that the frequency of out-of-pocket payments declined as policy size increased. Results are presented separately for perinatal physicians.