West Virginia doctors who say they pay too much for medical
malpractice coverage should count their blessings - they could be
living in Detroit, Fort Lauderdale or El Paso, where obstetricians pay
well over $100,000 a year for insurance.
Even so, a large rate hike by the state's largest malpractice
insurer last summer resulted in increased premium costs for many West
"Malpractice insurance rates in West Virginia are skyrocketing,"
Association. "The increases have only worsened a tough financial situation
doctors are already in."
Before the increase took effect, annual costs for medical
malpractice insurance ranged from $10,000 to $80,000 for some
between about $13,000 a year and $50,000 a year for other specialties
including family practice, orthopedic surgery and radiology.
Surgeons of all types pay more for insurance because of the greater
risk of harm to the patient.
"I know one surgeon who was paying $98,000 after the rate increase,"
Medical Assurance of West Virginia, which received a 35 percent rate
hike, insures about 1,000 of the state's 6,266 doctors. The company is
endorsed by the state Medical Association, which has about 1,700 active
physician members. Medical Assurance began doing business in the state in
Its parent company, Medical Assurance Inc., is based in Birmingham,
Ala. The company also insures doctors in Alabama and Ohio.
Medical Assurance is one of two insurers sharing half the state's
business. The second-largest company is the American Continental Insurance
Co., or AIG.
AIG has about 25 percent of the malpractice insurance market
granted AIG an average 55 percent increase in 1999.
The next largest company is St. Paul Fire and Marine Insurance Co., or
MICO. MICO has about 10 percent of the state's malpractice business
and imposed a 15 percent rate increase on its customers in 1999.
Several dozen smaller insurers write the remainder of premiums. One has
about 5 percent, with the rest carrying only minimal numbers.
West Virginia doctors in most specialties pay higher malpractice
rates than specialists in other states, according to an industry
organization that tracks rates.
"I don't like to do state comparisons based on averages - the rates can
vary so much from one doctor to another based on the doctor's
malpractice history," said Carol Golin, editor of Medical Liability
Monitor, a Chicago-based publication that tracks rates for
"But it does look like West Virginia had the highest rate increase of
any state last year."
The Medical Liability Monitor shows on average, an internist in West
Virginia pays $12,549 a year. The national average is $10,068.
Although it's apparent that insurance rates for doctors have risen
dramatically in the past two years, reasons for the increase are not
Doctors representing the Medical Association are quick to blame what
they call the "malpractice climate" in the state.
"Our judicial system in this state makes it easy for people to sue
doctors," Jenkins said.
Medical Assurance officials also point to West Virginia as being
different from other states in how the court system responds to medical
"In general, we see West Virginia as being a more costly and dangerous
place for insurance than other states," said Frank O'Neil, Medical
Assurance vice president for marketing.
However, compared to other states and the District of Columbia, West
Virginia ranked in the lower one-third in total award payments to
plaintiffs between 1990 and 1999.
The state ranked 35th in 1999, with No. 1 having the highest amount and
No. 51 the lowest, according to records compiled by the National
Practitioner Data Bank of the U.S. Department of Health and Human
Resources. Washington, D.C., has the highest median award, with
California, Idaho and Montana the lowest.
"We justified asking for a rate increase based on the increased
frequency and amount of awards we've seen in the state," O'Neil said.
Medical malpracticeclaims resolved between 1993 and 2000
paint a different picture. Frequency of claims, as well as the
amount of awards, have not increased in the past eight years. In fact,
they have decreased.