How often do physicians pay above malpractice limits?
What older Texas closed-claim research can, and cannot, show about physician payments above malpractice policy limits.
Personal payments above malpractice policy limits were rare in the best available closed-claim studies. Physicians contributed personal funds in 0.6% of the paid claims in the larger study. These studies used older Texas data. California has no comparable public dataset. They cannot predict the result of a California claim or establish an adequate limit for one physician.
What the studies found
Texas required insurers to report detailed closed-claim data for decades. Researchers compared payments with policy limits across thousands of physician claims.
| Study | Dataset | Physicians paid personally | Typical personal payment |
|---|---|---|---|
| Silver, Hyman, Black & Paik (2015) | 15,065 paid cases, Texas 1988-2005, $8.8B total payouts | 77 cases in 18 years - 0.6% of physician cases, 0.4% of all payout dollars ($15.9M) | median $62,000; mean $206,000 |
| Zeiler, Silver, Black, Hyman & Sage (2007) | 9,525 paid physician claims, Texas 1990-2003 | 62 cases - 0.65% | median $54,000; mean $190,000 (2003 dollars) |
Of the 77 personal payments in the larger study, 43 were $100,000 or less. Fifteen were between $100,000 and $250,000. Nineteen exceeded $250,000.
In the 2007 study, about 1.5% of paid claims included a payment above limits from any source. Primary carriers alone resolved 99.4% of paid claims. Carrier payments supplied 98.8% of all dollars that claimants received.
The larger study found about four physician personal payments per year across Texas. The median payment was $62,000.
A verdict is not the amount collected
Hyman and coauthors found that 75% of plaintiffs collected less than the adjusted verdict. Among verdicts above $2.5 million, 98% were reduced. The median reduction was 61%.
Policy limits explained most of that difference. In single-defendant cases with known limits, policy limits explained at least 73% of the total reduction. After trial, the parties settled 71 of 77 above-limit verdicts for a lower amount.
California law can expose an insurer to liability above a policy limit in a bad-faith settlement dispute when the applicable legal and coverage facts support that result. Comunale and Crisci describe the insurer's duty to give at least as much consideration to the insured's interests as its own. They do not predict the outcome of a particular claim.
Limits of the research
The Texas data end in 2005. The studies also reflect Texas law and insurance practices. They do not measure current California claims.
The risk was not zero. Seventy-seven physicians made personal payments in the larger study. Nineteen paid more than $250,000.
For an action filed, or arbitration demanded, on or after January 1, 2023, Civil Code section 3333.2 applies statutory collective limits to noneconomic damages. These damages include pain, suffering, and similar harm. In 2026, the limits are $470,000 for injury and $650,000 for wrongful death for each applicable collective category, not a separate limit for every defendant.
Economic damages can include medical costs, future care, and lost earnings. Section 3333.2 does not impose a dollar limit on that category. That fact alone does not establish liability, recoverable damages, or an insurance response.
What this means in practice
Use the data as context, not as a limit-selection rule. A stated per-claim or aggregate limit is subject to the issued form's definitions, exclusions, deductible or retention, defense-expense treatment, related-claims wording, allocation, and endorsements. Map the actual physicians, entities, services, locations, and contractual requirements before comparing quote options.
Also review the insurer's financial information, the policy's defense and settlement terms, and the reporting path. Those documents may affect the protection available, but they do not guarantee an insurer response or define a personal-liability outcome.
The studies show that physician personal payments were rare in older Texas closed-claim data. They do not identify a universally adequate limit or compare carrier financial strength. A current limit comparison must instead use the issued policy terms, contract requirements, and quoted options.
Sources
- Silver, Hyman, Black and Paik - Policy Limits, Payouts, and Blood Money (UC Irvine Law Review 2015)
- Zeiler, Silver, Black, Hyman and Sage - Physicians Insurance Limits and Malpractice Payments (Journal of Legal Studies 2007)
- Hyman, Black, Zeiler, Silver and Sage - Do Defendants Pay What Juries Award? (Journal of Empirical Legal Studies 2007)
- Comunale v. Traders and General Insurance Company (1958) 50 Cal.2d 654
- Crisci v. Security Insurance Company (1967) 66 Cal.2d 425
- California Legislative Information - Civil Code section 3333.2