Medical malpractice renewals are often viewed as a routine annual task. Today’s health care organizations, however, face evolving claims trends, telehealth exposures, AI-related risks, workforce changes and rising claim severity. As a result, the renewal process has become a critical opportunity to evaluate insurance coverage, identify emerging liabilities and strengthen risk management and patient safety efforts before a loss occurs.
Paul Greve, senior director at Markel Healthcare Risk Solutions, recommends that health care organizations ask three key questions before renewing malpractice liability coverage.
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Are the current limits of liability and self-insured retention adequate, given increasing claim severity trends?
Increasing claim severity can affect an organization’s risk profile and potential financial exposure. Evaluating whether current liability limits and self-insured retention levels remain aligned with emerging loss trends can help ensure the organization maintains appropriate protection while balancing risk retention and coverage needs. Medical malpractice actuaries can help determine appropriate risk retention levels.
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What claims trends stand out over the last 10 years, and what has been done to mitigate those risks?
Understanding long-term claims trends helps organizations identify recurring sources of loss, assess the effectiveness of mitigation strategies and prioritize risk management resources. Greve recommends paying particular attention to trends involving high-severity events and claims, especially those involving obstetrics and pediatrics.
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What systems and processes are in place to quickly identify and prevent batch claims?
An error in a process, system or product can affect multiple patients and result in significant financial and reputational consequences. Assessing whether there are controls in place to identify potential issues quickly, respond appropriately and prevent widespread losses before they escalate into multiple related claims should be an essential part of the renewal process. Establishing and monitoring these controls should be an integral part of the risk management process and should be described in detail during renewal.
Start planning early
The American Medical Association recommends beginning the renewal process three to four months in advance to allow adequate time for evaluation and decision-making.
Key internal stakeholders should include risk management, legal counsel, finance, clinical leadership, patient safety leaders and physician leadership, where applicable.
Renewal checklist
Before renewing, health care organizations should:
- Review five to 10 years of claims and loss-run history, including telehealth services and multi-state practice exposures.
- Confirm all current services, providers, locations, telehealth activities, acquisitions and geographic expansions are accurately reflected.
- Review staffing changes, supervision structures, turnover, new clinical services, specialty programs and other operational changes.
- Review AI applications, telehealth services, digital health tools and related cyber, privacy and technology liability exposures to ensure appropriate insurance coverage is in place.
- Verify coverage limits, deductibles, self-insured retentions and excess liability structures.
- Review exclusions, endorsements and coverage sublimits.
- Check retroactive dates, tail coverage obligations and any changes to claims-made provisions.
- Ensure systems are in place to rapidly identify, investigate and respond to incidents that could result in multiple claims.
Make renewal a strategic risk review
Health care organizations operate in a constantly changing risk environment as services expand, technology evolves and organizational structures shift. Treating malpractice renewal as a comprehensive risk review rather than a routine insurance exercise can help organizations strengthen protection, improve patient safety and better prepare for emerging liability challenges.
