Top 7 Medical Malpractice Insurance Carriers in Iowa
We recommend carriers with an AM Best “A” or higher rating. An A-rating indicates financial strength, long-term solvency, and an established history of protecting Iowa physicians.
- The Doctors Company
- Professional Solutions Insurance Co (PSIC)
- Medical Protective
- Coverys Group
- CURI Group
- ProAssurance
- COPIC Group

2025 Iowa Malpractice Insurance Rates by Specialty
These rate estimates are for informational purposes only and are based on the IA standard limits of $1,000,000 per claim / $3,000,000 aggregate per year in coverage.
Quotes require a completed application and approval from the underwriter. Contact us for a custom estimate if you don’t see your specialty.
Specialty | 2025 Annual Premium |
2025 Tail Premium |
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Anesthesiology | $14,000 | $28,000 |
Cardiovascular Disease– Minor Surgery | $15,000 | $30,000 |
Dermatology– No Surgery | $7,000 | $14,000 |
Emergency Medicine | $22,000 | $44,000 |
Family Practice– No Surgery | $10,000 | $20,000 |
Gastroenterology– No Surgery | $14,000 | $28,000 |
General Practice– No Surgery | $10,000 | $20,000 |
General Surgery | $29,000 | $58,000 |
Internal Medicine– No Surgery | $10,000 | $20,000 |
Neurology– No Surgery | $11,000 | $22,000 |
Obstetrics and Gynecology– Major Surgery | $48,000 | $96,000 |
Occupational Medicine | $7,000 | $14,000 |
Ophthalmology– No Surgery | $7,000 | $14,000 |
Orthopedic Surgery– No Spine | $27,000 | $54,000 |
Pathology– No Surgery | $8,000 | $16,000 |
Pediatrics– No Surgery | $9,000 | $18,000 |
Pulmonary Disease– No Surgery | $12,000 | $24,000 |
Psychiatry | $7,000 | $14,000 |
Radiology – Diagnostic | $15,000 | $30,000 |
Iowa Medical Malpractice Payouts From 2015-2024
The Hidden Link Between Weather Disasters and Rising Malpractice Insurance Rates
When floods, derechos, and other severe weather events hit, the damage goes beyond the physical. These disasters drive up insurance costs across the board. As severe weather events become more frequent, insurers are raising rates to account for growing risks, impacting homeowners, businesses, and medical professionals.
Why Are Insurance Rates Rising?
How Iowa’s Medical Malpractice Rates Are Impacted
Reinsurance providers are increasing their charges and tightening payout terms. In response, primary insurers, including those that offer medical malpractice coverage, are increasing premiums. According to a recent report by the American Medical Association, 46 states, including Iowa, experienced at least one medical malpractice premium increase in 2024.
Severe weather isn’t just a coastal problem; it’s reshaping insurance costs for everyone, especially physicians.
Types of Professional Liability Insurance for Iowa Physicians
Types of Professional Liability Insurance for Iowa Physicians
Doctors in Iowa can choose between these two primary types of medical malpractice insurance:

- Provides coverage for incidents that occurred during the policy period, IF the claim is filed while the policy is still active. If a claim is filed after the policy has ended, that claim is NOT covered.
- Typically, it offers lower premiums at the start of the policy, but rates increase yearly as the policy matures.
- Physicians must obtain tail insurance coverage when a claims-made policy ends to ensure protection against future claims related to incidents that occurred during the policy period. Tail insurance premiums require a one-time cash payment to the expiring carrier equal to approximately 200% of the claims-made policy’s annual premium.
- Iowa physicians may purchase nose coverage, or prior acts coverage, instead of tail coverage. Nose coverage can be purchased through a new carrier to protect physicians from claims that occurred before the effective date of the new policy, back to a specified date.

- Provides coverage for incidents that occurred during the policy period, regardless of when a claim is reported to the carrier.
- Typically, it offers more costly premiums at the start of the policy, but the rate stays constant throughout the policy’s duration.
- Physicians do not need tail coverage when an occurrence policy ends.
In 2024, Iowa physicians were held liable for 67 medical malpractice payouts.
- Average Payout: $582,268
- Total Payout: $39,012,000
(Source: National Practitioner Data Bank)
Does Iowa Have Damage Caps for Medical Malpractice Lawsuits?
Iowa Code 147.136 sets a $250,000 non-economic damages limit, except in cases involving substantial harm or death, where $250,000 would not be considered “just compensation.” In such cases, the cap increases to $1 million, or $2 million if a hospital is named as a defendant.
Key Rules & Exceptions
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- Non-Economic Damages Definition: These include pain and suffering, inconvenience, physical impairment, mental anguish, loss of consortium, or other non-monetary losses.
- Economic Damages: Iowa does not cap damages for quantifiable losses such as medical bills or lost income.
- Punitive Damages: Not capped when the injury or death results from willful and wanton disregard for the patient’s safety.
- Actual Malice: The caps do not apply if the “defendant’s actions constituted actual malice.”
- Loss of Dependent Care: The loss of dependent care – including child care – due to the death or severe injury of a primary caretaker falls under economic damages, so damages for this type of loss are not capped.
- Annual Cap Increases: Beginning in 2028, the $1M and $2M caps will rise 2.1% annually.
- Expert Witness: Most cases require an expert affidavit. The expert must be licensed and in good standing in the same or a similar specialty as the defendant, and must attest that the standard of care was breached.
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Iowa Statute of Limitations for Medical Malpractice Claims
Iowa Code 614.1 states that a medical malpractice claim must be filed within 2 years of when the claimant knew – or reasonably should have known – about the injury, or when they received written notice of the injury’s existence, whichever occurs first. A few key exceptions apply:
- Statute of Repose: No claim can be brought more than six years after the date of the alleged malpractice action resulting in injury or death, regardless of the date of discovery.
- Foreign Object: If a foreign object is unintentionally left in a patient’s body, the statute of repose does not apply.
- Minors: If the plaintiff was under age 8 at the time of the alleged malpractice, they have until their 10th birthday or the end of the applicable statute of limitations or repose period, whichever is later, to file a claim.
How Iowa’s Malpractice Laws Have Evolved
- 1970s: A nationwide medical malpractice crisis emerged, characterized by a sharp increase in claims and skyrocketing insurance premiums. States, including Iowa, began enacting tort reform measures in response.
- 1982: Iowa adopted a pure comparative fault system, allowing plaintiffs to recover damages reduced by their percentage of fault, even if they were primarily responsible.
- 1984: The law was revised to a modified comparative fault standard. Plaintiffs are not barred from recovering damages if they are found 51% or more at fault.
- 2017: $250,000 non-economic damage “soft” cap enacted. However, in cases involving substantial or permanent injury or death, juries retained the discretion to award unlimited non-economic damages.
- 2023: House File 161 sets a hard cap of 1 million dollar cap for non-economic damages in all cases, including those involving death or permanent injury. The cap increases to $2 million when a hospital is named as a defendant.
- 2028: Non-economic damage caps will begin increasing annually by 2.1%, adjusted for inflation.
Is Iowa a Physician-Friendly Place to Practice?
Iowa consistently ranks among the best states to practice medicine. It offers some big advantages for physicians:
However, Iowa is facing one of the most dire physician shortages in the nation, with many physicians retiring and others citing burnout and administrative burden as factors for leaving the profession.
Iowa doctors are also not immune to the nationwide increase in malpractice premiums. They can benefit from working with a knowledgeable malpractice insurance broker to manage rising costs. MEDPLI helps physicians find the right coverage at the best possible rate, bringing peace of mind through malpractice market uncertainty.
Idaho Doctors Partner with MEDPLI
We exclusively broker medical malpractice insurance, focusing daily on making the professional liability process less burdensome and expensive for doctors.
With MEDPLI, Iowa physicians:
MEDPLI helps doctors in every specialty.
Whether you’re an Orthopedic Surgeon in Des Moines or an Internist in Dubuque, MEDPLI will find you premier coverage at a competitive rate.
Call 800-969-1339 or Request a Quote.