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Return to Basics in Physician Medical Malpractice Underwriting

Friday, October 1, 2021
Mike Madey
Return to Basics in Physician Medical Malpractice Underwriting

Authored by Mike Madey, MBA, RPLU, MJ

As I’m sure you are aware, the Medical Professional Liability marketplace is going through some significant hardening. Some sectors have been impacted more than others (i.e. Senior Care, Excess Liability). In this article, I’d like to specifically address the physician marketplace.  

For the past three to four years, the physician space has seen unprofitable results. If it wasn’t for reserve redundancy and reserve releases, we might have seen this hardening start a few years earlier. At this stage of the cycle, even with some help from interest income, the industry as a whole is underperforming.

In listening to various leaders on the insurance carrier side, there seems to be a common theme developing: “We need to get back to basics.” What they are really saying is we need to begin actually underwriting again.

In the past 15 – 20 years, there has been an erosion (almost an elimination) of the non-standard market. Physicians with frequency issues and poor loss ratios who don’t participate in risk management and are not board-certified were historically steered to the non-standard market. Over the past decade and a half, most of these doctors been absorbed into the standard market. Similarly, clinic accounts who have underperformed or have demonstrated a reluctance to accept risk management, have also stayed in the standard market.

What can you expect to see going forward?

  1. More emphasis on Loss Ratio analysis
  2. More emphasis on active Risk Management
  3. Mandatory Board Certification
  4. Annual or Biannual review of Procedures and Policies
  5.  Underperforming physicians being non-renewed

Be prepared for more upfront underwriting in 2022 – especially on the renewal side.

For additional information, please contact Mike Madey, Senior Vice President of Horton Risk Advisory Solutions, Healthcare Practice, at 708.845.3805 or via e-mail at

Material posted on this website is for informational purposes only and does not constitute a legal opinion or medical advice. Contact your legal representative or medical professional for information specific to your legal or medical needs.