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South Carolina Medical Professional Liability Insurance Market Summary

Doctors in South Carolina have several good options for medical liability insurance. The best insurers in the state are:

  • The Doctors Company

  • Aspen American Insurance Company

  • Medical Protective

  • MagMutual

  • ProAssurance

  • Coverys

These companies have proven to provide robust financial and legal support for doctors, and all have an A-rating from A.M. Best.

These carriers use proprietary methodologies to set rates and there is no set standard rate across insurers for each specialty. However, South Carolina physicians tend to buy policies with $1,000,000 a claim/$3,000,000 aggregate per year in coverage. Currently, the medical malpractice insurance market in South Carolina is moderate and stable.

Historically, medical providers in South Carolina have experienced a market that mirrored the national market, with a crisis in the 1970s that resulted in the creation of the South Carolina Medical Malpractice Patient Compensation Fund (PCF).The PCF required a physician to carry minimum coverage of $200,000 per claim and $600,000 annual aggregate of all claims, with primary coverage paid by the PCF for any verdict in excess of the underlying. In addition, a Joint Underwriting Association was established to help regulate premiums by providing insurance to physicians who are unable to obtain affordable insurance in the marketplace.

In 2020, the South Carolina General Assembly combined the JUA and the PCF’s $88 million deficit into a new organization called the South Carolina Medical Malpractice Association (SCMMA), resulting in a levy of 2%-6% of net direct written premiums on all medical liability insurers. The money collected with this legislation will be used to reduce SCMMA’s deficit and is expected to continue until the deficit is retired. It remains to be seen how this change will impact the malpractice insurance market.

Medical Malpractice Insurance Requirements for South Carolina in 2020

Medical professionals in South Carolina are not required to obtain malpractice insurance. However, hospitals and other healthcare facilities may mandate that physicians carry medical malpractice insurance while working in their facility. The average physician requirement for coverage by South Carolina medical facilities is $1,000,000 per claim, $3,000,000 per year.

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

Medical Malpractice Insurance and COVID-19 in South Carolina

The state confirmed its first positive cases of COVID-19 in the state on March 6, 2020. On March 16, a nursing home patient was reported as the first virus-related death. In early April, Governor Henry McMaster ordered all non-essential businesses to be closed temporarily, with a home or work order and social distancing guidelines issued shortly after that. Despite being criticized for ranking last in the country for testing ability, on May 4, Governor McMaster lifted the home or work order and businesses moved to the first phase of reopening, with further restrictions lifted throughout the summer of 2020. The state reached its peak positive cases in late July 2020.

During this time, the state’s Medical Surge Planning Team developed a plan to expand hospital capacity by 3,000 beds for a total of roughly 9,000 beds for peak surge timing, identifying eighteen facilities for potential use as alternate care sites. As of late December 2020, nearly 80% of all ICU beds in South Carolina were filled from the second wave of cases, and the state was experiencing its highest number of cases yet.

With the symptoms of COVID-19 varying from patient to patient, the risk of misdiagnosis is high. It is recommended that any physician practicing medicine in North Carolina during the COVID-19 public health emergency be protected by medical malpractice insurance.

Telemedicine in South Carolina

As with many states, the COVID-19 pandemic rapidly threw providers into the deep end of the telehealth pool. Medicaid and private payers are starting to adjust their policies in response to the increased need for telemedicine. Notably, providers who want to utilize telehealth technology during the pandemic can request free access to a state-endorsed open-access telehealth network. In addition, providers are permitted to use platforms such as Skype, Facebook Messenger, and Apple FaceTime to conduct virtual visits.

The South Carolina Telehealth Alliance (SCTA) exists as a collaboration of many statewide organizations that provides guidance on telemedicine development, technology, and standards. The SCTA encourages the adoption of telehealth at medical facilities across the state in response to the COVID-19 pandemic to limit vulnerable patients’ exposure to areas where there is greater opportunity to come into contact with the virus.

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.

Malpractice Insurance Rates for South Carolina Doctors

Rates in South Carolina are moderate compared to the rest of the country and lower than in some of its surrounding states. 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 South Carolina).

Specialty Approximate Rate Minimum Rate Maximum Rate
Anesthesiology $13,000 $9,000 $18,000
Cardiovascular Disease Minor Surgery $17,000 $11,000 $22,000
Emergency Medicine $24,000 $17,000 $28,000
Family Practice No Surgery $10,000 $7,000 $12,000
General Surgery $37,000 $17,000 $47,000
Internal Medicine No Surgery $11,000 $8,000 $13,000
Gastroenterology No Surgery $12,000 $9,000 $16,000
Obstetrics and Gynecology Major Surgery $52,000 $29,000 $95,000
Occupational Medicine $7,000 $5,000 $9,000
Ophthalmology No Surgery $7,000 $4,000 $10,000
Orthopedic Surgery No Spine $31,000 $17,000 $50,000
Pathology No Surgery $10,000 $6,000 $12,000
Pediatrics No Surgery $10,000 $7,000 $12,000
Psychiatry $7,000 $5,000 $9,000
Radiology – Diagnostic $13,000 $9,000 $16,000

Tort Reform in South Carolina

South Carolina began reforming its medical liability system in 1976 with the South Carolina Medical Malpractice Patient Compensation Fund, followed by The South Carolina Tort Reform Act of 2005. This legislation created policy around medical malpractice law which is still followed today:

  • Non-economic damage caps were set at $350,000 with some exceptions provided for gross negligence or destruction of medical records

  • Plaintiffs must serve a Notice of Intent to Sue to all potential defendants

  • Plaintiffs must file an “affidavit of an expert witness” specifying the negligent act(s) signed by an expert who meets the court outlined standards of a qualified professional

  • Parties involved in a potential medical malpractice lawsuit must participate in a mediation in an attempt to resolve the dispute before the suit is filed

  • In instances where non-economic damages are awarded, punitive damages cannot exceed the greater of three times the amount awarded to each claimant or $500,000

  • Joint and several liability does not apply for a defendant whose conduct is determined to be less than fifty percent of the total fault

In 2019, the state passed a bill merging the South Carolina Patient Compensation Fund noted above with the South Carolina Joint Underwriting Association (JUA) into a new organization called The South Carolina Medical Malpractice Association (SCMMA).

South Carolina’s Damage Caps on Medical Malpractice Lawsuits

The state joined many others across the country when it passed the South Carolina Noneconomic Damage Awards Act of 2005, which placed a cap on non-economic damages. Non-economic damages include things like emotional distress, pain and suffering, depression, anxiety, and various other non-financial losses. For the state of North Carolina:

  • There is a $350,000 cap on non-economic damages in any medical malpractice case against a single care provider or institution.

  • For a judgment against multiple defendants, total non-economic damages can’t exceed $1.05 million, however, for each single provider or institution names in the suit the damage cap on non-economic damages still applies at $350,000

There are no caps on economic damages in the state. Economic damages include things like past and future medical bills and expenses, funeral expenses, and lost wages.

Statute of Limitations for Medical Malpractice Claims

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

  • An individual in South Carolina is required to file a medical malpractice claim within three years from the date of injury

  • If the injury is not discovered within the three-year deadline, the claim must be filed within three years of the discovery (or when it should have been discovered) with no more than six years passing from the date the injury was caused

  • In cases where a foreign object was left in the body, a medical malpractice claim must be filed within two years of the date of discovery and the six-year deadline does not apply

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

  • Claims filed by or on or behalf of minors must be filed within seven years after the date of injury or by their 19th birthday

Tail Insurance in South Carolina

Doctors practicing in South Carolina 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 South Carolina, 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 South Carolina for 2019

The total medical malpractice payout in South Carolina for 2019 was $40,217,250.

Closing Remarks

South Carolina has plenty of career opportunities for medical providers. Like many states across the country – and especially in the south – the Palmetto State is facing a projected physician shortage. For many years, there was only one medical school in the state, and incentives to attract new doctors from other states have had mixed results. In addition, doctors are working fewer hours than they did a generation ago, and more than a third of all practicing doctors will be 65 or older in the next decade, growing closer to retirement.

According to the University of South Carolina School of Medicine Greenville, every county in South Carolina is designated as medically underserved, with Oconee, Anderson, Laurens, Pickens, and Spartanburg counties considered to be shortage areas for primary-care doctors. “Even in medical hubs like Greenville, there are shortages of a variety of specialists, from endocrinologists and neurologists to rheumatologists and psychiatrists”.

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