This article is sponsored by MagMutual.
Malpractice claim frequency has been falling for years. Claim severity (the average cost of a paid claim) has been climbing just as steadily. Most physicians aren’t aware of either trend, and understandably so. The shift is happening in courtrooms, legislatures, and advertising budgets rather than in clinical practice. But they shape every physician’s exposure, whether or not a claim ever lands on your desk.
In 2023, MagMutual’s Risk Environment Reports examined these two national trends moving in opposite directions. Today, that divergence hasn’t just persisted. It has widened, and the forces driving it have multiplied.
Why fewer claims are being filed
Part of the good news is earned. Years of continued investment by the health care community in patient safety, structured communication, and risk management appear to be keeping more adverse events from turning into lawsuits. MagMutual’s own data supports this: Providers who completed four or more Learning Center courses saw approximately 20 percent fewer claims.
But there’s another factor at work. Plaintiff attorneys have become far more selective in taking cases based on projected outcome. Litigating a malpractice case can cost between $30,000 and $150,000 or more in expert witness fees, discovery, and trial preparation. National data shows that two-thirds of malpractice claims are dismissed, dropped, or withdrawn. And fewer than 10 percent reach trial. Faced with those economics, attorneys are concentrating on cases involving catastrophic injury, long-term care needs, or substantial economic damages.
The result: When a claim does proceed, it is more likely to be one with high damages potential.
Why the claims that proceed cost more
The medical facts of a case are no longer the primary driver that determines its value. Social inflation (the rise in claim costs beyond what medical and economic inflation alone would explain) has moved to center stage. It shows up in several ways:
- Rising litigation expenses: Higher expert witness, discovery, and trial costs are making cases increasingly expensive to pursue.
- Rising health care costs: As the cost of treatment and care rises, so does the value of those claims.
- Larger jury awards: Jurors are more willing to award larger damages, particularly in cases involving severe injuries, long-term disabilities, or emotionally compelling circumstances.
- Expanding liability expectations: Rare multimillion-dollar verdicts, or “nuclear verdicts,” are widely publicized, raising expectations for what a case should be worth.
The legal advertising effect
One driver that barely registered a decade ago is now impossible to ignore. According to the American Tort Reform Association report, more than $2.5 billion was spent on more than 26.9 million legal services advertisements across the United States in 2024, spanning television, radio, digital, print, and outdoor media. For comparison, that’s more than double what pizza restaurants spent on advertising in the same period.
The effect on physicians is twofold. Constant advertising normalizes the idea that an unexpected outcome is grounds for a lawsuit, and it keeps the public primed to view large awards as expected rather than exceptional. Both feed directly into the severity trend.
What hasn’t changed
Physicians cannot control jury sentiment, advertising budgets, or economic forces. But the fundamentals that reduce exposure are the same ones that improve care:
- Proactive malpractice risk management helps identify risk early and prevent avoidable harm.
- Strong physician-patient communication fosters trust and helps lessen the likelihood of unexpected outcomes escalating into disputes.
- Thorough documentation supports defensibility when claims occur.
- Meaningful, informed consent discussions set expectations and decrease misunderstandings.
In an environment where a single high-severity claim can be more costly than dozens of routine ones, fundamentals are not just best practice. They are the most reliable lever a physician has.
One important caveat
Everything above describes the national picture. But malpractice risk is increasingly local. State legislatures and courts are actively rewriting the rules on damages caps, evidence, and litigation procedures. Two physicians in the same specialty can face very different exposure depending on where they practice.
For a deeper look at the forces reshaping malpractice risk, read MagMutual’s full article: “Understanding Liability from Environmental Risks.”
Part two of this series will look at how these trends play out state by state. You’ll also be able to get access to both National and State Risk Environment Reports. Follow MagMutual on LinkedIn so you don’t miss it.
William S. Kanich is an emergency physician and executive chairperson, MagMutual Insurance Company.
MagMutual tracks the forces shaping medical liability risk, so physicians don’t have to navigate them alone. Drawing on insights from more than 100,000 claims, suits, and notices of intent to sue, we help 50,000+ physicians and health care organizations understand where their exposure is heading and what they can do about it.
Disclaimer: The information provided in this article does not constitute legal, medical, or any other professional advice. No attorney-client relationship is created, and you should not act or refrain from acting on the basis of any content included in this article without seeking legal or other professional advice.
