A small percentage of doctors commit the majority of medical malpractice. All the while, medical malpractice insurance companies continue to defend the blatant cases of medical malpractice and deny responsibility for preventable patient injury and death. Over these past several years, under the guise of doctors leaving their practices or medical malpractice claims being out of control, the right to hold careless doctors and hospitals accountable for wrongdoing has been limited. No longer are bad doctors and hospital staff responsible for all the harm inflicted on innocent patients.

As predicted,limiting patient rights and protecting careless doctors and hospitals will not make it any safer for consumers. Also, it has been shown that the medical malpractice insurance companies are making record profits and not passing those savings along to the good and deserving doctors.

Recently, the Florida Justice Association addressed the myth of the so-called "medical malpractice crisis." As medical malpractice and personal injury lawyers, we consider it our duty to properly inform our clients and friends of the truth when it comes to the vital issues of health care and patient rights. The information provided demonstrates that (1) there is no medical malpractice crisis (2) doctors are not leaving Florida and (3) the medical malpractice insurance companies are making record profits at the expense of their own doctors.

You must remain even more vigilant when you or your family receives health care. As we have warned before:

• ASK QUESTIONS
• CHECK ALL PRESCRIPTIONS TO ENSURE ACCURACY and
• INVESTIGATE ALL UNFAMILIAR DOCTORS BEFORE UNDERGOING ANY MAJOR PROCEDURE.

As you can see from the facts outlined below, the citizens of Florida including doctors and patients have suffered at the hands of medical malpractice insurance companies:

1. Medical Malpractice Insurance is Available

• "From January 1, 2004 to present eighteen (18) 'new' companies entered the Florida med-mal market. 'New' companies can either be a start-up company, a company operating in another state expanding to Florida, or an established company already writing in Florida that expanded its lines of business to include medical malpractice insurance."
  (Medical Malpractice Financial Information Closed Claim Database and Rate Filings. Florida Office of Insurance Regulation 2005 Annual Report, October 1, 2005)
  
  
• Competition in the medical malpractice insurance marketplace is returning to Florida. In the past three years several new carriers have come to Florida, including Florida Doctors Insurance Co. Inc., Florida Healthcare Providers Insurance Exchange, Healthcare Underwriters Group of Florida, PIC-Florida and Pediatricians Insurance RRG of America. All of these companies aim to pick up policies from First Professionals Insurance Co. (FPIC), which in 2004 controlled 25 percent of the market. These new firms offer similar coverage to that sold by FPIC.
  ("New Med Mal Company Brings More Choices to Florida." Crittenden's Medical Insurance News, January 16, 2006)
  
  
• "Florida falls in the top 4 market share for all eleven writing companies. Medical malpractice line of business represents a significant portion of the direct written premium for a majority of the companies."
  (Medical Malpractice Financial Information Closed Claim Database and Rate Filings. Florida Office of Insurance Regulation 2004 Annual Report, October 1, 2004)

2. Medical Malpractice Insurers Making BIG Profits in Florida

• "Profits for most carriers are soaring. While they face fewer claims and, with reserve redundancies in place, stockholders are being rewarded with dividends and growing stock values. Look for this to put increasing pressure on carriers to hold policyholders. Insureds, who have been paying record premiums, still want relief and may go elsewhere to get it."
  ("Med Mal Rates to Level Off Amid Consolidation." Crittenden's Medical Insurance News, January 1, 2006)
  
  
• "It is a good time to be a med mal carrier as the various factors that influence an insurer's return are conspiring to foster a strong bottom line, including lower frequency rates, continued rate increases due to steps on the claims-made form, higher interest rates and acquisitions that bolster economies of scale."
  ("Pressure Building on Med Mal Writers." Crittenden's Medical Insurance News, June 19, 2006)
  
  
• "Lots of money can be made in med mal when times are good and right now, times are good. ...Compounded rate increases over the past several years are bringing in tons of cash to insurers who now find their surpluses surging."
  ("Carriers Devise Strategies to Cope With More Competition in 2006." Crittenden's Medical Insurance News, January 9, 2006)
  
  
• Even after accounting for unnecessarily high defense costs, Florida's medical malpractice insurance market is among the most profitable in the nation.
  (Medical Malpractice Financial Information Closed Claim Database and Rate Filings. Florida Office of Insurance Regulation 2005 Annual Report, October 1, 2005)
  
  
• "2004 was a relatively good year for the sample companies featuring an overall return on surplus of 10 percent...a rate that shows a return to profitability."
  (Medical Malpractice Financial Information Closed Claim Database and Rate Filings. Florida Office of Insurance Regulation 2005 Annual Report, October 1, 2005)
  
  
• "Insurers such as American Physicians Assurance Corp. (APCapital), ProAssurance Corp. and First Professionals Insurance Co. (FPIC) face the possibility of sending dividends to investors and insureds/owners as one of the ways to make the best use of their capital."
  ("Cash-Flush Insurers Talk of Buybacks, Dividends, Acquisitions." Crittenden's Medical Insurance News, August 1, 2005)
  
  
• Florida's largest Medical Malpractice Insurer, FPIC, reported in February 2005, that their yearly profits for 2004 increased 70 percent ($28.2 million vs. $16.6 million) over yearly profits for 2003.
  ("FPIC Insurance Group, Inc. Reports Fourth Quarter and Year 2004 Results." FPIC Insurance Group, Inc., February 23, 2005)
  
  
• In November, FPIC's stock reached its highest price since the summer of 1999.
  ("Strong Earnings Help Propel FPIC Insurance's Stock Higher." The Florida Times Union, November 15, 2004)

3. The Number of Doctors Coming to And Practicing in Florida Continue to Increase

• Since 2001, the number of actively licensed medical doctors and osteopathic physicians in Florida increased from 47,510 to 53,062.
  (The Florida Senate Interim Project Report, Review of Medical and Physician Licensure; October 2005. Stats in report provided by the Florida Department of Health, Medical Quality Assurance Annual Reports)
  
  
• "Given the general trend and the number of new applications that we are approving and licensing, I would say if you look at it, for five years ago, yes there would be an increase."
  (Diane Orcutt, Deputy Director of Medical Quality Assurance, Department of Health, during sworn testimony on July 14, 2003, in answer to the question of whether doctors are leaving Florida)
  
  
• And nationally, "The U.S. physician population increased 26 percent" - twice the rate of "population growth, between 1991 and 2001."
  ("Physician Workforce." GAO Report, October 2003)

4. Medical Malpractice Claims are Down, But Doctors Not Receiving the Savings

• "One has to question how long it will be before doctors will begin wondering when they will get some trickle-down effect on their premiums because of the improving picture of claims frequency and severity at carriers such as APCapital, First Professionals Insurance Co (FPIC), ProAssurance, SCPIE and others."
  ("Carriers Reaping Benefits From Excess Reserves." Crittenden's Medical Insurance News, September 25, 2006.)
  
  
• At Keefe, Bruyette and Wood's 2005 Insurance Conference, FPIC president and CEO John Byers stated that FPIC could not have justified its most recent rate increases if not for the fact that in Florida, insurers are able to use a ten-year look back when setting rates. As a result of this policy, Florida's physicians are paying premiums based on the insurance market trends from ten years ago. This means they are getting none of the benefits of the current lower claims rate, increased insurer profitability, or any of the benefits that may have come from the myriad medical malpractice tort restrictions and immunities enacted over the last decade.
  (John Byers at the Keefe, Bruyett and Woods, Inc. 2005 Insurance Conference. September 8, 2005)
  
  
• "Medical malpractice insurance premiums rose much faster in 2002 and 2003 than was justified by insurance payouts. These price hikes were not connected to actual payouts, jury verdicts or the legal system. Rather, they reflect dropping interest rates and losses experienced by the insurance industry's market investments."
  (Americans for Insurance Reform Study, October 2004)
  
  
• Total Earned Premiums (amount collected by insurers) in Florida are among the highest in the nation.
  (Medical Malpractice Financial Information Closed Claim Database and Rate Filings, Florida Office of Insurance Regulation 2005 Annual Report, October 1, 2005)
  
  
• Bob White, president of First Professional Insurance Co. (FPIC), the largest medical malpractice insurer in Florida, said his company makes more money in Florida than in any other state - even states that have capped jury awards for pain and suffering in lawsuits.
  ("Surprise Follows Taking of Oaths." Tampa Tribune, July 15, 2003)
  
  
• Over the last five years, leading insurers increased their surpluses by a third - a level that is far above what is recommended by the National Association of Insurance Commissioners.
  ("Falling Claims and Rising Premiums in the Medical Malpractice Insurance Industry." Center for Justice and Democracy, July 2005)
  
  
• Despite a $4.5 million dollar assessment for the 2005 hurricanes, "an improvement in claims costs at FPIC may offset the assessment and diminish the need for a Florida rate increase in 2007."
  ("Hurricanes Finally Hit Med Mal Insurers." Crittenden's Medical Insurance News, September 25, 2006)
  
  
• "Newly reported claims and incidents were down 29 percent for 2004. This is a drastic reduction and a very positive leading indicator of claims frequency for 2004."
  (FPIC EVP and CFO Kim Thorpe. FPIC Insurance Group Fourth Quarter and Year-End 2004 Conference Call. February 24, 2005)
  
  
• "We continue to see lower than expected frequencies...As far as severity is concerned, it's basically flat."
  (FPIC President of Insurance Operations Bob White. FPIC Insurance Group Fourth Quarter and Year-End 2004 Conference Call. February 24, 2005)
  
  
• "After several years of consecutive rate increases coupled with apparent improvements in frequency and severity, as well as re-underwriting their books of business, a number of med mal carriers are now ready to put their extra cash to use."
  ("Carriers Ponder How to Spend Their Money." Crittenden's Medical Insurance News, October 31, 2005)
  
  
• "The overall frequency of claims is decreasing for both hospital professional liability and physician liability" and "Texas, Pennsylvania, Florida and California...are leading the frequency decline."
  (Hospital Professional Liability and Physician Liability Benchmark Study. AON Risk Consultants, October 2005)
  
  
• The frequency of medical malpractice claims in Florida will decrease by 4 percent in 2006 - four times faster than the reduction in the national claims rate.
  (Hospital Professional Liability and Physician Liability Benchmark Study. AON Risk Consultants, October 2005)
  
  
• A new comprehensive study of medical malpractice claims in Florida between 1990 and 2003 shows no sharp increase in lawsuits relative to population growth. The Duke University researchers who conducted the study found, "When we compared the number of malpractice cases to the population in Florida, there has been no (large) increase in medical malpractice lawsuits in Florida."
  ("Uncovering the 'Invisible' Profile of Medical Malpractice Litigation: Insights from Florida," Duke University, 2005)

5. Defense Costs Driven Up When Insurers Refuse to Settle Valid Claims

• Florida's insurers spend more on defense costs than any other state in the nation, even states with larger populations and more claims.
  (Medical Malpractice Financial Information Closed Claim Database and Rate Filings. Florida Office of Insurance Regulation 2005 Annual Report, October 1, 2005)
  
  
• Despite the fact that FPIC has reported a dramatic decrease in new claims since 2001 (see above), the number of claims that remain open has actually increased. This is because, in 2001, FPIC made a conscious decision to take as many cases to court as possible (even valid cases that many responsible insurers would settle) and to aggressively litigate those cases. As a result, these cases unnecessarily stay open much longer and cost more to defend, driving up defense costs and premiums.
  (FPIC Claims: 2001-2004, Closed Claim Data 2005 and FPIC President of Insurance Operations Bob White. FPIC Insurance Group Fourth Quarter and Year- End 2004 Conference Call, February 24, 2005)

6. Insurance Rate Fluctuations are a Natural Part of the Insurance Cycle

• "Carriers who helped create the soft market of the 1990s can also be blamed for helping to create the hard market cycle. It will be a long time before there is another confluence of events that can cause this to happen again. Some of the companies and executives who unknowingly laid the foundation for the hard market now find themselves under regulatory action or, in a few cases, headed to prison. Meanwhile, the survivors enjoy full coffers and opportunities for new business. Expect the market to soften even more. Signs of softening have already appeared in the form of smaller rate increases."
  ("Next Hard Market a Long Way Off." Crittenden's Medical Insurance News, September 26, 2005)
  
  
• "We find no evidence of the medical malpractice crisis that produced headlines over the last several years and led to legal reform in Texas and other states." "What we found is a sea of calm" in Texas malpractice claim cases from 1988 to 2002. "The rapid changes in insurance premiums that sparked the crisis appear to reflect market dynamics, largely disconnected from claim outcomes." 'So, at least in Texas, the tort system can't be the cause of spikes in malpractice premiums."
  ("Stability, Not Crisis: Medical Malpractice Claim Outcomes in Texas, 1988-2000." Released by The Center on Lawyers, Civil Justice, and the Media at the University of Texas School of Law. Studied data from the Texas Department of Insurance from 1988-2002, March 10, 2005)
  
  
• "While healthcare costs have been rising and some physicians have curtailed their practices because of rising insurance costs, there are insufficient data to conclude that this is the result of rising medical malpractice awards. In fact, the preponderance of available relevant evidence indicates that this notion is a myth. ...The recent spike in medical liability premiums was caused by the insurance cycle, not by increased numbers of new claims or 'skyrocketing' jury verdicts."
  (Commonweal Institute Report, October 2004)
  
  
• "Since 1975, the data shows that in constant dollars, per doctor written premiums - the amount of premiums that doctors have paid to insurers - have gyrated almost precisely with the insurer's economic cycle, which is driven by such factors as insurer mismanagement and changing interest rates."
  (Americans for Insurance Reform, October 2004)
  
  
• "Past and present malpractice payments do not seem to be the driving force behind increases in premiums. Premium growth may be affected by many factors beyond increases in payments, such as industry competition and the insurance underwriting cycle."
  (National Bureau of Economic Research Study, August 2004)
  
  
• Mismanagement is responsible for the insurance industry's woes. The focus on caps is an attempt by "insurance companies and their supporters...to divert the public's attention away from long years of mismanagement."
  (Weiss Report, June 2003)

Bad Medicine

There are several other findings reported by the Florida Justice Association which demonstrate that the public's interest in receiving quality health care has taken a back seat to politics. As you will see, the board which oversees doctors' conduct has not showed much interest in disciplining their own. Also, the health care costs involved with medical errors are staggering. Further, most victims of medical malpractice never file a claim; and if they do, they face an up-hill battle to recover fair compensation. Obviously, this is why you need a medical malpractice lawyer who has tried to verdict many multi-million dollar medical malpractice lawsuits. Without a specialist on your side, you stand little chance of a successful outcome.

7. Florida Board of Medicine Lags Behind Country in Disciplining Doctors

• Over half of the malpractice in Florida is committed by only 6 percent of doctors.
  (Public Citizen Report, September 2002)
  
  
• In 2005, Florida's Board of Medicine ranked 32nd in the country for its record of disciplining dangerous or incompetent doctors.
  (Public Citizen Report, Spring 2006)
  
  
• "Florida needs a better system of monitoring the state's 50,000 doctors, because the state Board of Medicine has proven physicians are unwilling to police themselves" (Editorial: "Making Florida Safe for Medical Malpractice." Palm Beach Post, August 5, 2006)
  
  
• "[T]he state Board of Medicine's wrist-slap approach to surgical errors might invite lawsuits and deepen mistrust."
  (Editorial: "Medical Errors." South Florida Sun-Sentinel, August 3, 2006)
  
  
• "[T]he Board of Medicine typically takes 18 months or more to determine punishment after cases deemed valid are referred from the Department of Health."
  (Editorial: "Making Florida Safe for Medical Malpractice." Palm Beach Post, August 5, 2006)
  
  
• From 2003 to 2005, Florida Seriously disciplined 2.9 doctors per 1,000 - less than half the rate of the toughest states such as Ohio and Kentucky.
  ("State Board's Slow Discipline of Doctors Questioned." Palm Beach Post, July 29, 2006)
  
  
• Between July 2002 and January 2004, the Department of Health received 48,926 complaints but only closed with disciplinary actions 1,607.
  (Florida Auditor General and OPPAGA Report, October 2004)

8. The Greatest Cost on Total Health Care  is Medical Errors

• Medical malpractice premiums account for less than 1 percent of total health care costs in Florida.
  (Americans for Insurance Reform, 2002)
  
  
• Medical malpractice costs account for less than 2 percent of total health care costs nationally.
  ("Limiting Tort Liability for Medical Malpractice." Congressional Budget Office, January 2004)
  
  
• At least 1.5 million preventable adverse drug events occur in the United States each year. Conservative estimates place the extra medical costs alone of treating drug-related injuries occurring in hospitals at $3.5 billion a year. This estimate does not take into account lost wages and productivity or additional health care costs.
  ("Preventing Medical Errors." National Academy of Science's Institute of Medicine, July 2006.)
  
  
• Medical errors kill 195,000 Americans every year. This is the 6th leading cause of death in the U.S., higher than AIDS, automobile accidents and breast cancer.
  ("Patient Safety In American Hospitals." HealthGrades, July 2005)
  
  
• In 2003 in Florida, there were 97 foreign objects left in patients during surgery, 46 incidents of operations being performed on the wrong body part and 14 occasions when an operation was performed on the wrong patient.
  (State of Florida Agency for Health Care Administration, July 2004)
  
  
• In Florida, approximately $965 million to $1.65 billion is lost annually due to preventable medical errors.
  ("Congress Watch." Public Citizen, January 2003)
  
  
• "More than 9 in 10 Americans (92 percent) say that reporting of serious medical errors should be required, and most (63 percent) want this information released publicly."
  (Kaiser/AHRQ/Harvard Study, November 2004)

9. Majority of Valid Medical Malpractice Claims are Never Filed

• In a three-year period Florida hospitals had nearly 20,000 preventable injuries or deaths involving patients, yet only 3,200 medical malpractice claims were filed.
  ("Congress Watch." Public Citizen, January 2003)
  
  
• In Florida hospitals the number of medical errors reported exceeds the number of medical malpractice claims filed by 6 to 1. ("Congress Watch." Public Citizen, January 2003)
  
  
• And nationally, only one out of every seven patients who are seriously injured or killed by medical negligence ever files a lawsuit.
  (Kaiser/AHRQ/Harvard Study, November 2004)

10. Jury Awards are Decreasing

• The average payment to victims of medical negligence in Florida is only $249,000 - this has gone DOWN by over 14 percent since 1991.
  (Florida Department of Insurance Closed Claim Data, 2004)
  
  
• Over the last five years, the amount malpractice insurers have collected in premiums has increased by 120 percent, while claims payouts have remained essentially flat (increase <6 percent) and are expected to decrease.
  ("Falling Claims and Rising Premiums in the Medical Malpractice Insurance Industry." Center for Justice and Democracy, July 2005)
  
  
• Between 1990 and 2003, the overall estimated median payouts in medical malpractice cases fell by 59 percent.
  ("Federal Tort Trials and Verdicts, 2002-03." Cohen, Thomas H. Bureau of Justice Statistics, August 17, 2005)

At Ward & Caggiano, we have been blessed with record results on behalf of our clients in this most challenging area of law. It is our mission to continue to fight the powerful medical malpractice insurance industry, the medical and hospital associations and to seek justice for victims of medical malpractice. Let us know if you or someone you know ever has a question about medical malpractice. Contact us online or call us at 407-244-1212.