September 08, 2009

Missouri medical malpractice insurers show profits for fifth consecutive year

Jefferson City, Mo. – Insurance companies providing medical malpractice coverage in Missouri returned a profit in 2008, marking the fifth consecutive year of positive earnings. The Missouri Department of Insurance has released its annual report on the industry, which shows increased profits are due to policyholders filing fewer claims and insurers paying far less for those claims.

According to Department of Insurance estimates, medical malpractice insurers reported return on net worth of 24.6 percent in 2008, down slightly from the previous year. These profit margins are a dramatic increase from the earnings numbers of 1999-2003, when insurers barely broke even and actually lost money in some years.

New claims filed in 2008 reached a 10-year low: 1,245 new malpractice claims were filed. A total of 3,160 claims were still open at the end of 2008, marking the lowest number in the nearly 30 years the Department of Insurance has been collecting data on medical malpractice insurer companies.

Average claims payments also remained low, although up slightly from 2007. The average claim was just $202,612 in 2008, up from 195,239 in 2007. The highest average claim number was recorded in 2005 at $253,888.

Insurers wrote more than $206 million in premiums in 2008, with the top two carriers – Missouri Professionals Mutual and Missouri Hospital Plan – holding a combined 33 percent market share.

Among insurers providing coverage to physicians and surgeons, market share has grown dramatically in the past 10 years for groups known as “383 companies,” named for the chapter of the Missouri Revised Statutes that governs them. These companies insure nearly half of all physicians and surgeons, and one of these companies controls 95 percent of the hospital market.

A 383 is a non-profit corporation formed by a coalition of physicians and is subject to less regulatory oversight than a traditional insurance company. Also, its obligations are not backed by the Missouri Property and Casualty Insurance Guaranty Association, as is the case with a traditional insurer. Instead, these companies have the legal authority the increase assessments to their current members if additional money is needed to pay claims.

The most common allegations in medical malpractice cases were:

• Poor surgical outcomes (32 percent)

• Non-surgical treatment (20 percent)

• Diagnostic errors (18 percent)

• Patient safety (11 percent)

• Medication problems (9 percent)

• Pregnancy and childbirth complications (7 percent)

The 2008 report also presents detailed tables on the nature of alleged errors leading to adverse outcomes, and the nature of injuries sustained by patients. The entire report is available at or by calling the department at 573-751-4126.