Pennsylvania Medical Malpractice Insurance

• Most Common Limits of Liability: $1 million/$3 million
• Major Malpractice Insurers:
  • Medical Protective Co.
  • Tri-Century Insurance Co.
  • NORCAL Mutual Insurance Co.
  • Franklin Casualty Insurance Co. (A RRG)
  • Mountain Laurel RRG Inc.
• Cost of medical malpractice insurance: Very High

Pennsylvania has a long history of high medical malpractice premiums. Many attempts have been made to reform the Quaker State’s medical liability system; some have been more successful than others. In the early 1970s, Pennsylvania faced the same malpractice crisis that was affecting many U.S. states. Premiums were skyrocketing, and the commonwealth’s then-largest medical liability insurer, Argonaut, threatened to stop writing policies altogether. In 1975, Argonaut sought to increase premiums by 200 percent for many specialties. In response, the Pennsylvania Medical Society and General Assembly worked together to pass the Health Care Services Malpractice Act (Act 111) of 1975, becoming one of the first states to pass wide-ranging legislative reforms in response to the medical liability crisis gripping the country. The act created the Medical Professional Catastrophic Loss (CAT) Fund. The CAT Fund was the United States’ first public patient compensation fund (PCF), a state-established liability-funding instrument that provides medical professional liability coverage in excess of a physician’s primary insurance limits. Several other provisions to restrict attorney fees, mandate arbitration panels and establish a collateral source rule were also included, but these were found to be unconstitutional by the Pennsylvania Supreme Court.

Pennsylvania has continued to reform its medical liability system since Act 111 was passed. In 1996, legislation limiting punitive damages to $100,000 was passed, CAT Fund surcharges were reduced, physicians were allowed to provide affidavits of non-involvement, meaning that they could swear under oath that they were not involved in a case and be cleared of wrongdoing and a four-year moratorium was placed on further medical liability legislation. However, difficulties in the Pennsylvania market continued, with three of the five major malpractice insurers in the state ceasing to write in Pennsylvania by the early 2000s. In response, the Medical Care Availability & Reduction of Error Act (Mcare) was passed in 2002. Its reforms were comprehensive, addressing both medical errors in the healthcare system and reforms to the legal system and the medical malpractice industry.

The Mcare Act sought to emphasize patient safety and reduce medical errors, creating a Patient Safety Authority and requiring all hospitals to incorporate detailed patient safety plans. It also included a range of legal reforms to restrict frivolous law suits by instituting stronger expert witness qualifications and sanctioning lawyers who brought frivolous claims. Additionally, Mcare restructured the states CATFund, renaming it the Mcare Fund and equipping it with $400 million in state subsidies to reduce physician assessments. It also increased assessments for doctors with excessive claims and required insurers to offer patient-safety discounts and credits.

In 2018, the Pennsylvania Supreme Court made a decision that has significantly changed the scope of what is available in the discovery process for medical liability lawsuits, making it easier for plaintiffs to obtain materials related to physician performance and credentials. These materials were previously considered protected from discovery by the commonwealth’s Peer Review Protection Act (PRPA), which gave increased protection to healthcare professionals and review panel evaluations of physician performance that investigate possible malpractice incidences. The PRPA considered materials that are prepared as part of a peer review process privileged and protected from discovery. However, in the 2018 decision of Reginelli v. Boggs, the Pennsylvania Supreme Court held that the PRPA does not extend protection from disclosure to a non-licensed, third-party entity or committees or individuals reviewing physician credentials. The Pennsylvania Supreme Court found the protective privilege of the PRPA did not apply to Bogg’s “performance file,” which was authored by his supervising doctor at the hospital. The court came to this conclusion because the hospital itself was not “approved, licensed or otherwise regulated to practice or operate in the healthcare field under the laws of the Commonwealth,” and because the performance file was a review of Boggs’s credentials, which does not fall within the PRPA’s evidentiary privilege. This holding has the potential to have widespread effects on the materials that are discoverable and likely opens the door for plaintiffs to seek additional reports and files during discovery.

In 2019, the Pennsylvania Supreme Court, in a 4-3 decision, struck down the seven-year statute of repose contained in the Mcare Act as unconstitutional. Mcare’s statute of repose had limited the application of the discovery rule to seven years. After seven years, the statute of repose barred the patient’s ability to bring action. Prior to this decision, the only exceptions to the seven-year limitation were for minors and/or those who suffered injuries caused by a foreign body unintentionally left behind. Now, there is no absolute time limitation on discovery. The court reasoned that Mcare’s statute of repose conflicted with the “open courts” provision in the Pennsylvania Constitution, which guarantees that “all courts shall be open; and every man for any injury done to him in his lands, goods, person or reputation shall remedy due course of law.” Medical professionals and their insurers now face potential exposure for claims long after treatment is rendered.

Tort reform has been carried out many times in the Quaker State, including the establishment of the first patient compensation fund in the United States, known as the CAT Fund and later reformulated as the Mcare Fund. However, Pennsylvania has been unsuccessful in creating damage caps, which are often considered the ‘holy grail’ of medical liability reform. Though many important provisions have been made to improve the medical liability system, physicians still face high rates throughout the state.

Currently, all Pennsylvania physicians are required to participate in Mcare. Physicians are legally required to maintain limits of $1 million/$3 million, with a primary private policy of $500,000/$1.5 million. The rest of the coverage is provided through Mcare, which provides up to an additional $500,000 of excess coverage per claim. Physicians must pay into the Mcare Fund, but it is generally less expensive than private policies. By state law, Pennsylvania must reevaluate the Mcare Fund every two years, with the plan of eventually closing the fund. This will be done gradually, with private insurers retaining more and more of the $1 million limit until they eventually reach 100 percent.

• Damage Caps? Yes, but only for punitive damages. Noneconomic damage caps have been ruled to be unconstitutional by the Pennsylvania Supreme Court.
• Patient Compensation Fund? Yes; see details above.
• Apology Law? Yes, actions, conduct, statements or gestures that convey a sense of apology, condolence, explanation, compassion or commiseration emanating from humane impulses can be made to a patient or a patient’s relative or representative.
• Joint Liability Reform? Yes, defendants who are less than 60 percent at fault are liable only for their portion of fault, except in cases of intentional misrepresentation or intentional tort. Defendants found to be 60 percent or more at fault are jointly and severally liable.
• Limits on Plaintiff Attorney’s Fees? No

Overview

Rates in Pennsylvania are high, with many surgeons paying well over $50,000 per year in premium. Specialists like OBGYNs frequently face premiums of well over $100,000, depending on their location and the procedures they do. Rates for general practitioners can range up to $30,000, but are generally in the $12,000 – $25,000 range, depending on location. Rates have fallen for some specialties and in some locations in recent years, but medical liability costs still remain a major concern for Pennsylvania physicians.

Get Historic Rates

By combining our efforts with those of the Medical Liability Monitor – the nation’s leading independent source of Medical Liability Insurance news, as well as the political, legal and risk management issues that affect the healthcare industry – we’ve published historic rate data for every county in the Quaker State. You can view all the rates by completing the three simple steps on the left of this page. You’ll find the insights offered by this information invaluable when making your decision on your medical malpractice insurance coverage and carriers. This is only one of the many reasons that Cunningham Group Insurance has become the preferred online source for Pennsylvania physicians, healthcare professionals and medical groups looking to find the best coverage and lower their medical malpractice insurance rates.

Coverage by Pennsylvania County

The highest rates in Pennsylvania are generally found in Philadelphia and Delaware Counties, which include Philadelphia and the surrounding areas. In general, counties in the eastern part of the state tend to have more expensive premiums than those in Western Pennsylvania. For example, Alleghany County, which includes the city of Pittsburgh, has substantially lower malpractice premiums than eastern parts of the state.

Pennsylvania Medical Society
Pennsylvania Insurance Department
The Hospital and Healthsystem Association of Pennsylvania
Pennsylvania State Board of Medicine
Pennsylvania Osteopathic Medical Association
Pennsylvania Medical Group Management Association
All MD Pennsylvania Healthcare Defense Attorney Listing