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Texas Medical Professional Liability Insurance Market Summary

Doctors in Texas have a handful of good options for medical malpractice insurance. The top insurers are:

  • The Doctors Company

  • Medical Protective (MedPro)

  • TMLT

  • Norcal Mutual Insurance Company

  • ProAssurance Insurance Group

These companies are regarded as the best insurers in Texas because of their A-rating from A.M. Best, their long-term financial solvency, and their history of successfully defending Texan physicians.

Obtaining insurance from an A-rated company is always recommended. Take the example of Capson Physicians Insurance, which did not have an A-rating. The company had at one time been a rising star in the medical liability insurance industry, but it went into receivership in 2019 after 3 years of operating losses. When this happened, its policyholders had to scramble to secure replacement coverage.

While Capson was not A-rated by A.M. Best, at least the company was admitted and participated in the Texas Property and Casualty Insurance Guaranty Association. The TPCIGA protects Texans that obtain malpractice insurance from licensed insurers for up to $300,000 per claim if their medical malpractice carrier becomes insolvent.

Each carrier uses its own proprietary methods of setting rates, causing rates to vary between carriers and specialties. Most of the top carriers offer common policy limits selected by Texas physicians: $200,000 Each Claim/ $600,000 Aggregate; $500,000/$1,500,000; and $1,000,000/$3,000,000. The first dollar of coverage is the most expensive to insure.

Malpractice Insurance Rates for Texan Doctors

Insurance rates for doctors practicing in Texas are well below the national average due to Texas’ tort reform and caps on damages. Doctors practicing in the following Texas locations pay more than those in most other localities: Houston (Harris County), El Paso (El Paso County), Brownsville (Cameron County), McAllen (Hidalgo County), Laredo (Webb), and other locations with a higher claims frequency or severity.

Note that insurance companies consider location, specialty, and past claims history when they set the rates for a physician’s malpractice insurance policy. Every policy is underwritten on a case-by-case basis, but the following estimates will give you an idea of costs by specialty. Reach out to a broker like MEDPLI to get an exact quote from multiple carriers.

See below for approximate rates across all territories for limits of $200,000 Each Claim/$600,000 Aggregate (the minimum limits of liability for most medical facilities in Texas).

Specialty Approximate Claims Made Rate Approximate Tail Rate Approximate Occurrence Rate
Anesthesiology $9,000 $18,000 $10,800
Cardiovascular Disease Minor Surgery $11,000 $22,000 $13,200
Emergency Medicine $14,000 $28,000 $16,800
Family Practice No Surgery $8,000 $16,000 $9,600
Gastroenterology Major Surgery $12,000 $22,000 $14,400
General Surgery $23,000 $46,000 $27,600
Internal Medicine No Surgery $8,000 $16,000 $9,600
Neurology No Surgery $9,000 $18,000 $10,800
Obstetrics and Gynecology Major Surgery $29,000 $58,000 $34,800
Ophthalmology Major Surgery $8,000 $16,000 $9,600
Orthopedic Surgery No Spine $19,000 $38,000 $22,800
Pathology No Surgery $7,000 $14,000 $8,400
Pediatrics No Surgery $8,000 $16,000 $9,600
Psychiatry $7,000 $14,000 $8,400
Radiology – Diagnostic $9,000 $18,000 $10,800

Medical Malpractice Insurance Requirements for Texas in 2023

Texas does not legally require physicians to carry medical malpractice insurance to work. However, hospitals and other facilities may mandate providers have malpractice insurance in order to work there. Though tort reform did reduce liability for medical providers in Texas, medical malpractice insurance can still protect physicians from damages in the event of a lawsuit.

Because Texas has relatively low liability limits compared to other states, you may not need as much coverage. The minimum coverage most facilities require is $200,000 Each Claim/$600,000 Aggregate, with some facilities in south Texas only requiring $100,000 Each Claim/$300,000 Aggregate. High-risk specialties like surgeons and OB/GYNs will need more coverage.

Medical Malpractice Insurance and COVID-19 in Texas

The latter half of 2020 saw mounting numbers of coronavirus cases in Texas, and it was considered one of the worst-hit states as of August 2020.

The Texas healthcare system – already suffering from a doctor shortage – has become even more strained by COVID-19. While Texas remains in a state of emergency related to the pandemic, on October 11, 2021, Texas Governor Greg Abbott issued Executive Order GA-40, banning COVID-19 vaccine mandates by any entity, including private employers, in Texas. It follows a previous Executive Order which had already banned COVID-19 vaccine mandates by government agencies, cities, counties, and school districts in Texas. As of late October 2021, approximately 53% of Texans have been fully vaccinated.

Given the emergency nature of the situation, the severity of symptoms caused by COVID-19 and the increase of patients needing medical care, it is recommended now more than ever that Texan physicians be covered by medical malpractice insurance.

Telemedicine in Texas

Across the United States, Telemedicine is becoming more popular. The increase in popularity is in part due to COVID-19, but Telemedicine is expected to remain an ideal form of treatment after the impact of the coronavirus subsides.

In 2017, Texas amended their state law to define telemedicine as “a health care service delivered by a physician licensed in this state, or a health professional acting under the delegation and supervision of a physician licensed in this state, and acting within the scope of the physician’s or health professional’s license to a patient at a different physical location than the physician or health professional using telecommunications or information technology.” This expanded the meaning of telemedicine and made it easier for doctors to treat patients through telecommunications.

Additional provisions of the 2017 Texas law have made it so that:

  • There is no requirement that blanketly requires an in-person examination of a patient in connection with a telemedicine visit

  • Doctors must uphold an applicable standard of care with their telemedicine patients

  • Doctors must establish a practitioner-patient relationship with their telemedicine patients

  • If you are treating patients in Texas via telemedicine, you must be licensed to practice medicine in Texas

  • Texan physicians must obtain informed consent from telemedicine patients before telemedicine services take place

  • Texan doctors must provide telemedicine patients with privacy policy information, confidentiality information and notices regarding the complaint process for any alleged misconduct

Doctors treating patients via telephone or video call are subject to the same liability as doctors meeting with patients face-to-face. It is recommended that doctors carry insurance that specifically covers telemedicine.

Tort Reform in Texas

In 2003, Texas passed significant tort reform for medical malpractice lawsuits. Among other things, the reform put a cap on damages for pain and suffering. Plaintiffs can now only collect a maximum of $250,000 in damages for pain and suffering from individual doctors (they can collect a maximum of another $250,000 from each healthcare facility involved in the injury).

The effect of tort reform in Texas has been an influx of doctors from all specialties, as well as lower insurance premiums.

Damage Caps on Medical Malpractice Lawsuits for Texas

Non-economic damage caps for medical malpractice lawsuits in Texas are set at $250,000 for individual healthcare providers and $250,000 for each medical facility involved in their injury. There is an overall cap of $500,000 per plaintiff when it concerns how much they can collect from the total amount of medical facilities they sue.

There is no limit on the amount of compensation a plaintiff can recover for economic damages in Texas. Economic damages can include:

  • Medical costs for surgeries, physicians’ appointments, prescription medications and medical equipment

  • Lost wages due to the injury

  • Lost earning capacity if the injury is permanently debilitating or makes it impossible for you to continue working

Statute of Limitations for Medical Malpractice Claims

The statute of limitations in Texas for medical malpractice claims are as follows:

  • Typical negligence and injuries carry a 2-year statute of limitations. This starts the date the harm was discovered or could reasonably have been discovered.

  • If the injury occurred as part of a continuing course of healthcare treatment, the two years does not start running until the treatment is concluded.

  • Lawsuits filed on behalf of children under 12 years old must be filed by their 14th birthday.

  • Given various court rulings, there is some confusion over the true statute of limitations for minors. It is generally believed that the 2-year statute of limitation for minors will not begin to run until they legally become an adult (18-years-old).

  • Texas’ statute of repose mandates that patients must file a lawsuit for medical errors within 10 years; if no lawsuit is filed before the 10 years runs out, they can no longer bring a claim.

Tail Insurance in Texas

If you are a physician practicing in Texas with a claims-made policy and you DON’T have Prior Acts insurance (also known as Nose Coverage), having tail insurance will ensure you’re protected if you change jobs. Tail insurance covers the gap between your retroactive date with your former employer to your start date with your new employer. To get the best rates on tail insurance, 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 and before the policy with your new employer kicks in. Tail insurance covers you during that interim time. Read more about tail malpractice insurance.

Medical Malpractice Insurance Outcomes in Texas for 2022

The total medical malpractice payout in Texas for 2022 was $95,130,100.

Closing Remarks

Tort reform has made Texas a very friendly state for doctors, and it offers some of the lowest medical malpractice insurance rates in the country. There is currently a physician shortage in Texas, especially primary care doctors and OB/GYNs. Areas most severely impacted by the doctor shortage are rural locations, though cities are also somewhat impacted. This shortage has led to higher than the national average salaries for Texas doctors.

If you’re a physician working in Texas and looking for medical malpractice insurance, reach out to MEDPLI. Whether you’re an endocrinologist in Dallas, a surgeon in Austin, or an OB/GYN in Houston, we can help you obtain coverage from an A-rated carrier.