Jury Awards Injured Baby $25.4M in KC Metro’s Largest Medical Malpractice Verdict

April 6, 2022 by matray

A jury in Jackson County, Mo., awarded a record $25.4 million medical negligence judgment todau against Kelli Sandri, MD, for failing to properly treat a mother in labor. The child suffered permanent birth injuries due to a lack of oxygen.

After a two-week trial, the jury determined Sandri violated her duty of care when improperly supervising a student doctor with respect to the administration of Pitocin medication used to speed up labor. Fetal monitoring equipment demonstrated more than six hours of excessive Pitocin administration, resulting in a loss of oxygen to the baby’s brain that caused cerebral palsy.

The jury awarded $18,972,000 for ongoing medical care and damages for the plaintiffs, as well as $5 million for past and future pain, suffering and disfigurement. The Greater Kansas City Jury Verdict Service referred to the verdict as the highest for medical malpractice in the metropolitan area’s history.

Illinois Jury Awards $14.75 Million in Medical Malpractice Lawsuit

November 15, 2021 by matray

A jury in Vermilion County, Illinois, reached a verdict of more than $14.75 million today in a medical malpractice action brought against Presence Hospitals, PRV, the former operator of the Presence United Samaritans Medical Center in Danville, Ill. The lawsuit was brought on behalf of L.B., a disabled person, through her guardian CIBC Bank USA.

The lawsuit alleged that Presence, individually and through its agents, was negligent in the medical care and treatment provided to L.B. while she was an inpatient at Presence United Samaritans Medical Center on April 22, 2014. L.B. was pregnant with twins and underwent a cesarean section procedure by the obstetrician on call, Mohannad Rajjoub, MD. Following the delivery of the twins, Rajjoub attempted to remove L.B.'s placenta when she had a condition known as placenta accreta, in which the placenta attaches deeply into the uterine wall. As a result, plaintiff presented evidence that the placenta was torn, and L.B. suffered massive hemorrhaging resulting in hypoxic brain injury and seizure like activity.

The plaintiff further alleged that negligent conduct of the anesthesiologist, Damon Green, MD, contributed to L.B.'s injuries. Plaintiff presented evidence that following the massive hemorrhage, L.B. did not receive proper resuscitative care which contributed to the hypoxia. This evidence included that no blood was available in the operating room for transfusion and that more than 30 minutes elapsed before the first transfusion was begun.

Plaintiff's medical expert in rehabilitation testified that L.B. sustained a severe and diffuse brain injury with global consequences, and that her intellectual age is 3 years, 3 months with an estimated IQ less than 34. L.B. is virtually totally dependent on all aspects of daily life and will require 24-hour, life-long care.

Presence Hospitals denied that Rajjoub and Green were its agents. It further maintained at trial that L.B. was not stable for transfer to a different hospital and required an emergency c-section during which the doctors and the hospital each acted within the standard of care.

The jury awarded the plaintiff a total of $14,756,744.03 consisting of $3 million each for loss of a normal life and pain and suffering, $7.4 million for future medical and caretaking expenses and $1,356,744.03 for past medical expenses.


Medical Liability Monitor February 2024 issue highlights

February 8, 2024 by matray

Below are some headlines and article synopses from the February 2024 issue of Medical Liability Monitor. To read the articles in entirety, please subscribe today.

Florida Looks to Impose Noneconomic Damage Caps, End ‘Free Kill’ Law
A bill that would end a Florida law denying recoverable damages for certain wrongful death medical liability claims and impose noneconomic damage caps on medical malpractice awards cleared a key hurdle last month when it was approved by the state’s Senate Judiciary Committee …

New York Gov. Hochul Vetoes Bill Expanding Recoverable Wrongful Death Damages
New York Gov. Kathy Hochul vetoed for a second time the Grieving Families Act, a bill that would have expanded recoverable damages in wrongful death claims to include noneconomic damages. Under the current 177-year-old law, compensable damages in wrongful death actions are limited to economic loss only. New York and Alabama are the only two states that currently restrict family members from seeking recovery for their emotional suffering by limiting recoverable damages to the deceased’s earning potential …

Ohio Statute of Repose ‘Means What It Says,’ Applies to Wrongful Death
The Supreme Court of Ohio finally put to rest the issue of whether the state’s statute of repose for medical claims applies to wrongful death claims on Dec. 28, 2023, answering the long-discussed question in the affirmative …

Iowa Advances Bill to Pierce State’s Medical Malpractice Statute of Repose
Iowa lawmakers advanced a bill last month that would remove time requirements for filing a medical liability lawsuit against healthcare providers who conceal a cause of injury. Iowa law currently imposes a strict six-year statute of repose on medical liability claims, except those involving medical equipment left in a patient’s body post-surgery. If the bill becomes law, there will be no constraint for patients whose cause of injury or death was concealed by a healthcare provider …

Developing Safe Harbors to Address Malpractice Liability, Wasteful HealthCare Spending
With U.S. healthcare spending expected to exceed $7.2 trillion annually by 2031, the push to reduce healthcare resource utilization will only intensify in the coming years. Evidence suggests inpatient spending declines by about 5% — with no significant change in patient outcomes — when the threat of malpractice liability is removed. Current guidelines aimed at reducing waste do not account for the potential impact of medical liability and therefore may miss an opportunity to reduce spending without harming patients …

MPL Association Publishes Report on Industry’s 2023 Midyear Results
The Medical Professional Liability (MPL) Association recently published its Medical Professional Liability Insurance Sector Report: 2023 Midyear Financial Performance. This semiannual report provides insights into the MPL insurance market’s financial performance with commentary on the internal and external forces impacting insurer performance. Based on their review of the industry’s loss data, the report’s authors anticipate that frequency will likely remain flat at around 8,000 annual paid claims going forward, while average severity will continue its relentless climb …
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Subscribe today to get this issue (as well as the 2023 Annual Rate Survey at no additional cost).

Medical Liability Monitor March 2023 issue highlights

March 7, 2023 by matray

Below are some headlines and article synopses from the March 2023 issue of Medical Liability Monitor. To read the articles in entirety, please subscribe today.

Curi, Constellation to Merge into Organization with National Scope
Curi Holdings and Constellation Inc. last month announced the signing of a merger agreement. Combined, the two organizations intend to build on their legacies of mutual ownership, client service and innovation, while creating a national brand that delivers the products, services and advice that healthcare providers need to thrive in a rapidly evolving healthcare landscape. With more than $2 billion of consolidated assets and generating nearly $400 million in annual revenue, the merged companies will serve more than 50,000 physicians, healthcare providers and organizations across the United States. With minimal geographic overlap between the two companies, the merger positions the combined organization to continue meeting its member-owners wherever they are in their own evolutionary journey …

Iowa Enacts Hard Cap on Medical Liability Noneconomic Damages
Iowa Gov. Kim Reynolds last month signed a bill into law that limits noneconomic damages to $2 million for medical liability verdicts involving permanent impairment, disfigurement or death against hospitals and $1 million for those types of verdicts against clinics and individual doctors. The state had already capped most medical malpractice awards at $250,000, but had included an exception for those involving permanent impairment, disfigurement or death, for which there was no cap …

Arkansas Weaponizing Medical Malpractice Law to Restrict Transgender Youth Care
An Arkansas Senate panel advanced a bill last month that would make it easier to file medical liability lawsuits against doctors who provide gender-affirming care to minors. The proposed Protecting Minors from Medical Malpractice Act of 2023 would create civil liability for any doctor who “performs a gender transition procedure on a minor … if the minor is injured, including without limitation any physical, psychological, emotional, or physiological injury, by the gender transition procedure, related treatment, or the after effects.” The bill would also grant potential plaintiffs an up-to-30-year statute of limitations for filing a medical liability claim against a doctor who provided them with gender-affirming care as a minor. All other medical liability claims are subject to a two-year statute of limitations under Arkansas law …

Prior Paid Claims Are Predictive of Future Malpractice Claims
Physicians often view malpractice claims as mostly random events that reflect bad luck, rather than a lack of clinical skill. But a paper published Feb. 13 in JAMA Health Forum that examined all paid medical liability claims against U.S. physicians between 2004 and 2018 uncovered strong evidence that paid claims are far from random. Rather, physicians with even a single paid claim are far more likely than those with no paid claims to pay additional claims in the future. The effect held regardless of specialization or whether a doctor’s prior malpractice claims had been disclosed publicly, which suggests that in an average case, patients and attorneys who sued were unlikely to be acting on the belief that they could win a case in a risky subfield or against a vulnerable doctor ...

Nearly a Quarter of Inpatient Visits Had an Adverse Patient Safety Event
Almost a quarter (23.6%) of the inpatient hospital visits in Massachusetts during 2018 had at least one adverse patient safety event, and almost a quarter (22.7%) of those patient safety issues were preventable, according to a new study from Mass General Brigham and CRICO, the medical professional liability insurer for the Harvard medical community and its affiliated organizations ...

Medical Liability Tort Fix Blocked by New Mexico House Panel
The Health & Human Services Committee of the New Mexico House of Representatives last month blocked a bill that would have capped recoverable damages at $750,000 for medical malpractice claims against outpatient facilities not owned or controlled by a hospital. Those facilities otherwise face a $5 million cap set to go into effect Jan. 1, 2024, as part of the state’s 2021 overhaul of its Medical Malpractice Act …

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Medical Liability Monitor December 2022 issue highlights

December 12, 2022 by matray

Study Shows Wide Variance Among States’ Malpractice Costs
Physicians, nurses and healthcare workers in the state of New York suffered the largest number of medical malpractice lawsuits filed between 2012 and 2022, while those in Wisconsin experienced the fewest filings during the same period, according to a study published online last month. Ohio incurred the most expensive medical liability reports during the 10-year period with 2,325 medical liability filings costing its healthcare industry more than $853 million, while New York ranked No. 40 with a total costs to its industry at $6.85 million …

Alaska Supreme Court Overturns Law Limiting Awards in Some Medical Malpractice Cases
The Alaska Supreme Court determined last month that a 1976 law limiting financial awards in medical liability lawsuits for Alaskans with health insurance is unconstitutional. The statute at issue, AS 09.55.548(b), provided that when a medical malpractice claimant’s losses have already been compensated in part by a collateral source, such as a health insurer, the claimant’s damages award will be reduced by the value of the collateral source compensation, except when the collateral source is a “federal program that by law must seek subrogation” …

Favorable Reserve Development for MPL Specialty Insurers During Third Quarter
Medical Liability Monitor’s quarterly analysis conducted by Milliman Inc. indicates the MPL industry reported a cumulative favorable development through the third quarter of approximately $22 million on reserves related to prior years. This reflects an improvement relative to the same point in 2021 and 2020 through the third quarter. Third-quarter 2021 saw $200,000 of adverse reserve development, while third-quarter 2020 saw adverse reserve development of nearly $40 million. This favorable reserve development further supports our anticipation that the 2022 annual financial results will also reflect some reserve redundancy. However, how much reserve redundancy remains uncertain …

Ohio Supreme Court Chips Away at Vicarious Liability Claims
The Ohio Supreme Court ruled last month in Clawson v. Hts. Chiropractic Physicians that if a physician cannot be held directly liable for malpractice, then a lawsuit seeking to hold the physician’s employer vicariously liable must be dismissed. In a 4-3 decision, the Supreme Court dismissed a medical liability lawsuit filed by a patient of a Montgomery County chiropractic firm. The decision reversed a ruling by the Second District Court of Appeals, which held that Cynthia Clawson could sue Heights Chiropractic Physicians despite her malpractice claim against the chiropractor who allegedly harmed her having been dismissed as untimely ...

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Medical Liability Monitor May 2022 Issue Highlights

May 16, 2022 by matray

The May 2022 issue of Medical Liability Monitor features the following articles and more. Click here to subscribe today.

Corporate Acquisitions Accelerating Surge in Employed Physicians
New research from the Physicians Advocacy Institute (PAI), a nonprofit physician advocacy organization, in conjunction with the healthcare consultancy Avalere Health, indicates almost three quarters (73.9%) of all U.S. physicians were employed by a hospital, health system or other corporate entity as of Jan. 1, 2022, up from 69% at the same point last year. And researchers noted the employed-physician trend accelerated drastically after the onset of the COVID-19 pandemic — with 83,000 physicians having transitioned from independent practice since March 2020. …

California Healthcare Providers, Trial Attorneys, Legislators Reach Deal to Increase MICRA Cap
Stakeholders in the decades-long battle over California’s noneconomic damages cap for medical liability jury verdicts announced they have reached a compromise between healthcare, legal and consumer advocates on legislation to modernize the Medical Injury Compensation Reform Act (MICRA). Signed into law in 1975, MICRA established a $250,000 cap on medical malpractice awards for things like pain and suffering, which proponents argued was necessary to balance compensatory justice for injured patients with important legal and financial protections for healthcare providers. The cap has never been adjusted for inflation ...

Virtual or Hybrid Trials, Arbitration Expected to Continue Post-Pandemic
The national law firm Wilson Elser LLP expects virtual and hybrid jury trials, bench trials and arbitrations to continue as the nation and its court systems transition out of the COVID-19 pandemic. The prediction came during the 42-location firm’s recent National Mock Trial Training Program, where senior partners train Wilson Elser’s next generation of trial attorneys …

New York High Court to Determine Who Gets MLMIC Demutualization Money
The New York Court of Appeals, the highest court in the Unified Court System of the State of New York, heard oral arguments last month for a set of related cases questioning who is the rightful beneficiary of monies generated by the demutualization of Medical Liability Mutual Insurance Co. (MLMIC). What’s the question at hand? While the healthcare providers were listed as the policyholders on paper, their employers argue that because the medical practice paid the premium, they are, in fact, the policyholders and are entitled to the demutualization proceeds. The employed healthcare providers counter that the medical liability insurance coverage was part of their work compensation and they deserve the proceeds. …

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Medical Liability Monitor March 2022 Issue Highlights

March 7, 2022 by matray

The just-published March 2022 issue of Medical Liability Monitor features the following articles and more. Click here to subscribe today.

Doctors, Politicians Battle Over COVID Disinformation, Standard of Care
A growing number of state medical boards have been pushing back against the minority of healthcare professionals spreading dangerous COVID-19 disinformation and prescribing unproven coronavirus treatments. They are increasingly meeting resistance from conservative lawmakers …

Battle Over California’s MICRA Cap on Noneconomic Damages Heats Up
Consumer advocacy and plaintiff attorney groups are squaring off against physicians and healthcare interests over California’s Medical Injury Compensation Reform Act (MICRA). The 1975 medical liability tort law capped noneconomic damages at $250,000, created a tiered cap for attorney fees, established a one-year statute of limitations and codified periodic payments for jury awards ...

Kentucky Legislators Want to Amend Constitution for Damage Cap
Kentucky lawmakers last month introduced legislation to start the process of amending Section 54 of the commonwealth’s Constitution in order to give the General Assembly authority to limit non-economic damages for personal injury lawsuits and provide statutes of limitation …

Iowa House Advances Bill with Hard Noneconomic Damage Cap
The Labor Committee of the Iowa House of Representatives advanced legislation last month intended to combat the state’s worker shortage by reforming unemployment and tort laws. The bill is divided into two sections: one relates to unemployment insurance and the other would create a $1 million hard cap for noneconomic damages in medical liability and commercial motor vehicle claims. Gov. Kim Reynolds listed medical malpractice reform as a priority in her Condition of the State address in January …

New Report: Medical Liability Programs, Reforms Can Help States Ease Shortage of Rural Healthcare Providers
Many rural communities across the United States lack access to healthcare, but states have tools to help relieve rural care shortages and support healthcare professionals, according to a new report from the Center for American Progress. And the left-leaning public policy research and advocacy organization says medical malpractice programs and reforms can play a significant role in alleviating those shortages …

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The Doctors Company: Retired Physician Volunteers Receive No-Cost Malpractice Coverage during COVID-19 Pandemic

March 26, 2020 by matray

As U.S. healthcare systems are being pushed to their limits during the COVID-19 pandemic, The Doctors Company announced that it will provide free medical professional liability coverage to retired physicians formerly insured by the company who volunteer during the crisis.

"Today, our mission to advance, protect and reward the practice of good medicine is more important than ever. We appreciate our members' lifesaving work during this crisis and want to make it as easy as possible for our retired members to assist," said Richard E. Anderson, MD, FACP, chairman and chief executive officer of The Doctors Company.

If retired former members of The Doctors Company return to practice as volunteers, this decision will not impact their extended reporting period, or tail, coverage. Additionally, there will be no impact on previous Tribute Plan awards.

To qualify, a retired healthcare professional must be providing professional services for no fee, salary or other compensation — with the exception of expenses incurred delivering those services. Retired former members of The Doctors Company interested in the free coverage can complete an online form or call (800) 421-2368, press 1 for Member Services, then 6 for coverage activation.

Retired members considering volunteering can find more information at "COVID-19 Malpractice Coverage FAQs." All healthcare providers can visit "COVID-19 Resource Center for Healthcare Professionals" to keep up to date on the pandemic.

Supreme Court Upholds Affordable Care Act Subsidies: What it Means for the Medical Professional Liability Industry

July 2, 2015 by matray

On June 25, the U.S. Supreme Court endorsed consumer subsidies to purchase healthcare insurance in the 36 states that have not established their own exchange under the Patient Protection & Affordable Care Act. The decisive 6 - 3 decision in King v. Burwell further cemented the reforms from President Barack Obama’s signature legislation into the American healthcare delivery system. “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” wrote Chief Justice John Roberts, explaining the Court’s rationale in the majority opinion. “If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.” With King v. Burwell decided, and the Affordable Care Act the law of the land, the question that remains to be answered is how the healthcare law will affect the medical professional liability industry. Since its passage in 2010, many medical malpractice professionals have worried that the influx of 10 to 30 million newly insured individuals carries the potential to create a spike in claims frequency. The reasoning is that individuals who have health insurance are more likely to engage the healthcare system, which creates more opportunity for unintended medical outcomes. Alarmists also point to coordinated care as a depersonalization of medicine because patients will no longer just see one doctor for their healthcare needs, and studies show that patients are less likely to sue a physician they have a personal relationship with. A contrary theory is that greater access to healthcare will equate to better preventive care, which will lead to fewer bad medical outcomes, which will lead to fewer claims of medical malpractice. An emerging legal theory expected to be tested is whether the Affordable Care Act could have a deflating effect on medical liability indemnity payments in those states that limit awards based on reimbursement from collateral sources—e.g., healthcare insurance. In a Rand Corp. white paper titled How Will the Patient Protection & Affordable Care Act Affect Liability Insurance Costs?, David Auerbach, Paul Heaton and Ian Brantley argue that the court systems that limit the collateral source rule could actually see a reduction in medical liability damage awards. Payments to victims of medical malpractice could be reduced once the injured party obtains coverage under the Affordable Care Act and payments for care made on their behalf by health insurers deducted from their award. “What we’re going to be litigating in the near future is whether covering the out-of-pocket expenses related to buying healthcare insurance can substitute for the high-dollar cost of care. That’s an interesting issue that’s going to play out throughout all the states,” said Craig Brodsky,  Esq., a partner in the law firm Goodell Devries, who specializes in professional liability defense. “The defense will argue that the plaintiff’s future medical costs should be measured by the out of pocket expenses for a health insurance policy and co-pays that will provide care at no cost for the rest of the plaintiff’s life. That’s a lot less than paying for the actual care. The question is whether states will allow healthcare providers to make this argument.” The Supreme Court decision in King v. Burwell turns the page on what might be the last significant legal challenge to the Patient Protection & Affordable Care Act of 2010. What remains to be seen is exactly how it will affect medical professional liability claims frequency and severity. This article appears in the July 2015 issue of Medical Liability Monitor.

PIAA Members Convene in Toronto For Medical Liability Conference Focused on Navigating Uncertain Times in Healthcare Delivery

June 4, 2014 by matray

With the healthcare delivery system navigating a sea of reform, PIAA members convened from May 14 - 16 to share ideas for success and gain insight from experts at the medical professional liability insurance trade association’s annual Medical Liability Conference. This year’s confabulation took place at Toronto’s Fairmont Royal York Hotel and tackled topics such as enterprise risk management, electronic health records, hospital employment of physicians, new systemic risks, alternative business models and more. Following is a review of the educational sessions and panel discussions that took place: After welcoming remarks and industry awards, the Medical Liability Conference kicked off with a special keynote session by Reed Tuckson, MD, titled Sustaining Cost-Effective, Patient-Centered Care in an Era of Transformation. As a former vice president for professional standards at the American Medical Association, a previous commissioner of public health for the District of Columbia and former president of the Charles R. Drew University of Medicine & Science, he was uniquely qualified to offer fresh perspectives on recent developments in U.S. healthcare as well as insights into the successes and challenges experienced as the Affordable Care Act continues to roll out. Prowling the crowd with his wireless microphone, Dr. Tuckson shared volumes of data on what healthcare reform might really mean to medical professionals, their patients and the medical liability insurance industry. He shared his belief that PIAA companies have an important role to play in the future of healthcare delivery and praised the association’s Data Sharing Project as a potentially invaluable resource moving forward. In conclusion, Dr. Tuckson encouraged PIAA members to be “more public with your contributions to the industry.” With the Affordable Care Act ushering physicians into a healthcare delivery model that emphasizes accountable care organizations and coordinated care, Gregg Hansen, chief executive and president of Coverys, moderated a widely attended panel discussion on Hospital Employment: The Physicians Changing Role, during which Hayes Whiteside, MD, chief medical officer and senior vice president of risk management at ProAssurance Corp., compared the exodus of physicians from private practice to hospital employment to a sort of schizophrenia, “where everything about the trend of hospitals employing physicians is consistently inconsistent.” While noting a statistically significant increase in the number of physicians employed by hospitals, Dr. Whiteside pointed to a number of factors that signal the era of private practice is far from dead. Graham Billingham, MD, chief medical officer at Princeton Insurance Co., and Luke Sato, MD, senior vice president and chief medical officer at CRICO, focused their attention on the opportunities for PIAA companies in an era of physician hospital employment. Specifically, hospitals are not educated in physician exposures and physician risk management in the same way the medical professional liability insurance industry is. This spells opportunity for PIAA companies. Joan Winters Burmaster, RN, JD, general counsel at LAMMICO, moderated a panel discussion about Attacks on Civil Justice Reform. With an initiative that would retroactively index the MICRA cap on noneconomic damages to inflation qualifying for this November’s ballot in California making headlines, panelists examined the latest information on what is being done to defend important reforms, including what has and has not been successful so far and why. With physicians and attorneys often holding divergent opinions on the merits and risks involved in using clinical decision support tools, the session titled Information Technology-Based Decision Support: the Good, the Bad & the Unknown provided a valuable update on the rapidly advancing science of health information-based decision support. Moderated by Jaan Sidorov, MD, chairman of the board of directors at NORCAL Mutual Insurance Co., panelists Domenic Crolla, Esq., partner at Gowling Lafleur Henderson LLP, and Martin Kohn, MD, chief medical scientist at Jointly Health, examined a range of potential liability risks associated with the use of this emerging technology in both diagnosis and treatment. Of particular concern to both panelists was how constantly evolving technologies affect standard of care issues. In a session titled From Obstacles to Opportunities: Using ERM as a Platform for Business Success, Catherine Walberg, JD, senior vice president of legal and government relations at Physicians Insurance A Mutual Co., moderated a discussion on how medical professional liability insurance companies can employ enterprise risk management (ERM) metrics to identify and evaluate new business opportunities. Panelists Gerry Glombicki, CPA, director at Fitch Ratings, David Ingram, executive vice president at Willis Re, and Mark Stephens, managing director of corporate risk advisory services for Milliman Inc., discussed how a disciplined approach to risk management and strategic planning may prove helpful to medical liability insurers in preserving capital and reducing market volatility. Stephen Underdal, JD, managing director and head of global healthcare for Guy Carpenter, moderated a session on Alternative Business Models for MPL Insurers. With an increasing number of physicians choosing hospital employment over private practice, smart medical professional liability insurance companies are founding risk retention groups, creating captives, entering into contractual partnerships with hospital systems or unbundling their services to sell them as individual products. Panelists Susan Forray, principal and consulting actuary at Milliman Inc., Michael Maglaras, principal at Michael Maglaras & Co, and Neil E.S. Morrell, president of MagMutual Insurance Co., discussed how this trend has been impacting the traditional medical professional liability insurer as well as the pros and cons of each alternative business model. In the session New Systemic Risks in Medical Indemnity: Prediction, Mitigation & Management, moderator Gerry Lewis-Jenkins, executive vice president at COPIC, as well as panelists Paul McKeon, senior vice president and chief underwriting officer at Transatlantic Reinsurance North America, and Thom Petty, senior medical claims handler and clinical risk manager for MDU Services Ltd., walked attendees through the extent of risk inherent in serial claims, class-action litigation and systemic risk. After breakfast and the Annual Meeting of Members hosted on the second day of the PIAA Medical Liability Conference, educational sessions resumed with the universally attended MPL Financial Update: What Exactly Is the “New Normal?” Presented by James Hurley, consulting actuary at Towers Watson, attendees were treated to a detailed look at the critical elements and trends observed in a composite of PIAA companies’ loss experience, premium, balance sheets and income statements during the past 10 years. While aggregate financial results have been favorable for the last several years, Hurley drew attention to a combined ratio that has been creeping upward since 2010, declining investment income as a percentage of premiums, loss reserves that have been deteriorating since 2007 and a small, but steady, increase in the underwriting expense ratio during the last decade. The PIAA Medical Liability Conference closed out with a presentation by Daniel Friedland, MD, president and CEO of SuperSmartHealth, titled A Framework for Cultivating Resiliency in Healthcare, in which he introduced attendees to tools for enhancing healthcare professional wellbeing, patient satisfaction and mitigate malpractice risk. * this article appears in the June 2014 issue of Medical Liability Monitor.