November 4, 2026 by matray

Diagnostic errors and communication breakdowns are leading contributors to radiology malpractice claims, with nearly half of the cases examined involving serious permanent injury or patient death, according to a new analysis from The Doctors Company.

The medical professional liability insurer reviewed 735 closed malpractice claims involving radiologists from 2010 through 2025, finding that 75% involved diagnosis-related allegations, including failure to diagnose, incorrect diagnosis or delayed diagnosis.

Nearly half, 47%, of the claims involved high-severity injuries resulting in significant permanent harm or death. Indemnity payments were made in 42% of cases, with an average payment of approximately $456,000. Average gross expenses incurred were $76,000 per claim.

The findings appear in The Doctors Company's Malpractice Risk Review: Radiology Claims, a November 2026 report examining negligence allegations, contributing factors and strategies for reducing patient harm.

Clinical judgment errors were identified as contributing factors in 80% of radiology claims. These included misinterpretation of diagnostic imaging studies, an overly narrow diagnostic focus and failure or delay in ordering appropriate tests.

Communication breakdowns contributed to approximately 26% of claims, most frequently involving failures to exchange critical information between healthcare practitioners. Behavior-related factors, including patient failure to comply with recommended follow-up studies or treatment plans, were identified in approximately 20%.

Although clinical judgment errors were substantially more common, claims involving communication failures generated the highest average indemnity payments among the major contributing factors examined.

The average payment for claims involving communication breakdowns was $518,000, compared with $487,000 for clinical judgment errors and $444,000 for behavior-related factors. Claims involving documentation deficiencies averaged $511,000, while those involving technical skill deficiencies averaged $423,000.

Because individual claims could involve multiple contributing factors, the percentages exceeded 100% when combined.

Beyond diagnosis-related allegations, 13% of claims involved medical treatment, 5% involved patient safety and security, and 3% involved surgical treatment.

The analysis identified cognitive errors as a central contributor to missed or delayed diagnoses. Radiologists may overlook abnormalities because of diagnostic assumptions, distractions, visual fatigue or excessive workloads, according to the insurer.

The report distinguishes between interpretive errors, in which an identified abnormality is incorrectly characterized, and perceptual errors, in which an existing abnormality is overlooked entirely. Citing research on radiology diagnostic errors, The Doctors Company reported that perceptual errors account for 60% to 80% of such errors, compared with 15% to 28% for interpretive errors.

Faster reading rates, higher imaging volumes and studies interpreted near the end of a work shift were associated with increased perceptual errors.

The insurer recommended standardized checklists for commonly missed diagnoses, consistent image-review patterns, reduced interruptions during complex studies and scheduling practices designed to minimize fatigue.

It also identified artificial intelligence detection systems as potentially useful tools for flagging abnormalities and recommended obtaining second interpretations when imaging findings are uncertain.

Communication failures represent another significant area of liability exposure, particularly when unexpected or potentially serious imaging findings are not promptly conveyed to the physician responsible for the patient's care.

The Doctors Company emphasized the importance of closed-loop communication, in which the radiologist delivers a significant finding, the receiving practitioner acknowledges the information and the sender verifies receipt.

The approach is consistent with the American College of Radiology's practice parameters for communicating diagnostic imaging findings, which recommend prompt notification of significant, unexpected findings that could adversely affect patient outcomes.

The insurer also recommended documenting nonroutine communications, including the date, time, method of communication and identity of the recipient.

An accompanying case study illustrates how diagnostic and communication failures can combine to produce a fatal outcome.

The case involved a patient admitted to a community hospital with chest pain who subsequently underwent angioplasty and stent placement at a regional medical center.

An initial chest x-ray was interpreted as unremarkable, although a subsequent expert review identified a visible lung nodule. A second x-ray performed the following day at the regional medical center revealed a suspected lung mass and recommended additional imaging to exclude malignancy.

However, the radiologist did not notify the treating cardiologist, and a system error prevented the report from appearing in the patient's medical chart. The cardiologist discharged the patient without learning of the abnormal finding.

Nearly a year later, the patient was diagnosed with inoperable lung cancer after imaging revealed lesions suspicious for metastases. The patient died approximately one month after the diagnosis.

An expert reviewing the case concluded that both the initial failure to identify the lung nodule and the subsequent failure to communicate the suspicious finding fell below the standard of care.

The case demonstrates how an imaging interpretation error, combined with deficiencies in communication and electronic reporting systems, can delay diagnosis even when an abnormality is subsequently identified.

The Doctors Company also highlighted the importance of patient education as radiology reports become increasingly accessible through electronic patient portals. Practices should use understandable language when explaining findings and recommended follow-up care to help ensure patients recognize the significance of abnormal results.

The insurer concluded that reducing radiology malpractice exposure requires coordinated attention to diagnostic decision-making, communication between practitioners and reliable systems for tracking and managing significant imaging findings.

November 4, 2026 by matray

Sentinel Risk Group has expanded its artificial intelligence risk assessment and governance program for medical and behavioral health practices, adding safeguards specific to mental healthcare while addressing emerging malpractice insurance and regulatory concerns associated with clinical AI use.

November 4, 2026 by matray

Specialty Program Group LLC has appointed Victoria "Vicky" Dearing senior vice president of SPG ExecuPro, expanding its brokerage expertise in medical malpractice, allied health and other professional liability risks.

November 3, 2026 by matray

The New York Court of Appeals ruled that a hospital’s self-insurance plan provided malpractice coverage for an employed physician, but that the coverage was excess to the physician’s primary insurance, requiring the hospital and the physician’s excess insurer to share settlement costs beyond the primary policy’s limits.

Case: Kolli v. Kaleida Health, No. 72, 10/22/2026, published.

Facts and procedural history: In 2011, Dr. Venkateswara Kolli treated a patient as part of his duties pursuant to an on-call, per diem physician employment agreement with Kaleida Health.

When the patient later filed a medical malpractice action against Kolli and Kaleida, Kolli filed an insurance claim with his primary medical malpractice insurer, the MLMIC Insurance Co., as well as his excess insurer, the Healthcare Professionals Insurance Co.

After Kolli died in 2020, the medical malpractice action settled. Kaleida, MLMIC, and HPIC agreed to fund the settlement while reserving their rights to determine insurance coverage and priority of coverage.

The executor of Kolli’s estate then filed a declaratory judgment action to determine those coverage issues.

The estate argued Kaleida provided Kolli with insurance coverage under Kaleida's self-insurance plan and that MLMIC is entitled to be reimbursed by Kaleida for expenses it incurred defending Kolli.

Kaleida contended HPIC was obligated to provide first layer excess coverage pursuant to the policy HPIC issued to Kolli.

HPIC moved for summary judgment dismissing all claims against it and seeking reimbursement of its contribution towards the settlement. The estate also moved for summary judgment, as did Kaleida.

Niagara County Supreme Court Justice Edward Pace granted the motions of HPIC and the estate, and denied Kaleida’s motion. Pace concluded HPIC's coverage constituted excess coverage and declared that the full amount of the settlement must be paid by Kaleida and MLMIC in proportion to their respective policy limits.

Kaleida appealed.

The Appellate Division’s 4th Department found Kolli was entitled to coverage under Kaleida's self-insurance plan.

“Kaleida failed to meet its burden of establishing that its construction is the only fair construction,” the Appellate Division said, finding the language in Kaleida's self-insurance plan could reasonably be interpreted to limit coverage when Kolli treated his private practice patients at Kaleida, but not to limit coverage where, as in the underlying action, he treated a patient at Kaleida as part of his on-call duties pursuant to his employment agreement.

Since Kaleida’s self-insurance plan protected against physicians' medical malpractice liability, the Appellate Division said it constituted "other insurance policy or equivalent coverage" under MLMIC's policy.

The Appellate Division also said Kaleida's coverage was excess to MLMIC's policy, as Kaleida's self-insurance plan provides that physicians "shall be assumed to be maintaining primary medical practice insurance."

The Appellate Division said MLMIC’s $1.3 coverage limit applied, and Kaleida and HPIC are responsible as excess insurers for the remaining portion of the settlement, with Kaleida responsible for 91.67% and HPIC responsible for 8.33%.

Analysis: The New York Court of Appeals agreed Kolli was covered pursuant to the unambiguous terms of Kaleida's self-insurance plan and Kaleida's employment agreement with him.

The court rejected Kaleida's contention that its self-insurance plan falls outside the "other insurance" clauses in the policies issued by MLMIC and HPIC. The court said it was an insurance policy as it protected physicians against risks, and contained terms regarding priority of coverage and coverage exclusions.

Moreover, the "other insurance" clauses contained within the MLMIC and HPIC policies expressly encompassed "insurance equivalent[s]" or "equivalent coverage," the court said. So even if the self-insurance plan was not "insurance," it was at a minimum an "equivalent" thereto, the court said.

The court further agreed that Kaleida's coverage is excess to MLMIC's coverage, and that Kaleida and HPIC are responsible for excess coverage on a pro rata basis.

Disposition: Affirmed.

To read the court’s decision, click here.

November 3, 2026 by matray

Medical professional liability insurers continued to benefit from improving investment income in 2025, although their fixed-income portfolios generated slightly lower yields than those of the broader property/casualty insurance industry, according to a new analysis by New England Asset Management (NEAM).

Portfolios Remain Conservative

Higher Risk Associated With Higher Yields

November 3, 2026 by matray

Aon plc has launched a North America Healthcare division within its Risk Capital business to help U.S. healthcare providers and their insurers manage increasingly interconnected financial and liability risks.

The new division will combine Aon's medical professional liability reinsurance expertise with its commercial risk capabilities, serving hospitals, health systems, physician groups and the insurers that cover them.

Announced Nov. 3, the initiative comes as healthcare organizations assume greater financial responsibility for patient outcomes while confronting rising liability costs, social inflation and increasingly large malpractice verdicts.

According to the Health Care Payment Learning & Action Network, nearly 29% of U.S. healthcare payments now flow through value-based arrangements that expose providers to downside financial risk.

Aon said the new division will help healthcare organizations and insurers evaluate their combined risk exposures, determine which risks to retain or transfer, and develop financing strategies using traditional insurance, reinsurance, captive insurance arrangements and alternative capital.

“Healthcare providers in the U.S. are becoming risk-bearing organizations, and the insurers that protect them face the same pressures,” said Joe Peiser, CEO of Aon's Risk Capital business. “Through our Risk Capital structure, Aon is uniquely positioned to help connect both providers and insurers with the right capital, in the right structure, at the right time.”

Aon appointed Nick Gaudiosi as North America Healthcare Industry Leader, Risk Capital, to oversee the new division.

Gaudiosi has served as senior managing director and healthcare segment leader for Aon's reinsurance business since 2025, helping develop the firm's medical professional liability reinsurance practice. He will continue overseeing that strategy in his expanded role.

Gaudiosi joined Aon in 2023 after serving as president and chief operating officer of American Healthcare Providers Insurance Services, which he led through its acquisition by Curi.

“The risks carried by health systems and by the insurers that protect physicians and hospitals are increasingly linked,” Gaudiosi said. “Bringing our reinsurance and commercial risk expertise together gives clients one integrated view of that risk and a clear strategy for financing it.”

November 2, 2026 by matray

Willis Re has completed its acquisition of BMS Re US, expanding its reinsurance broking capabilities in medical malpractice and other property and casualty lines, the company announced Nov. 1.

October 29, 2026 by matray

The American Medical Association has proposed a framework for determining liability when artificial intelligence used in clinical care causes patient harm, calling for responsibility to be allocated among physicians, technology developers and healthcare organizations according to their ability to prevent or mitigate risks.

The framework, announced Oct. 29 by the AMA's Center for Digital Health and AI, addresses concerns that existing medical liability standards were not designed for technologies in which multiple parties exercise varying degrees of control over clinical decisions and patient outcomes.

The AMA warned that physicians could face liability for AI-related risks they cannot reasonably identify or prevent, while patients harmed by the technology could encounter difficulties obtaining legal remedies.

“Patients must have meaningful avenues for recourse when clinical AI causes harm, and physicians must be able to use these technologies with confidence that responsibility reflects what they can reasonably know and control,” said AMA President Willie Underwood III, MD.

The proposed approach would establish distinct but complementary responsibilities for the parties involved in developing, deploying and using clinical AI systems.

Under the framework, developers and manufacturers would be responsible for demonstrating and maintaining the safety and effectiveness of their products, including addressing risks within their control.

Hospitals, health systems and other healthcare organizations would be accountable for selecting, implementing, governing and monitoring AI technologies in clinical settings.

Physicians, meanwhile, would remain responsible for exercising clinical judgment, but their liability would be tied to the degree of oversight they can meaningfully provide, considering an AI system's intended use, known limitations and the information available when making treatment decisions.

The AMA also emphasized that patients must retain meaningful opportunities to pursue remedies when injuries result from defective AI products or other failures for which a party may be held legally responsible.

The framework recognizes that multiple parties could share liability for an AI-related patient injury, rather than placing responsibility exclusively on the treating physician or the technology developer.

A central principle is that requiring physician oversight of AI does not automatically relieve developers or healthcare organizations of their own responsibilities. The AMA said clinical review cannot compensate for inadequate evidence supporting an AI system's safety, deficiencies in its design or circumstances that prevent physicians from exercising meaningful oversight.

“As AI assumes more clinical functions, developers, healthcare organizations and physicians each have important responsibilities,” Underwood said. “We need clear expectations that protect patients, support sound clinical judgment, and ensure accountability remains with those best positioned to prevent harm.”

The proposal reflects growing concern over how traditional medical malpractice and product liability principles should apply as AI technologies become more deeply integrated into patient care.

The AMA's framework outlines recommended principles for assigning responsibility rather than establishing binding legal standards. Its central recommendation is that liability should follow each party's authority over an AI system and its practical ability to identify, prevent or mitigate harm.

October 28, 2026 by matray

Corgi Insurance, a relatively new, venture-backed insurer specializing in AI-driven underwriting, has entered the medical professional liability market with the launch of coverage for physician practices, urgent care centers, dental offices and other healthcare providers.

October 28, 2026 by matray

The Iowa Supreme Court reversed the dismissal of a medical malpractice lawsuit against a physician assistant, ruling that physicians and physician assistants practice in substantially similar fields under the state's certificate of merit requirements. The court held that an expert's qualifications depend on the field covered by their professional license, rather than their particular area of medical practice. The decision allows a surgeon's certificate of merit affidavit to support a malpractice claim against a physician assistant practicing in primary care.

Case: Davenport v. Fuller, No. 25–1183, 10/16/2026, published.

Facts: In March 2023, Joshua Davenport saw his primary care provider, physician assistant Nathaneal Fuller, twice in three days, complaining of abdominal pain and trouble urinating.

Fuller diagnosed Davenport with urinary retention secondary to a probable enlarged prostate and sent him home with medication.

A few days later, Davenport’s symptoms worsened, and he sought emergency care. Davenport was then diagnosed with acute diverticulitis. He suffered a perforated bowel, feculent peritonitis, and septic shock, requiring him to be hospitalized for several weeks.

Procedural history: Davenport filed a medical malpractice action against Fuller. He timely served Fuller with a certificate of merit affidavit signed by Dr. Cass Franklin.

After Davenport’s deadline to designate additional experts expired, Fuller moved to dismiss the lawsuit for failure to comply with Iowa’s certificate of merit affidavit requirements. Fuller argued that Franklin, as a surgeon, was not qualified to opine on the standard of care for a physician assistant practicing as a family medicine or primary care provider.

A trial judge agreed and granted the motion to dismiss.

Analysis: The Iowa Supreme Court explained that a medical malpractice expert must be “licensed to practice in the same or a substantially similar field as the defendant,” and have “actively practiced in the same or a substantially similar field” for the past five years.

The court said it has interpreted the term “field” as categorically distinguishing one type of healthcare provider from another, and that it has rejected the argument that “field” means a specific practice area.

An expert and defendant are therefore “licensed in and practice in the same field if they hold the same license and practice under the same license,” the court said.

Here, the court noted, the judge found Fuller practiced “mainly as a primary care provider in the practice of family medicine” and Franklin practiced “in the fields of general surgery, vascular access surgery, and transplant surgery” while working as a trauma surgeon in the emergency department.

The court said that “a healthcare provider’s field is coterminous with his license, not a specific area of practice within that license,” and so the judge erred in focusing on Fuller and Franklin’s respective areas of practice within their licenses to conclude they did not practice in the same or substantially similar fields.

While Fuller’s license as a physician assistant is not “the same” as Franklin’s license as a physician, the court said they are licensed and practice in substantially similar fields.

“Fields are substantially similar when they share a high degree of likeness in their core characteristics, although not identical, such that a practitioner licensed in one field would, by virtue of that license alone, possess the foundational knowledge and competence to evaluate and opine on the standard of care applicable to the other field,” the court said.

The court said it has identified seven nonexclusive factors relevant to assessing whether specialties are substantially similar: (1) the formal definitions of the specialties, (2) the certifying board structures, (3) the required education and training, (4) the scope of practice, (5) overlap in core and procedural competencies, (6) professional association overlap, and (7) hospital credentialing patterns.

The court determined “the respective definitions, scopes of practice, certifying board structures, and education and training requirements for physicians and physician assistants demonstrate that the two fields are substantially similar.”

Iowa defines both physician assistants and physicians based on a shared “practice of medicine, the court said. The specific medical services physician assistants can provide also indicates that their scope of practice is substantially similar to physicians, the court said, and there is licensure oversight by the board of medicine and mandatory physician participation on the board of physician assistants.

“The requirement for physician oversight before a physician assistant can practice medicine independently further supports a determination that the fields are substantially similar,” the court added.

In light of these considerations, the court concluded physicians and physician assistants are licensed to practice in substantially similar fields.

Disposition: Reversed and remanded.

To read the court’s decision, click here.