Yesterday the New England Journal of Medicine released a study on the rates and payments of medical malpractice claims submitted by patients to doctors’ insurance companies. The study found that most claims are dropped without payment. This study has reiterated two points we already know: insurance companies deny far more medical malpractice claims than they pay out and doctors’ perceptions of medical malpractice claims are not in line with actual risk.
The study found that the majority of the largest groups of doctors - internal medicine, family medicine and pathology - will never make a malpractice payment in their lifetime. In fact, for all low risk specialties, 81 percent of physicians never paid a malpractice claim. Additionally, 95 percent of low risk specialty and 67 percent of high risk specialty physicians would not make a payment during the first half of their medical career. Despite the low risk of having a patient file a malpractice claim, most physicians perceive their risk to be much greater than it actually is.
There are also two important points to make about what this study does not do. The researchers only analyzed data from closed claims from one major insurance company. This study did not look at the rate or frequency of medical malpractice lawsuits. This is an important distinction because there is a big difference between a claim and a lawsuit. A claim is filed by a patient with an insurance company, while a lawsuit is filed in a court. The researchers’ use of “lawsuit” and “claim” interchangeably creates confusion, but the two are completely different. Many patients file a claim with an insurance company without filing a lawsuit. In fact, patients who are injured in the course of medical care often have to file a claim just to see what went wrong. These claims do not always lead to lawsuits.