Last year marked the seventh in a row that medical liability premiums continued to trend upward—a sustained trajectory hasn’t been seen since the early 2000s.
While no one is declaring that a national hard market has emerged—and annual growth in premiums in 2025 wasn’t as dramatic as in 2024—certain states are seeing notable premium surges and patient access to care could suffer if this pattern continues. According to a newly published AMA Policy Research Perspectives report (PDF), there are some clear trends emerging.
For a deeper dive on the latest in legislative trends, research and advocacy efforts on medical liability reform, tune into the AMA’s May 20 webinar on the subject. Learn more and register now.
In the meantime, here are a few nuggets from the 2025 report worth keying in on.
Nearly 40% of reported premiums rose. Excluding last year when nearly half of reported premiums increased, 2025 marked the highest rate since 2005 when 65.5% of reported premiums rose.
Overall, 36 states reported at least one premium increase last year. That is comparable to levels seen between 2021 and 2023, but below the 46 states that reported at least one premium increase in 2024.
There were 18 states where at least half of the reported premiums rose, similar to numbers in recent previous years.
There were 11 states where at least one reported premium grew by 10% or more. The previous year, 16 states experienced that increase and in 2023, 11 states saw notable premium increases.
Generally speaking, reported premiums for obstetrics and gynecology and general surgery were significantly higher than for internal medicine, in line with the higher liability risks those first two specialties face. For example, premiums for ob-gyns and general surgeons are $243,988 in Florida, while the reported rate for internists there is $59,736.
Across all three specialties studied, reported premiums were significantly lower in California than in other states. This is likely driven by California’s law enacting caps on noneconomic damages. The average premium was unchanged in California between 2024 and 2025, as was the case between 2021 and 2022. There was a 1.5% increase in 2023 and 2024 and an 11.6% average rise between 2022 and 2023 when the cap limit increased.
The recent premium increases are not as dramatic as they were 20 years ago, when increases were even more prevalent and larger and “whether this upward trajectory will worsen in the near future remains to be seen,” according to the report. “However, if the trend continues, it could negatively impact patients’ access to care.”
Some states see hard-market conditions
While the overall medical liability insurance environment is not a hard market, the same cannot be said in every state. For example, Illinois has seen considerable premium spikes since 2020, and Pennsylvania has experienced a similar surge since 2023.
Here are the 11 states, along with the share of reported premiums that saw increases of more than 10% in 2025:
- Pennsylvania—52.9%.
- Rhode Island—25%.
- Kansas—25.0%
- Utah—25.0%.
- South Carolina—20%.
- Kentucky—20%.
- Florida—19%.
- Georgia—12.5%.
- Illinois—9.7%.
- West Virginia—8.3%.
- New York—4.3%.
In addition to Illinois and Pennsylvania seeing these increases over multiple years, the AMA report notes that Kentucky, Florida and New York each had one or more premiums with an increase of at least 10% between 2023 and 2024 as well.
The AMA report uses new data published annually in Medical Liability Monitor, considered the most comprehensive source of data on medical liability insurance premiums from a national perspective.
Medical Liability Monitor annually surveys major U.S. liability insurers and reports manual premiums for obstetrics and gynecology, general surgery and internal medicine in each state where those insurers provide coverage.
The data directly compares how many premiums rose, fell or stayed the same from one year to the next and is a useful indicator of whether premiums in the aggregate have been changing, in which direction and by how much. The data doesn’t reflect all insurers or all physician specialties and are for manual premiums, which could be different than the final premiums physicians pay.
To protect patients’ access to physician care, the AMA is committed to keeping medical liability insurance premiums stable through its work with state and specialty medical associations and other stakeholders to pursue traditional and innovative medical liability reforms.
“Medical Liability Reform NOW!” (PDF) gives physicians the facts they need to address the broken medical liability system, including updates on state laws, innovative reforms, efforts to reform the system at the federal level and high-impact court cases at the federal and state levels.
Lawsuit frequency trends down
When it comes to the frequency of medical liability claims, the number continues to fall, according to a second new AMA Policy Research Perspectives report, “Medical liability claim frequency among U.S. physicians” (PDF).
In 2024, 1.8% of physicians reported that they were sued in the previous 12-month period, according to previously published research. On average, between 1991 and 2005, 7.4% of physicians were sued annually. Between 2007 and 2008, 5% of physicians were sued annually. In 2016, the figure was 2.3%.
“Physicians know the practice of medicine carries risk, and even highly skilled doctors face lawsuits,” said AMA President Bobby Mukkamala, MD. “But a claim does not mean a mistake was made. Most cases never find fault with the physician, and the majority are dropped or dismissed before trial. Doctors continue to take on complex, high-risk care because patients depend on it. However, the ongoing liability risk not only challenges physicians but it increases practice expenses, reinforces defensive medical practices, and drives up health care costs for patients and families.”
That downward trend has carried into the long-term exposure that physicians have to facing a medical liability lawsuit. By year, here is the share of physicians who reported having at least one medical liability claim filed against them at some point in their career:
- 2024—28.7%
- 2016—34%
- 2007–2008: 42.2%
But the AMA report notes that, “despite the declining trend in frequency, medical liability claims against physicians remain common, especially for certain subgroups.”
Physicians in surgical specialties, for example, faced the highest risk of facing a medical liability claim during their career. About 60% of ob-gyns were sued at least once in their career, while 53.1% of general surgeons faced a lawsuit at some point. Among ob-gyns and general surgeons who were 55 and older, that share jumps to nearly 75% for each specialty.
When it comes to gender, male physicians were more likely to face liability claims than female physicians over the short- and long-term, but the gap was present only among physicians 45 or older.
For example, 2.2% of male physicians were sued in the previous 12-month period, compared with 1% of female physicians. Longer-term, male physicians were nearly 15 percentage points more likely to face a claim at some point in their career than female physicians. However, the gaps shrunk by about half when factors such as age and specialty were controlled because, in part, because male physicians have on average been in practice longer and are more likely to practice in riskier specialties.
The report notes that being sued is not necessarily indicative of a medical error, with 65% of claims against physicians dropped, dismissed or withdrawn between 2016 and 2018. This AMA Policy Research Perspectives report was done by analyzing data from the biennial AMA Physician Practice Benchmark Survey.
