Report: Missouri Medical Professional Liability Insurers Saw Slight Profit in 2017

In 2017, poor underwriting results for medical professional liability insurers in Missouri were partially offset by higher investment returns, and insurers barely eked out a profit, earning a 0.2 percent return on net worth, according to a new report by the state insurance department.

The Annual Report on Medical Professional Liability issued by the Missouri Department of Insurance is based upon data provided by insurers and self-insured hospitals to the department. The data includes open and closed claims that insurance companies and self-insured hospitals are required to report.

Other highlights of the report include:

• The average payout declined somewhat in 2017 to $403,222, compared with an average of $465,055 during the prior year.
• Since 2005 (the earliest year for which data exists), all payouts exceeding $500,000 involved significant injuries, the most common of which were significant cognitive impairment, paraplegia and quadriplegia, amputations of one or more limbs, and loss of vision, hearing or other significant organ function.

Missouri implemented caps on non-economic damages in medical malpractice cases in 2015. Limits for non-severe injuries and catastrophic injuries were initially set at $400,000 and $700,000, respectively. These caps increase by a constant rate of 1.7 percent annually, and now stand at $420,749 and $736,310.

For the first time, the report includes data related to “never events,” which are adverse medical errors that are unambiguous, serious and usually preventable.

Departmental data suggests that never events are more common than their name might imply. The most common and most costly never event associated with malpractice actions is serious injuries due to falls — of which there were 597 since 2005. Those resulted in payouts of $62 million.

Other common never events were the retention of surgical material (350 actions with $24.9 million in payouts), medication errors (wrong medication/dose, 248 claims, $59 million payouts), serious injuries associated with pressure ulcers (272 / $40.7 million), and performing an invasive procedure/surgery on the wrong body part (128 / $22.7 million).