Massachusetts Medical Professional Liability Insurance Market Summary

Doctors in Massachusetts have a variety of good options for medical liability insurance. The top insurers in the state are:

  • Coverys Group (ProSelect and ProMutual)

  • Medical Protective

  • The Doctors Company

  • ISMIE Indemnity

  • ProAssurance

These companies have a history of providing robust financial and legal support for physicians and all have a financial strength rating of “A” from independent insurance rating company A.M. Best. These carriers use proprietary methodologies to set rates and there is no set standard rate across insurers for each specialty.

Because Massachusetts law requires doctors to carry a minimum level of malpractice insurance to practice in the state, all insurance carriers in the commonwealth are required to make their insurance products available to all providers, regardless of specialty.

Despite tort reform measures that have passed in the state, medical malpractice insurance rates have been historically expensive and have remained high for current Massachusetts doctors. A report by Wallethub named Massachusetts in the top 5 states with the highest malpractice award payout per capita.

Medical Malpractice Insurance Requirements for Massachusetts in 2021

Massachusetts law requires individuals that are licensed and providing direct care to patients to maintain medical malpractice insurance, with required minimum coverage amounts for claims against injury or death set at $100,000 per claim and $300,000 annual aggregate.

These requirements are quite low compared to the limits set in most other states that require doctors to maintain liability insurance. Higher risk specialties may need more coverage, and most hospitals in Massachusetts require physicians to carry coverage set at $1,000,000 per claim and $3,000,000 annual aggregate.

Even the best doctors need to protect against the possibility of a medical malpractice lawsuit and partnering with an independent broker to secure comprehensive medical malpractice insurance is fundamental to reducing risk in your practice.

Telemedicine in Massachusetts

The COVID-19 pandemic caused a monumental shift in how health care is delivered all over the country, including in the Bay State. When the governor declared a state of emergency due to COVID-19 in early 2020, temporary legislation was quickly passed that allowed safe access to quality healthcare through telehealth services, including requiring all commercial insurers and the Group Insurance Commission to:

  • cover medically necessary telehealth services in the same manner they cover in-person services

  • impose no restrictions on the technology used to deliver telemedicine, and

  • reimburse telemedicine services at the same rate as face to face visits

Through the passage of “An Act Promoting a Resilient Health Care System that Puts Patients First”, Massachusetts has signaled that they will continue to support the expansion of telehealth services beyond the COVID-19 pandemic. This Act expands upon the emergency orders to require that insurers provide coverage for health care services that are delivered via telehealth, provided the services would have been covered if they were performed in-person and the services are an appropriate use of telehealth, plus more.

Research into telehealth indicates that patients are largely satisfied with the ease and quality of care, and the adoption of telemedicine services is only expected to grow. Since physicians are held to the same standard of care regardless of whether they are practicing via telehealth or in-person visits, it is recommended that doctors carry insurance that specifically covers telemedicine. If you are unsure, consult with your insurance broker.

Malpractice Insurance Rates for Massachusetts Doctors

Despite the enactment of several tort reform policies, rates for medical malpractice insurance are high for Massachusetts providers. See below for approximate rates across all territories for limits of $1,000,000 Each Claim/$3,000,000 Aggregate. The minimum required limits of liability for some practices and specialties in Massachusetts is $100,000 Each Claim/ $300,000 Aggregate. Speak with a qualified broker about rates for your specific needs.

Specialty Approximate Rate Minimum Rate Maximum Rate
Anesthesiology $15,000 $9,000 $20,000
Cardiovascular Disease Minor Surgery $19,000 $11,000 $23,000
Emergency Medicine $28,000 $18,000 $34,000
Family Practice No Surgery $13,000 $7,000 $15,000
General Surgery $41,000 $18,000 $53,000
Internal Medicine No Surgery $13,000 $8,000 $16,000
Neurology No Surgery $17,000 $10,000 $19,000
Obstetrics and Gynecology Major Surgery $71,000 $29,000 $105,000
Occupational Medicine $7,000 $5,000 $8,000
Ophthalmology No Surgery $8,000 $5,000 $12,000
Orthopedic Surgery No Spine $35,000 $18,000 $49,000
Pathology No Surgery $11,000 $6,000 $15,000
Pediatrics No Surgery $10,000 $9,000 $15,000
Psychiatry $8,000 $5,000 $12,000

Tort Reform in Massachusetts

Like all states, Massachusetts has enacted several tort reform policies in an effort to stabilize the medical malpractice insurance landscape and reduce malpractice litigation. Notable tort reform in the state includes:

  • The Health Payment Reform Act, also known as the “Disclose, Apologize, and Offer” Law, which was passed in 2012. Under this law, doctors are encouraged to tell patients when a medical mistake has happened, apologize for the mistake, and offer a reasonable settlement to resolve the matter. Payments made under this system are not reported to the National Practitioner Data Bank. If the situation is not resolved and is taken instead to court, the physician’s apology is inadmissible as evidence of admission of guilt.

  • A tribunal consisting of a judge, an attorney, and a physician must examine the preliminary evidence in every medical malpractice case in the state to determine if there is sufficient evidence to proceed with the claim. According to the Massachusetts Medical Society, tribunals screen out approximately 16% of all medical malpractice cases in Massachusetts.

  • Limits on plaintiff attorney’s fees are set at 40 percent of the first $ 150,000 recovered, 33 1/3 percent of the next $ 150,000 recovered, 30 percent of the next $ 200,000 recovered, and 25 percent of any amount exceeding $ 500,000.

  • Caps on noneconomic damages

Massachusetts’s Damage Caps on Medical Malpractice Lawsuits

The current caps on medical malpractice damages in Massachusetts as of 2021 are:

  • Economic damages (reimbursement for out-of-pocket losses resulting from the injury) are NOT capped

  • Noneconomic damages (reimbursement for pain and suffering, loss of life enjoyment, etc.) are limited to $500,000

It is important to note that in cases where there is a “substantial or permanent loss or impairment of a bodily function or substantial disfigurement or other special circumstances that would warrant a finding that imposition of such limitation would deprive plaintiff of just compensation for injuries”, plaintiffs CAN be awarded more than $500,000.

Statute of Limitations for Medical Malpractice Claims

The major guidelines regarding the state’s medical malpractice statute of limitation are as follows:

  • An individual in Massachusetts is required to file a medical malpractice claim within three years from the date of injury or date of discovery (or date of reasonable discovery)

  • If the patient is receiving ongoing treatment from the defendant provider for the same medical condition, the three-year deadline starts when the patient actually knows the defendant’s negligence was the cause of injury (the discovery rule does not apply)

  • For minors younger than 6 at the time of injury, lawsuits can be filed up until the minor’s 9th birthday

  • For minors 6 or older at the time of injury, the three-year deadline applies

  • The three-year statute of limitations can be paused in cases where the patient is incapacitated by mental illness, the defendant provider is living out of state, or if the defendant provider fraudulently hides the negligent action

  • The state’s statute of repose mandates that under most circumstances, a lawsuit must be filed within seven years after the date of injury

In addition to filing a malpractice claim within the designated time period, plaintiffs must also submit an “offer of proof” to a three-person medical malpractice tribunal in order to proceed with the lawsuit. The offer of proof must provide evidence that the defendant provider did not meet the appropriate standard of care and the patient was harmed as a result. If the tribunal rules there isn’t sufficient evidence to take the claim to court, the patient is required to post a bond of $6,000 in order to proceed with the lawsuit.

Tail Insurance in Massachusetts

Doctors practicing in Massachusetts that have a claims-made policy but DON’T have Prior Acts insurance (also known as Nose Coverage) need a tail insurance policy to ensure that they’re protected from malpractice claims when changing jobs. Your exposure period begins with your retroactive date (the first date of employment with your last employer) and ends on the policy cancellation date (your last day seeing patients at that job). If a claim is made after your policy expires, tail malpractice insurance will protect you. Often before you begin a new job, your new employer will want to confirm you have tail coverage from your prior job. To get the best rates on tail insurance in Massachusetts, contact a broker before you notify your employer of your resignation.

When and why is tail insurance necessary?

When a physician ends their employment, their insurance coverage with that employer also ends. Because most liability policies are underwritten on a claims-made basis, if a claim is filed against you after you leave your employer and your insurance coverage has already ended, you can be exposed to a lawsuit. 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 options for tail insurance.

Medical Malpractice Insurance Outcomes in Massachusetts for 2020

The total medical malpractice payout in Massachusetts for 2020 was $127,447,300.

Closing Remarks

Massachusetts is home to numerous medical centers and several top hospitals in the nation, including Mass General and Brigham and Women’s Hospital. Massachusetts residents have great access to high quality healthcare at an affordable price – the state’s Department of Public Health reports that 98% of residents are covered by insurance, more than any other state in the country.

Doctors in the state are also paid well. The top 4 of the 10 highest paid jobs in Massachusetts are in the medical field, with the Bureau of Labor Statistics reporting that surgeons, ob/gyns, anesthesiologists, and family medicine physicians are the highest paid professions in the state. Psychiatrists, dentists, and nurse anesthetists also make their way onto the top 10 list. Still, physicians practicing in Massachusetts must battle with expensive premiums for medical malpractice insurance, and some argue that further tort reform is needed to retain top medical talent.

MEDPLI helps doctors from all specialties. Whether you are a plastic surgeon in Boston, a radiologist in Worcester, or a urologist in Springfield, we can help you find medical malpractice insurance. To get coverage from an A-rated carrier, contact us by requesting a quote.