Approximately 30% of physicians face lawsuits. “Any doctor can be sued for even petty reasons. Doesn’t mean you’re a bad doctor—it comes with the territory,” one family medicine doctor posted on Sermo.
A Sermo survey found that healthcare system malpractice is the top legal issue that 39% of physicians feel they face.
Malpractice insurance costs differ from physician to physician. But one thing is clear: Average costs are rising. An MGMA poll found that 68% of medical groups reported higher malpractice premiums in 2024 compared to 2022, and only 1% noted a decrease in premiums. This impacts physicians in certain specialties more than others.
Read on to learn more about the average cost of malpractice insurance across specialties and locations, factors affecting malpractice insurance and helpful insights from other physicians.
What is malpractice insurance?
Medical malpractice insurance protects physicians against an alleged or substantiated breach in their duty of care. Duty of care refers to a physician’s legal and ethical responsibility to deliver safe, competent medical services that meet established professional standards.
In filing a malpractice suit, claimants must prove the following:
- Their physician owed them a duty of care
- Their physician breached their duty of care
- The breach directly caused harm
- The harm led to economic or noneconomic damages
Economic damages refer to tangible monetary losses resulting directly from an injury. For example, these damages typically cover medical expenses, lost income and diminished earning potential.
Noneconomic damages—commonly termed “pain and suffering”—compensate claimants for psychological harm or lifestyle losses without direct monetary value. Malpractice insurance protects physicians from financial liability arising from economic and non-economic-related malpractice claims.
Medical malpractice insurance varies by practice setting and structure. Insurance arrangements include employer-provided plans and policies purchased directly from private insurers by individual practitioners or groups. They also include coverage acquired through risk retention groups (RRGs): member-owned organizations that offer liability coverage specifically for healthcare providers.
Federal government-employed clinicians generally don’t require individual malpractice coverage, as federal self-insurance programs handle liability claims. State or local government employers may similarly cover their clinicians under public liability protections.
While not all states mandate malpractice insurance, physicians recognize it as essential. One Psychiatrist and Sermo member wrote, “Huge percentage of good docs get sued—usually for something that should not have caused a lawsuit… Errors can only be minimized and learned from, not avoided entirely… We often have lots of cognitive and emotional responses [to being sued] since we are normally functioning human beings.”
What malpractice insurance does and doesn’t cover
Malpractice insurance covers legal fees and damages if the courts find a physician liable. This coverage may include arbitration costs, attorney and court fees, HIPAA violation fines and settlements. Without malpractice insurance, you may have to pay these costly fees out-of-pocket.
Malpractice insurance doesn’t cover criminal conduct. Depending on the policy, it may also not cover punitive damages—court-awarded compensation intended to punish the defendant for egregious misconduct. This functions as a deterrent for similar actions from other clinicians.
One Sermo member added, “Physicians should also consider investing in comprehensive malpractice insurance to protect themselves financially in the event of a claim. While prevention is always the best course of action, having adequate coverage can provide peace of mind and support in case of unforeseen circumstances.”
How much is malpractice insurance? Factors that affect costs
Insurance type, location, specialty, claims history and limits of liability are five primary factors that influence pricing. Here’s more about each:
Insurance type
There are two primary types of malpractice insurance: claims-made and occurrence. A claims-based policy covers claims only if the policyholder reports them during the policy term or any applicable reporting extension. An occurrence policy covers incidents that occur during the policy term, regardless of when the claimant files. Occurrence policies are generally more expensive, although they eliminate the need for tail coverage.
Location
Locations with a high incidence of lawsuits tend to have costlier malpractice insurance premiums. States with comparatively higher premiums include New York, Florida, Illinois and Louisiana. States with comparatively lower average premiums include Kansas, South Dakota, Minnesota and Wisconsin. Rates further differ at the city and regional level.
Specialty
Specialties with statistically greater malpractice risk, like OB/GYN and surgical specialties, involve higher premiums. Offering advice to another physician amid a lawsuit, one OB/GYN posted on Sermo, “Welcome to the club. The majority of practitioners in my specialty have been through this. But just keep it in perspective. It’s almost the price of doing business today in medicine.”
A Sermo member working in general surgery says, “From a surgeon standpoint, one lawsuit in 15 years would be a stellar percentage, and one of the best in our field. So don’t overthink the concerns and consequences of being named in litigation. It may increase your premiums to a degree, but except in very egregious circumstances it will not besmirch your career, or your standing with the state medical board or your hospital Board of Trustees.”
Generally, physicians in pathology, dermatology, family medicine, pediatrics and psychiatry
have comparatively lower premiums. RAND Institute for Civil Justice published a more extensive (though outdated) list, comparing malpractice risk by specialty.
Claims history
Insurance carriers evaluate past claims to assess risk. Multiple or severe claims may increase premiums or limit coverage options.
A physician posted on Sermo seeking advice after a patient sued them for malpractice. One internal medicine physician responded. “SO sorry! Yes, deep breaths and meet with your attorney and follow what they say. It may be a big nothing. Or you could end up in court but many jurors are on the doctor’s side. Just remember—you WILL get through this. It does not mean that you are a bad doctor!!! Chin up and take care of yourself.”
Limits of liability
Liability limits determine the maximum amount an insurer pays for covered claims. Naturally, higher limits provide greater protection but may increase premiums—a policy with a $1 million per-occurrence and $3 million aggregate limit often costs more than a $500,000 and $1 million policy.
Higher limits offer stronger financial protection in the event of multiple or high-value claims. Carefully assess your exposure to choose the coverage level that aligns with your needs.
Malpractice insurance costs by specialty and location
Cunningham Group has a helpful tool for comparing annual malpractice insurance costs across specialties and locations. Here’s how the prices of six states correspond with premiums for internal medicine, general surgery and OB/GYN:
| State | Internal medicine | General surgery | Obstetrics/Gynecology |
| California | $8,784 | $15,284 | $14,616 |
| New York | $5,220 | $22,541 | $28,212 |
| Florida | $15,436 | $49,942 | $66,373 |
| Illinois | $12,175 | $37,455 | $54,307 |
| North Dakota | $4,273 | $13,851 | $18,200 |
| Wisconsin | $3,261 | $9,781 | $14,945 |
While these figures represent average malpractice insurance costs, your malpractice insurance policy terms will be specific to you. Consider working with an independent insurance agent who can compare rates across multiple providers, rather than a captive agent who represents only one company. The insurance provider you choose pays the independent agent, which means these agents are generally less inclined to prioritize a single insurer’s interests over your needs.
Add your voice to discussions happening on Sermo
On Sermo, physicians share their experiences with malpractice suits and other legal issues. It’s a collaborative space to discuss topics with peers who share your concerns.
One internist posted, “My attorney once gave me great advice, ‘Consider this as just part of your job.’ Try as best you can to approach systematically as you would any problem, without a bunch of emotion and try not to take it home with you. There is almost no fairness or justice in a lawsuit. Get ready for a long drawn out affair. Listen to your lawyer.”
Another noted, “What you’ll get from Sermo is advice and support in letting this be a bad day, and, not a career changer. It happens.”
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