Physicians’ Insurance Limits and Malpractice Payments: Evidence from Texas Closed Claims, 1990–2003

Zeiler, Kathryn; Silver, Charles; Black, Bernard S.; Hyman, David A.; Sage, William M.

doi:10.1086/519467

Cited by 64 publications

(22 citation statements)

References 23 publications

(33 reference statements)

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“…But, many of the factors that drive liability costs—the rate and severity of patient injuries; medical costs; wages; access to legal services and courts; and jurors’ attitudes—should change slowly over time. And, the med mal liability system rarely pays victims more than insurance policy limits, regardless of the level of damages a jury might award (Zeiler et al ; Silver et al ). The de facto cap on recovery set by policy limits is an additional reason why rapid changes in liability costs should be unusual…”

Section: Discussionmentioning

confidence: 99%

Insurance Crisis or Liability Crisis? Medical Malpractice Claiming in Illinois, 1980–2010

Rahmati

Hyman²,

Black³

et al. 2016

J Empirical Legal Studies

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Since 1980, Illinois has experienced three medical malpractice insurance crises—in the mid‐1980s, mid‐1990s, and early‐2000s. Each time, Illinois responded by enacting tort reform. Using a previously unavailable database of closed medical malpractice (med mal) claims, maintained by the Illinois Department of Insurance, we analyze statewide trends in med mal claiming from 1980–2010, covering all three crises. Paid claim rates rose sharply from 1980–1985, roughly leveled off from 1986–1993, and then began a sustained decline. By 2010, paid claims rates were 75 percent lower than in the peak year (1991). Payout per claim has steadily increased since 1980, but these increases can be entirely explained by the virtual disappearance of smaller paid claims and claims involving less severe injuries. The total direct cost of med mal litigation (payouts and defense costs) rose sharply from 1980–1992, with a jump in 1991, and then declined steadily, with a more modest jump during 2000–2002, which persisted through 2006. Thus, of the three Illinois insurance crises, only the first coincided in time with a major change in claiming. Rather than becoming more generous over time, the Illinois med mal system has squeezed out claimants with less severe injuries and smaller claims.

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Section: Discussionmentioning

confidence: 99%

Insurance Crisis or Liability Crisis? Medical Malpractice Claiming in Illinois, 1980–2010

Rahmati

Hyman²,

Black³

et al. 2016

J Empirical Legal Studies

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“…47 Zeiler et al (2007). provides an objective way to quantify how cap design is likely to affect case outcomes.…”

Section: Cap Designmentioning

confidence: 99%

Estimating the Effect of Damages Caps in Medical Malpractice Cases: Evidence from Texas

Hyman¹,

Black²,

Silver³

et al. 2009

Journal of Legal Analysis

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Using claim-level data, we estimate the effect of Texas's 2003 cap on noneconomic damages on jury verdicts, post-verdict payouts, and settlements in medical malpractice cases closed during 1988-2004. For pro-plaintiff jury verdicts, the cap affects 47-percent of verdicts and reduces mean allowed non-economic damages, mean allowed verdict, and mean total payout by 73-percent, 38-percent, and 27-percent, respectively. In total, the non-econ cap reduces adjusted verdicts by $156M, but predicted payouts by only $60M. The impact on payouts is smaller because a substantial portion of the above-cap damage awards were not being paid to begin with. In cases settled without trial, the non-econ cap affects 18-percent of cases and reduces predicted mean total payout by 18-percent. The non-econ cap Downloaded from 356 ~ Hyman, Black, Silver, Sage: Estimating the Effect of Damages Caps in Medical Malpractice Cases has a smaller impact on settled cases than tried cases because settled cases tend to involve smaller payouts. The impact of the non-econ cap varies across plaintiff categories. Deceased, unemployed, and (likely) elderly plaintiffs suffer a larger percentage reduction in payouts than living, employed, and non-elderly plaintiffs.We also simulate the effects of different caps and fi nd substantial differences in cap stringency across states. Different caps reduce aggregate payouts in tried cases (all cases) by between 16-percent and 65-percent (7-percent and 42-percent). Caps on total damages have especially large effects.

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“…At first blush, one may doubt this considering that physicians generally face limited immediate financial risk from associated damage awards insofar as they are insured against such losses with coverage that is typically not experience rated (Sloan 1990, Zeiler et al 2007). However, despite this limited immediate financial risk, physicians may face a number of uninsurable costs as a result of malpractice liability–e.g., reputational and psychological damage (Jena et al 2011).…”

Section: Malpractice Law and Physician Behaviormentioning

confidence: 99%

Does medical malpractice law improve health care quality?

Frakes

Jena

2016

Journal of Public Economics

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We assess the potential for medical liability forces to deter medical errors and improve health care treatment quality, identifying liability’s influence by drawing on variations in the manner by which states formulate the negligence standard facing physicians. Using hospital discharge records from the National Hospital Discharge Survey and clinically-validated quality metrics inspired by the Agency for Health Care Research and Quality, we find evidence suggesting that treatment quality may improve upon reforms that expect physicians to adhere to higher quality clinical standards. We do not find evidence, however, suggesting that treatment quality may deteriorate following reforms to liability standards that arguably condone the delivery of lower quality care. Similarly, we do not find evidence of deterioration in health care quality following remedy-focused liability reforms such as caps on non-economic damages awards.

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Physicians’ Insurance Limits and Malpractice Payments: Evidence from Texas Closed Claims, 1990–2003

Cited by 64 publications

References 23 publications

Insurance Crisis or Liability Crisis? Medical Malpractice Claiming in Illinois, 1980–2010

Insurance Crisis or Liability Crisis? Medical Malpractice Claiming in Illinois, 1980–2010

Estimating the Effect of Damages Caps in Medical Malpractice Cases: Evidence from Texas

Does medical malpractice law improve health care quality?

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