House Bill 393

In 2005, House Bill 393 was signed and approved to designate tort reform for the state of Missouri. The bill made several changes to the medical malpractice insurance market in the state. It capped punitive damages and revised the cap placed on non-economic damages. The limit on punitive damages is set as the greater of $500,000 or five times the full amount to be paid to the claimant. Non-economic damages have been lowered the inflation-adjusted cap of $570,000 to $350,000.

Missouri’s tort reform also places certain stipulations for defendants to have joint and several liability. Joint and several liability only applies to defendants who are 51% or more at fault. Any defendant found less than 51% at fault is not liable. Defendants found to have joint and several liability are responsible for proportionate damages bases on their liability. In addition, joint and several liability is not taken into account for punitive damages.

House Bill 393 has affected the rule regarding the venue. In order to protect the physician from an unfair trial that is typically in the claimant’s favor, the location of the trial must be where the individual resided in when the injury first occurred.

Chapter 383 RsMO

The Missouri medical malpractice insurance market has remained stagnant for the past decade. However, Chapter 383 of the Missouri Revisited Statutes has made a distinct change in the market, allowing new competition to arise. This new competition, known as a mutual insurance company, is a nonprofit that provides malpractice insurance to physicians.

Chapter 383 of the Missouri Revised Statutes covers a series of topics including:

  • The Healthcare Stabilization Fund Feasibility Board
  • The annual publication of market rates
  • Reporting medical malpractice claims

Major Carriers

  • Missouri Professionals Mutual (MPM)
  • ProAssurance Company, Inc.
  • Medical Protective Company
  • Intermed Insurance Company
  • The Doctors Company
  • Medicus Insurance Company
  • Medical Liability Alliance (MLA)

Missouri Medical Malpractice Insurance Rates - Top 15 Specialties

Undiscounted State Filed Rate Data averages across all territories for $1m / $3m limits

SpecialtyAverage RateMin RateMax RateCount
Internal Medicine No Surgery$13,425$4,997$24,2662464
Family Practice No Surgery$12,379$4,997$24,2662367
Occupational Medicine$9,179$5,084$13,9331702
Pediatrics No Surgery$12,309$7,309$24,2661353
Emergency Medicine$31,344$19,068$53,3851077
Anesthesiology$16,120$5,997$24,9561018
Radiology - Diagnostic$17,299$9,217$30,333910
Psychiatry$10,291$5,084$19,413815
Obstetrics and Gynecology Major Surgery$67,181$31,781$121,330809
General Surgery$41,516$14,872$72,798665
Orthopedic Surgery No Spine$38,874$16,061$60,665590
Cardiovascular Disease Minor Surgery$18,991$12,077$33,972475
Ophthalmology No Surgery$10,298$4,450$19,413430
Neurology No Surgery$17,810$10,806$30,333359
Pathology No Surgery$11,861$6,356$19,413350
* Please note that the above rates are state filed rates. It is not uncommon for Gallagher Healthcare clients to receive up to 50% or more in discounts from state filed rates. Please Request a Quote to receive a custom premium indication.

Rate Range by Specialty

This chart compares the range of possible state filed medical malpractice premium rates by admitted markets and a few Gallagher Select markets broken out by the top 15 specialties in Missouri.

Missouri Medical Malpractice Rate Range Chart

USA Ranking Map

The map below provides a visual display of the nation and compares what a typical primary care physician might pay compared to each individual state and county. This research is based on the average rate for a single specialty, the most common limits in that state, and the mature claims made premium. The darker the blue, the higher the average premium, see how Missouri compares to other states.

Malpractice Rate Heat Map - United States