If you’re a nurse practitioner, PA, nurse, physical therapist, or counselor, you probably don’t spend your evenings reading healthcare liability market reports. Fair enough. But the data coming out of the malpractice market right now is worth your attention, because it’s changing the math on how much coverage you need, what kind of policy makes sense, and why the cheapest option on the screen might not be the smartest one.
This isn’t a pitch. It’s a look at what’s actually happening in healthcare liability claims in 2025 and 2026, drawn from industry claims analyses, the National Practitioner Data Bank (NPDB), the MedPro Group Healthcare Liability Market Update, and CM&F Group’s own claims experience across millions of policies written over the past 107 years. CM&F has been insuring healthcare professionals since 1919, and in that time, we’ve never seen a market quite like this one.
Verdicts Are Getting Larger, and They’re Not Slowing Down
The headline number that every healthcare professional should know: verdicts greater than $10 million have more than doubled between 2015 and 2023. The average award in those cases rose from $23 million to $40 million in the same period. And every U.S. state reported at least one verdict above $10 million during that timeframe.
These aren’t just physician cases. In 2025, a $951 million verdict in a birth injury case in Utah involved nursing care. In Florida, a jury awarded $70.8 million to a patient after a nurse practitioner did not order the appropriate imaging or specialist consultation. And in what is believed to be the largest single-plaintiff medical malpractice verdict in U.S. history, a New Mexico jury awarded $412 million against a men’s health clinic after a physician associate administered an unnecessary and improperly dosed injection that caused permanent injury. The jury found the clinic engaged in fraud and negligence.
These cases make the news, but they also make the actuarial tables. When carriers pay out nine-figure verdicts, the entire market adjusts.
What does that mean for you as an individual practitioner? It means the cost of defending and resolving claims is rising across the board, and the carriers who have been underwriting healthcare liability for decades are pricing their policies to reflect that reality. Newer entrants offering dramatically lower premiums may not have the claims history or financial reserves to sustain those prices when their first wave of payouts arrives.
What Claims Actually Look Like for NPs, PAs, and Nurses
Market-level verdict data tells you the environment is getting more expensive. Profession-level claims data tells you where the risk actually concentrates. Both matter, but the second one is what helps you make personal coverage decisions.
An industry claims analysis of nurse practitioner claims, incorporating data reported through the National Practitioner Data Bank, found that the average total incurred per NP malpractice claim is $332,137. For NPs who own their own practices, that figure climbs to $431,634. The most expensive category of NP claims involves diagnosis-related allegations (missed, delayed, or wrong diagnosis), which account for 37.1% of all claims and carry the highest average severity at $385,947.
One data point that stands out: death is the reported patient outcome in 45.7% of NP injury claims. These are disproportionately concentrated in primary care settings where NPs are functioning as the first and sometimes only point of clinical contact.
For physician associates, CM&F’s internal claims experience spans over 1,000 PA claims. PA claim patterns mirror NP patterns in primary care but diverge in surgical and emergency medicine settings, where PAs face distinct procedural liability.
For nurses, a 2025 industry report puts the average total incurred on nursing claims at $236,749. The claim drivers are familiar: medication errors, patient falls, and documentation gaps.
None of these numbers are designed to alarm you. They’re designed to help you make informed decisions about coverage limits, policy structure, and carrier quality.
Why “How Much Does Malpractice Insurance Cost?” May Not Be the Right Question to Ask First
The most-searched questions about malpractice insurance are almost always about price. “How much does NP malpractice insurance cost?” “What is the cheapest malpractice insurance for nurses?” “PA malpractice insurance cost.” These are completely reasonable questions. Nobody wants to overpay for anything.
But the claims data points to something worth considering before price: what actually happens when you need the policy to work. There’s a meaningful difference between a carrier that defends 90% of cases that go to trial and wins, versus one that settles early to minimize their own costs, potentially with a mark on your record. There’s a meaningful difference between a policy where defense costs are paid outside your coverage limits (leaving your full policy limit available for any settlement) versus one where your legal fees eat into the same pool that would cover damages.
CM&F’s carrier-partner, MedPro Group, maintains an A++ (Superior) rating from A.M. Best, the highest available. Eighty percent of claims are closed without any payment to the plaintiff. When cases do go to trial, the win rate is 90%. And defense costs are paid outside the limits of liability, meaning your full policy limit remains intact for settlements or judgments.
These details matter more than they might seem on a quote comparison screen. In a market where average NP claims exceed $330,000 and jury verdicts regularly reach eight and nine figures, the quality of your carrier’s claims defense is the single most consequential variable in your coverage.
Why Malpractice Insurance Is Getting More Expensive (and What That Means for You)
If you’ve noticed your premium creeping up at renewal, you’re not alone. It’s something we hear from practitioners regularly, and it’s a fair concern. The reality is that across the healthcare liability market, the cost of defending and resolving claims has been rising faster than premium revenue for several years. That pressure shows up in rates.
We want to be straightforward about this because understanding why it’s happening puts you in a better position to make coverage decisions that actually protect your money and your career.
The MedPro Group Healthcare Liability Market Update tracks the data behind these trends, including payout ratios, premium movement, and financial strength ratings across the industry. The short version: when jury verdicts grow larger and defense costs increase, carriers have to adjust their pricing to continue paying claims reliably. The alternative, cutting prices and hoping for the best, is how carriers become insolvent, and that leaves their policyholders scrambling for new coverage at the worst possible time.
What CM&F focuses on is keeping coverage as affordable as possible while making sure the carrier behind your policy has the financial strength to actually be there when you need it. That balance is what matters. A policy that saves you $50 a year but can’t defend a $300,000 claim isn’t saving you anything.
For individual practitioners, the broader market shift means a few things worth watching. Premiums across the industry are likely to continue rising modestly year over year. Some carriers with thinner financial reserves may exit the market or stop covering certain professions. And the difference between well-established carriers with decades of claims experience and newer entrants still building their track record will become easier to see.
As William Sullivan, Executive Vice President of CM&F Group, noted in a recent analysis: most new carriers need five to eight years of data before they understand how their book of business performs. In that period, their pricing is based on projections, not experience. When the payouts arrive, the math changes.
What This Means for Physical Therapists and Counselors
The data conversation tends to center on NPs and nurses because of volume. But the trends are relevant across every profession CM&F serves.
Physical therapist claims are driven by a distinct set of factors. A PT claims analysis found that the average total incurred on PT claims is $134,761, with patient falls and manual therapy complications as the leading categories. PT coverage has grown substantially in recent years, reflecting both increased policy volume and the expanding scope of PT practice (dry needling, direct access, cash-pay models). For PTs opening clinics, the insurance stack now extends beyond professional liability to include general liability, cyber coverage, and potentially workers’ compensation.
For counselors and clinical social workers, the risk landscape is shaped by the therapeutic relationship itself. Licensing board complaints, boundary violation allegations, and duty-to-warn scenarios drive the majority of claims. The counseling profession is one of the fastest-growing segments in CM&F’s portfolio, reflecting the rapid expansion of mental health professionals entering private practice through platforms like Headway and BetterHelp. The Bureau of Labor Statistics projects 17% employment growth for mental health counselors through 2034, which means more clinicians will need coverage, and the claims volume for the profession will grow with it.
What This Means When You’re Evaluating Your Own Coverage
You don’t need to become a market analyst to use this information. But a few practical takeaways from the data can make a real difference the next time you’re reviewing your policy or comparing options.
Look beyond price. A policy that costs $50 less per year but lacks defense outside limits, consent-to-settle rights, or adequate licensing board defense coverage is not actually cheaper when you need it. Evaluate what the policy does, not just what it costs.
Check your carrier’s financial strength. An A.M. Best rating of A or higher indicates that the carrier has the financial reserves to pay claims even when the broader market is under pressure. This matters more now than it has in years, because weaker carriers are the first to cut corners or exit the market when payouts increase.
Confirm your coverage limits reflect your actual exposure. Many clinicians commonly start at lower limits of $100K/$300K per-claim and aggregate, with additional limit options available depending on your application inputs and practice profile. If you’re in a high-acuity specialty, own a practice, or work across multiple states, your exposure may warrant a conversation with your insurance advisor about whether your limits are appropriate. A good rule of thumb is to purchase limits that are within budget, but also provide peace of mind.
Make sure your policy includes licensing board defense as a separate benefit. An industry analysis found that 43% of board matters led to some form of action against a clinician’s license. Board complaints do not require a lawsuit to cause serious professional and financial harm, and the legal costs of defending them should not draw from your malpractice limits.
Understand occurrence vs.?claims-made. In a market where claims take 18 to 24 months to surface, occurrence-based coverage provides the cleanest long-term protection. CM&F offers occurrence-based policies for most allied health professions, eliminating the need for tail coverage during career transitions.
Key Takeaways
Healthcare liability verdicts are rising, with awards above $10 million more than doubling between 2015 and 2023 and average awards reaching $40 million. This affects every profession, not just physicians.
The average NP malpractice claim costs $332,137 to resolve. For NP practice owners, that average is $431,634. Diagnosis-related claims are the most expensive category. These numbers should inform your coverage limit decisions.
Carrier quality matters more when the market is under pressure. Defense outside limits, consent-to-settle rights, and A++ financial strength ratings are not marketing language. They are the structural features that determine whether your policy performs when you need it.
The cheapest policy is not the most cost-effective policy. Carriers entering the market with aggressively low pricing may not have the claims history or reserves to sustain those prices long-term. A policy that doesn’t exist when you need it has no value regardless of what you paid for it.
Frequently Asked Questions
- How much does the average nurse practitioner malpractice claim cost?An industry claims analysis found that the average total incurred per NP malpractice claim is $332,137. For nurse practitioners who own their own practices, the average rises to $431,634. Diagnosis-related allegations are the most expensive claim category, averaging $385,947.
- Why is malpractice insurance getting more expensive in 2026?Healthcare liability verdicts are increasing in both frequency and severity. Verdicts above $10 million have more than doubled since 2015, and average awards in those cases have risen to $40 million. These trends increase the cost of defending and resolving claims, which carriers pass through as modest premium increases to maintain financial stability.
- What should healthcare professionals look for in a malpractice insurance carrier?Prioritize financial strength (A.M. Best A or higher), defense costs paid outside limits of liability, consent-to-settle rights, and separate licensing board defense coverage. These features determine how well your policy performs when a claim is filed. A low premium means little if the carrier lacks the reserves to defend and resolve claims effectively.
