Malpractice insurers record positive results for 2004

Those results are among the highlights of the 2004 Missouri Medical Malpractice Insurance Report, which was released by the Department of Insurance in October. It is important to note, though, that nonreporting and underreporting of claims data continue to be a significant problem. Though the actual number is unknown, the department estimates that between 15 percent and 20 percent of all medical malpractice claims go unreported.

While all malpractice providers are required by statute to report claims data, the department has limited regulatory control over surplus lines insurers and entities that self-insure. About 75 percent of surplus lines insurers and risk retention groups filed no claims with the department, but in other filings reported total losses of $12.5 million. Additionally, the incidence of nonreporting among self-insured entities is believed to be even higher.

The report also states that the average award per claim increased sharply for the third consecutive year. The average award in 2004 amounted to $252,666. This is compared to $166,623 in 2001, $207,627 in 2002, and $212,006 in 2003. Average payments for physicians and surgeons alone reached $287,733 in 2004.

Payments for hospitals seemed to be the exception to this upward trend, declining to an average payment of $177,740, down from $195,034 in 2003. The total paid claims by physicians and surgeons, excluding practitioners such as dentists, nurses, and clinics and hospitals, increased from $53.9 million in 2003 to $81.1 million in 2004.

The most reported medical errors leading to a malpractice award are those associated with surgery and diagnosis. Errors are grouped into 10 broad categories. The single most common error reported was “failure to diagnose,” which means a medical provider reportedly concluded that a patient has no disease or condition where observation or follow-up would be necessary.

The full report is available online at www.insurance.mo.gov.

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