Medical liability insurance premiums rose for 39.9% of U.S. physicians in 2025, the seventh straight year of increases, according to an American Medical Association analysis published in April 2026. That share is down from a 2024 peak of 49.8%, but it remains the second-highest rate of premium increases recorded since 2005.
A Seven-Year Climb Toward 2005 Levels
The AMA's Policy Research Perspectives report tracked premium changes from 2016 through 2025 using data from the Medical Liability Monitor's Annual Rate Survey, which covers 60% to 80% of the medical liability insurance market. The share of premiums holding flat from one year to the next fell from 80.8% in 2018 to 57.0% in 2025. The share of premiums that declined fell too, from 9.4% in 2016 to 3.1% in 2025.
The upward run began in 2019, when the share of premiums rising from the prior year nearly doubled to 26.5%, up from 13.7% in 2018. That share kept climbing through 2022 and 2023, then jumped to 49.8% in 2024, the highest rate since 2005, when 65.5% of reported premiums rose. Even after the pullback to 39.9% in 2025, the seven-year run has not returned to pre-2019 levels.
| Year | Any Premium Increase | Increase of 10% or More | No Change |
|---|---|---|---|
| 2016 | 15.4% | 1.0% | 75.2% |
| 2018 | 13.7% | 3.9% | 80.8% |
| 2020 | 31.1% | 5.2% | 60.8% |
| 2022 | 36.2% | 10.2% | 56.1% |
| 2024 | 49.8% | 7.7% | 45.5% |
| 2025 | 39.9% | 6.0% | 57.0% |
Source: American Medical Association, Policy Research Perspectives, April 2026, Exhibit 1, based on Medical Liability Monitor Annual Rate Survey data.
Most of the 2025 increase was modest rather than sharp. Only 6.0% of all reported premiums rose by 10% or more in 2025, down from 7.7% in 2024 and well below the 10.2% recorded in 2022. The bulk of the 39.9% figure, 33.9 percentage points of it, came from smaller, single-digit adjustments spread across most of the country.
Which States Saw the Sharpest Jumps in 2025
Premium increases spread unevenly across the country. 36 states reported at least one premium increase in 2025, down from 46 states in 2024. In 18 of those states, at least half of the reported premiums rose, down from 22 states in 2024, but still above the 13 states recorded in 2023, 15 in 2022, and 6 in 2021.
Eleven states had at least one premium jump of 10% or more in 2025, down from 16 states in 2024. Five of those states, Pennsylvania, Kentucky, Florida, Illinois, and New York, posted a 10%-or-larger increase in both 2024 and 2025. Pennsylvania led the list: 92.2% of its reported premiums rose in 2025, with the largest single increase reaching 29.6%. New York was close behind, with 95.7% of its reported premiums rising that year.
Why State Law Shapes the Bill
Six states, Indiana, Kansas, Louisiana, Nebraska, New Mexico, and Pennsylvania, run a Patient Compensation Fund that adds a surcharge on top of the base premium. In those six states, 76.1% of premiums rose in 2025, compared with 35.9% in states without a fund.
California sits at the other end of the range. Its premiums stayed unchanged between 2024 and 2025 and rose just 1.5% between 2023 and 2024. The one exception was an 11.6% average increase between 2022 and 2023, the year California raised the cap on non-economic damages under its Medical Injury Compensation Reform Act from $250,000 to $350,000. That cap is set to keep rising to $750,000 over the following decade, with a 2.0% annual inflation adjustment after that.
What the Same Specialty Costs in Different States
Reported premiums for the same specialty vary widely by state. In Florida, insurers reported an average premium of $243,988 for obstetrics/gynecology and general surgery, against $59,736 for internal medicine, a gap tied to the higher liability risk carried by surgical and OB specialties. Connecticut shows the same pattern at a lower scale: $159,537 for obstetrics/gynecology and general surgery, versus $22,467 for internal medicine.
| State | Specialty | Average Reported Annual Premium |
|---|---|---|
| Florida | OB/GYN and general surgery | $243,988 |
| Florida | Internal medicine | $59,736 |
| Connecticut | OB/GYN and general surgery | $159,537 |
| Connecticut | Internal medicine | $22,467 |
Source: American Medical Association, Policy Research Perspectives, "For the seventh consecutive year, medical liability premiums continue to rise," April 2026, based on Medical Liability Monitor 2025 Annual Rate Survey data.
How This Compares to the Last Hard Market
The current run of increases has not reached the scale of the early 2000s liability crisis. In 2003, 77.4% of reported premiums rose from the prior year, and in 2004 that share reached 82.1%. Some general surgeons in Miami-Dade County, Florida faced manual premiums as high as $277,241 in 2004. By comparison, 2025's 39.9% increase rate and the 2024 peak of 49.8% stay well under those levels, even after seven straight years of increases.
What This Means for Practice Budgets
A practice's malpractice line item depends on specialty mix and location more than on the national trend. A multi-specialty practice with a surgical or OB/GYN division in a state without a damages cap carries a different renewal risk than a primary-care-only practice in California. The AMA report tracks premiums for three specialties only, general surgery, obstetrics/gynecology, and internal medicine, so a practice outside those specialties should treat the state-level and fund-status findings as the more transferable signal for its own renewal.
Practices in the 18 states where at least half of reported premiums rose in 2025, and especially the 5 states with two straight years of 10%-plus increases, have the clearest reason to budget for a renewal increase rather than assume last year's premium holds.
Sources
- American Medical Association, "For the seventh consecutive year, medical liability premiums continue to rise," Policy Research Perspectives, April 2026
- Fierce Healthcare, "Medical professional liability premiums rise for 7th straight year," 2026
Talk to us
Fifteen minutes about your practice and the systems you run.