More than 70 percent of those attending a conference of U.S. medical liability insurers said they anticipate their primary rate levels will decrease this year, compared with 2007, while average frequency and severity of claims will remain about the same.

The findings were made yesterday by Minneapolis-based reinsurance broker Collins, which polled medical liability insurance executives attending its seventh annual Medical Liability Insurance Networking Forum in Las Vegas.

Among other opinions noted, a majority of those polled expect a soft market will continue until 2010, and many believe claims have dropped off because a change in focus by negligence lawyers.

The Forum offers presentations on marketplace issues and discussion of topics of current interest to insurance and reinsurance company officials in the medical liability business segment.

Collins said the meeting this year drew 70 representatives of medical liability insurers from across the country, including executives of stockholder-owned companies, mutual insurers and risk retention groups. Forty reinsurance company executives also attended the event.

"The survey results indicate, overall, optimism and confidence among medical liability insurers for the near-term future," Charles (Chip) Ott, executive vice president and co-leader of the professional liability practice at Collins, said in a statement.

He noted, "There are, however, signs of growing concerns about the competitive marketplace."

Senior Vice President and Professional Liability Practice Co-Leader Steve Underdal added that medical liability insurers were split on whether they would declare a policyholder dividend in 2008, with 45 percent indicating they would and 49 percent indicating they would not.

"This speaks not only to favorable market conditions but to the strong performance and operations of these companies," Mr. Underdal said. "For those who said they would pay a dividend, estimates as to the sizes of those dividends ranged from $5 million to more than $40 million."

Of insurance company executives polled, 72 percent said they expected their firms' primary rate levels to, on average, decrease in 2008, while 24 percent said they expected rates to remain level with 2007.

Sixty-nine percent said the average frequency of medical liability claims sustained by their companies would remain the same as last year.

In terms of the severity of claims, however, 55 percent said they expected the average severity would remain the same this year, compared with last year, while 39 percent expected an increase in severity.

When asked to identify the single biggest reason for the overall decline among the frequency of medical liability claims in recent years, 33 percent said it is because the plaintiffs' bar is being more selective in their choice of cases due to the increased costs of litigating medical malpractice suits.

Twenty-four percent said the decline was due to tort reform. Other factors identified as key reasons for the decline were effective risk management (17 percent), heightened media attention to the medical malpractice problem (17 percent) and a decision by the plaintiffs' bar to seek other, more lucrative tort opportunities (9 percent).

Insurance company executives were split on whether health care providers, overall, are doing an effective job of lowering the risk of medical malpractice through risk management and loss control--58 percent said they were, while 42 percent said they were not.

When given five options as to what they expected to be their biggest challenge in 2008, 74 percent of the insurers identified the "competitive market," far outpacing "jury verdicts" (2 percent), "overall claim costs" (2 percent), "physician errors" (2 percent) and "none of the above" (20 percent).

Asked to identify the health care issue that most concerns them "looking five-to-10 years in the future," 61 percent pointed to the financing of the U.S. health care system. 20 percent said they were most concerned about an adequate supply of trained health care professionals; 13 percent, the aging of the U.S. population; and 2 percent, stem cell research, cloning and other issues with ethical implications.

All attendees, including both insurance and reinsurance executives, were asked for their views on market conditions and prospects for medical liability insurers. Thirty-eight percent said the current "soft" insurance market would end in 2011; 28 percent predicted it would end in 2010; 23 percent predicted an end by 2012 or later; and 11 percent said the market turn would come in 2009.

Forty-five percent of all attendees said that by the end of 2008, there will be about the same number of medical professional liability insurers. Thirty-seven percent predicted there will be more medical professional liability insurers, while only 18 percent said there will be fewer insurers.

As for the alternative market, including captives and risk retention groups, 49 percent said the size of the alternative market for medical professional liability will remain the same in 2008. Thirty-two percent of respondents said the alternative market will increase, while 19 percent said it would decrease.

Special Reports /

Med-Mal Insurers See Soft Market Till 2010 Or Longer

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