Iowa is considered a physician friendly venue from a medical malpractice insurance premium point of view. Medical malpractice insurance premiums are generally more affordable in Iowa when compared to neighboring states. Iowa has experienced a steady decline in the number of paid claims since the 1990s and has historically paid on average less than the national average per closed claim. The total number of filed claims has dropped from 335 in 2002 to 159 in 2012. These trends have led to decreases in Iowa's average medical malpractice insurance premiums and some of the most competitive rates in the nation.

The carrier marketplace for medical malpractice insurance has been dominated by three carriers. Since 2006, roughly half of the total premium in Iowa has been written by MMIC Insurance, Inc, ProAssurance Wisconsin Insurance Company and NCMIC Insurance Company.

House Study Bill 36

Iowa Governor Terry Branstad has advocated for, and the Iowa state House recently advanced, House Study Bill 36 which would create a physician review panel for the purpose of screening potential medical malpractice liability suits for merit before going before a court. Bill 36 allows for a claim found baseless by the panel to proceed to court, but would require that the plaintiff bear the defendant's defense costs and caps non-economic damages as $250,000 in the event of a ruling in favor of the plaintiff. This contested bill will continue to be the subject of debate through 2013 and its fate is currently uncertain.


  • Average total incurred amount is $100,000 per closed claim
  • Average indemnity payment is $23,000 per closed claim

Statute of Limitations

2 years from date of injury (unless foreign object or minors before 10th birthday)

Major Medical Malpractice Insurance Carriers:

  • MMIC Insurance, Inc.
  • ProAssurance Wisconsin Insurance Company
  • NCMIC Insurance Company
  • Medical Protective Company
  • CNA Insurance Company

Punitive Damages Reform: SB 2265 (1986):

Iowa Code Ann. § 668A.1.

Requires a plaintiff to show that a defendant acted with "willful and wanton disregard for the rights and safety of another." (In 1987 the evidence standard was elevated to "clear, convincing, and satisfactory" evidence.) Requires 75% or more of all punitive damages awards to be paid to the State Civil Reparations Trust Fund. The statute directing 75% of punitive damages awards to a civil reparation trust fund did not violate the equal protection or due process clauses of the State or Federal Constitutions. Shepherd Components, Inc. v. Brice Petrides-Donohue & Associates, Inc., 473 N.W.2d 612 (Iowa 1991).

SF 482 (1987)

Requires a plaintiff to show by a "preponderance of clear, convincing, and satisfactory evidence that the conduct of the defendant from which the claim constituted willful and wanton disregard for the rights or safety of another."

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 Iowa.

Iowa 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 Iowa compares to other states.

Malpractice Rate Heat Map - United States