NEWS

Why Are Medical Liability Premiums Rising Again in Some States?

May 4, 2026

Medical liability premiums are rising again in some states because claim severity, venue risk, specialty exposure, and local tort environments are putting uneven pressure on MPL carriers.

The national trend is not a uniform hard market. It is a more selective market shift in which some states and specialties are seeing meaningful rate pressure while others remain comparatively stable.

For retail agents, that distinction matters. A physician account that looks routine in one state may become harder to place in another because MPL underwriting remains highly sensitive to jurisdiction, specialty, limits, claims history, and local loss development.

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Premium pressure is still widespread

Medical liability premium increases remained widespread in 2025, even though the pace eased from 2024.

The AMA’s latest medical liability premium research found that nearly 40% of reported premiums increased from 2024 to 2025. Thirty-six states reported at least one premium increase, and 18 states had increases in at least half of reported premiums.

That does not mean every physician is facing the same market. It means retail agents should expect more geographic variation, more underwriting questions, and more account-by-account pricing discipline.

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Some states are seeing sharper increases than others

State-level variation is the central story behind the current MPL premium environment.

New York and Pennsylvania were among the states with especially broad reported increases in 2025. The AMA report found that 95.7% of reported New York premiums rose, while 92.2% of reported Pennsylvania premiums increased.

For agents, that kind of state-level concentration affects more than renewal pricing. It can influence carrier appetite, minimum premiums, required documentation, limit structure, deductible options, and whether a risk moves from standard placement to a more specialized market search.

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Specialty still drives pricing pressure

High-severity specialties remain more exposed to premium pressure because MPL carriers price around expected claim cost, not just claim frequency.

Obstetrics and gynecology, general surgery, emergency medicine, anesthesia, and other higher-severity classes can face greater scrutiny when local verdict trends or claims inflation are moving in the wrong direction.

This is where Western Summit’s placement role becomes especially relevant. A premium increase is not always a simple renewal negotiation. For harder-to-place providers, the issue may be whether the account still fits admitted appetite, whether alternate structures are needed, or whether a wholesale market search can produce more workable terms.

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Claim frequency is not the only issue

Premiums can rise even when claim frequency is not rising sharply because severity is often the larger underwriting concern.

A market can experience fewer claims but still face higher loss costs if the claims that do occur are more expensive to defend or settle. Large verdicts, higher defense costs, longer litigation timelines, and plaintiff-friendly venues can all affect how carriers view a state or specialty.

For retail agents, that means “no recent claims” does not automatically equal a soft renewal. Carriers may still adjust pricing because of broader territory or specialty trends.

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Tort environment affects carrier confidence

State malpractice laws influence how predictable MPL losses are for carriers.

Caps on noneconomic damages, venue rules, expert-witness standards, pre-suit requirements, and appellate decisions can all affect whether a state is viewed as stable or volatile. When reforms are weakened, overturned, or uncertain, carriers may respond with more conservative pricing or narrower appetite.

Agents do not need to become tort-law specialists, but they do need to recognize when legal environment is part of the underwriting story. In those situations, simply remarketing the account without context may not solve the problem.

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What agents should watch at renewal

Retail agents should watch for more underwriting discipline in states where premiums are rising broadly.

The most important signals include:

Larger year-over-year premium changes
More questions about procedures, supervision, and patient volume
Reduced appetite for higher-risk specialties
More restrictive terms for accounts with prior claims
Increased interest in deductibles, retentions, or lower limits
Greater scrutiny of entity coverage and affiliated providers

These signals do not always mean coverage is unavailable. They often mean the account needs a more deliberate placement strategy.

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The practical takeaway

Medical liability premiums are rising again in some states because MPL carriers are responding to uneven local loss conditions, specialty risk, and legal-environment uncertainty.

For retail agents, the important takeaway is not that the entire market is moving in one direction. It is that placement conditions are becoming more state-specific and class-specific. That is where experienced wholesale access can matter most: not by treating every renewal as distressed, but by knowing when a standard-market renewal has become a more complex MPL placement.