Physicians’ medical liability insurance premiums rose for the seventh consecutive year in 2025, a first for the field since 2005, and at the second-highest rate since that same year, according to a new American Medical Association analysis.
Among responses to an annual survey of leading medical liability insurers, 39.9% reported a year-to-year increase in medical liability during 2025, with 6% indicating an increase of 6% or more and 3.1% any level of decrease. Since the early 2000s, only 2024 was higher, with 49.8% of premiums rising.
The AMA, which broadly advocates for policy to reduce provider burdens stemming from “the broken medical liability system,” noted in the analysis that the 2025 increases were felt across 36 states. Eighteen states had at least half of their reported premiums rise, and 11 states had at least one premium increase by 10% or greater.
Allen Hardiman, Ph.D., AMA’s lead economist and the report’s author, emphasized that the current increases still pale in comparison to the “hard market” of 20 years ago, when the prevalent increases were larger and accompanied by other coverage difficulties.
“Whether this upward trajectory will worsen in the near future remains to be seen,” he wrote in the report (PDF). “However, if the trend continues, it could negatively impact patients’ access to care.”
One outlier flagged in the report was California, where reported premiums were “significantly lower” across insurers and the survey’s three queried specialties (obstetrics/gynecology, general surgery and internal medicine). Hardiman said the “likely” reason was a state law capping noneconomic damages.
“Previous research has consistently shown that such caps are associated with reductions in premiums,” he wrote. “When examining all the reported premiums in California, aside from a 11.6% average rise between 2022 and 2023 that coincided with the cap limit increase that year, California has otherwise experienced minimal premium growth.”
The upward trend in medical liability premiums aligns with a separate survey report (PDF) from the association, also released Monday, that found the likelihood of any one physician having been recently sued has stayed “relatively low.”
Specifically, the portion of 3,500 respondents to AMA’s biennial Physician Practice Benchmark Survey who reported a lawsuit in the past year dropped slightly from 2016’s 2.3% to 2024’s 1.8%, with no significant change from 2022 to 2024.
The share of physicians who reported ever being sued in 2024 was 28.7%, reflecting a steady reduction from 2016 (34%) and the prior such survey in 2022 (31.2%). The average number of claims ever filed—just over one claim for every two physicians—has also dropped over time.
But “despite the declining trend in frequency, medical liability claims against physicians remain common, especially for certain subgroups,” wrote Hardiman, who also authored the second report. “… Beyond the aggregate trend, there is a considerable variation in claim frequency against physicians by age, specialty and gender.”
In that order, AMA found:
- 45.2% of physicians aged 55 and older had ever been sued, as opposed to 11% of those under 45
- Surgical specialties like obstetrics and gynecology (45.2%) and general surgery (53.1%) were most likely to ever have been sued, versus 8.9% of endocrinologists and 9.2% of psychiatrists
- Male physicians were more often sued than female physicians in the past year (2.2% versus 1%), across their careers (35.1% versus 20.6%) and in terms of total claims filed against them (72 claims per 100 physicians versus 33 per 100). However, the broader gender trend is heavily influenced by male physicians tending to be older than female physicians, as lawsuit risk was even among genders among those younger than 45, but veers widely with higher age groups
- Additionally, employed physicians were less often ever sued than those with ownership (25.9% versus 34.4%)
The AMA, in materials accompanying the reports and other online advocacy messaging, emphasizes that any policy changes around medical liability must be made “while ensuring that injured patients are fairly compensated.” However, doctors’ “significant risk of being sued during their careers” and the rising premiums are weighing down practitioners and contributing to the broader issue of rising healthcare costs.
“Physicians know the practice of medicine carries risk, and even highly skilled doctors face lawsuits,” AMA President Bobby Mukkamala, M.D., said in a release. “But a claim does not mean a mistake was made. Most cases never find fault with the physician, and the majority are dropped or dismissed before trial. Doctors continue to take on complex, high-risk care because patients depend on it. However, the ongoing liability risk not only challenges physicians but it increases practice expenses, reinforces defensive medical practices, and drives up health care costs for patients and families.”