Alabama Medical Professional Liability Insurance Market Summary

If you are a doctor looking for medical liability insurance in Alabama, MEDPLI can recommend many great insurers. The top companies in the state are:

  • ProAssurance

  • Medical Protective

  • The Doctors Company

  • Mag Mutual

  • State Volunteer Mutual Insurance Co

The best insurers in Alabama will carry an A-rating from A.M. Best like the companies above. These insurers are top-rated because of their history of being able to provide robust legal and financial support for physicians. These carriers use proprietary methodologies to set rates and there is no set standard rate across insurers for each specialty.

The medical malpractice insurance marketplace is very hospitable to Alabama health care providers because:

  • premium rates are some of the lowest in the country

  • 90% percent of malpractice claims that reach trial are decided in favor of the defendant physician

  • Alabamans receive fewer payments per capita in medical liability cases than any other state

Medical Malpractice Insurance Requirements for Alabama in 2020

Doctors are not required to carry medical malpractice insurance in the state of Alabama, but physicians should still protect themselves with a comprehensive policy. The low cost of liability premiums allows smart physicians to mitigate the risk of costly and lengthy future malpractice battles.

In addition, many hospitals in Alabama require that doctors have malpractice coverage to treat patients. Liability limits of $1 million per occurrence or claim and $3 million per annual aggregate are the standard policy amounts for medical malpractice insurance in Alabama. High-risk specialties like surgery or Obstetrics/Gynecology usually require policies with higher liability limits.

Medical Malpractice Insurance and COVID-19 in Alabama

The state formed its Coronavirus Task Force on March 6, 2020, a week before Alabama announced its first seven positive cases of COVID-19 and Governor Kay Ivey declared a state of emergency. Later that month all non-essential businesses were ordered to close, and a stay-at-home order was issued until May. When cases peaked in early July, Governor Ivey issued a state-wide public mask mandate.

With an influx of patients seeking medical care, and in response to ranking 4th nationally for the highest rate of COVID-19 fatalities, Governor Ivey also allowed the state to:

  • expand the scope of practice for many healthcare providers

  • allow the process of reinstatement of medical licenses to be expedited

  • start to expand the capacity of health care facilities

Alabama has experienced a significant spike in positive COVID-19 cases throughout the fall and winter of 2020, with 5% of the population having tested positive since the pandemic began. With hospitalizations at the highest point yet, many understaffed Alabama hospitals plan to suspend elective procedures in order to reserve resources for the explosion of cases expected to result from the 2020 holiday season.

COVID-19 cases are predicted to increase significantly across the country until a vaccine is made available to the public. In these unprecedented times, it’s important for Alabama doctors to protect themselves now with medical malpractice insurance from an A-rated carrier.

Telemedicine in Alabama

Telehealth laws continue to evolve in the state of Alabama. The largest use of telemedicine is through the remote monitoring of patient vitals by home health nurses employed by the Department of Health. While the state joined the Interstate Medical Licensing Compact in 2015 (which allows physicians to consult out-of-state patients via telemedicine), telehealth delivery in the state is still limited to physicians, nurse practitioners, physician assistants, and clinical nurses and psychologists.

Since early March 2020, COVID-19 has rapidly changed the way that providers are permitted to delivery telehealth services in the state, with many of the laws temporarily relaxed during the pandemic state of emergency. Notably:

  • providers are now encouraged to utilize telehealth services whenever possible and prudent

  • DEA-registered practitioners are allowed to prescribe controlled substances to patients for whom they have not had a face to face visit

  • telemedicine can now be provided regardless of where the patient is located geographically and the type of site

  • several private payor health plans have announced that they will make telehealth more widely available

  • restrictions are loosened on the types of devices physicians and patients can use for e-visits

  • Medicaid telemedicine visits are reimbursed at the same rate as in-person visits

For a current list of legislative updates, Alabama physicians should check state resources like the Alabama Department of Public Health website that outline the specifics of telehealth delivery and reimbursement.

Malpractice Insurance Rates for Alabama Doctors

Malpractice insurance rates for physicians in Alabama are considered some of the lowest across the country. See below for approximate rates across all territories for limits of $1,000,000 Each Claim/$3,000,000 Aggregate (the most common limits of liability in Alabama).

Specialty Approximate Rate Minimum Rate Maximum Rate
Anesthesiology $12,000 $8,000 $18,000
Cardiovascular Disease Minor Surgery $11,000 $10,000 $12,000
Emergency Medicine $19,000 $16,000 $22,000
Family Practice No Surgery $8,000 $6,000 $9,000
Gastroenterology No Surgery $9,000 $8,000 $11,000
General Surgery $26,000 $16,000 $31,000
Internal Medicine No Surgery $8,000 $7,000 $9,000
Obstetrics and Gynecology Major Surgery $39,000 $31,000 $42,000
Occupational Medicine $6,000 $5,000 $7,000
Ophthalmology No Surgery $5,000 $4,000 $7,000
Orthopedic Surgery No Spine $23,000 $16,000 $27,000
Pathology No Surgery $7,000 $4,000 $8,000
Pediatrics No Surgery $8,000 $6,000 $10,000
Psychiatry $6,000 $4,000 $7,000
Radiology – Diagnostic $9,000 $7,000 $11,000

Tort Reform in Alabama

The first major tort reform in Alabama was passed in 1987. Legislation included a $400,000 cap on non-economic damages, a stricter burden of proof for the plaintiff to be awarded punitive damages plus a $250,000 cap on punitive damages, and a total damage cap of $1 million. All legislation was struck down by the State Supreme Court in the years to follow.

In 2010, the state passed a slew of new legislation that included “reductions to the statute of repose… in civil cases, prohibited forum-shopping in wrongful death lawsuits, and changed the state’s expert witness rules to conform to stricter federal standards”. Tort reform legislation and lobbying continue to be a focus of the medical landscape in the state.

Alabama’s Damage Caps on Medical Malpractice Lawsuits

Alabama does not place caps on economic or non-economic damages. However, the state does place a cap on punitive damages – to the larger of three times the compensatory award or $1,500,000.

Alabama also has the following medical malpractice legislation in place:

  • Contributory Negligence and Contribution – if the patient is found to be at any fault of their own for their injury, the court will dismiss the case and no payout will be awarded

  • Joint and Several Liability – if two or more entities are to blame for the patient’s injury, those entities are jointly and severally liable for the injury and will be included in the judgment

Statute of Limitations for Medical Malpractice Claims

The following guidelines outline the state’s statute of limitations for medical malpractice claims:

  • A person in Alabama has two years from the date of injury to file a medical malpractice claim

  • If the injury is not discovered and could not have reasonably been discovered within the two-year deadline, the claim must be filed within six months of the discovery

  • There is a statute of repose which states that all medical malpractice lawsuits must be filed within four years from the date of injury

  • In cases of wrongful death, claims need to be filed within two years of the death

  • An exception applies to minors four years or younger at the date of injury – they have until their eighth birthday to have a claim filed on their behalf

Tail Insurance in Alabama

If you are a physician with a claims-made policy practicing in Alabama and you DON’T have Prior Acts insurance (also known as Nose Coverage), having a tail insurance policy will make sure you’re protected from malpractice claims if you change jobs. Tail insurance covers the time between your retroactive date with your former employer, and the last day you are covered by that policy. The dates typically line up with your first day on the job and your last day seeing patients at that job. Before you start with your new employer, the new employer will often want to confirm you have tail coverage from your prior job. To get the best rates on tail insurance in Alabama, contact a broker before you notify your employer of your resignation.

When and why is tail insurance necessary?

When a doctor leaves an employer, their insurance coverage with that employer ends on the last day of employment. Since most malpractice insurance policies are underwritten on a claims-made basis, you will be exposed to a lawsuit if someone files a claim against you after you leave your employer, without tail coverage. Tail insurance covers you from your retroactive date up to the last day the policy is in effect – with the ability to report claims years after the last day. Read more about tail malpractice insurance.

Medical Malpractice Insurance Outcomes in Alabama for 2019

The total medical malpractice payout in Alabama for 2019 was $22,347,000.

Closing Remarks

In the last several years, Alabama has had the honor of being included in a handful of “top ten” lists of places for doctors to practice medicine. While the average cost of living in the state is 10% less than the national average, the average salary for physicians is 4.6% above the national average and is the number one occupation for the top 1% of earners in the state.

Additionally, there are plenty of career opportunities for physicians as well, especially in rural areas where the state is seeing a shortage of healthcare workers and an aging population with growing healthcare needs. Rural doctors report close connections with their patients and communities, but Alabama cities are a great option for providers as well. The University of Alabama at Birmingham Medical Center is recognized as one of the premier healthcare facilities in the country.

MEDPLI helps doctors from all specialties. Whether you are a neurosurgeon in Montgomery, a cardiologist in Birmingham, or a radiologist in Mobile, we can help you find medical malpractice insurance. To get coverage from an A-rated carrier, contact us by requesting a quote.