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Survey Report

Insurance Marketplace Realities 2023 Spring Update – Healthcare professional liability

April 28, 2023

While overall rate increases appear to be stabilizing, decreases are not expected any time soon.
Rate predictions: Healthcare professional liability
  Trend Range
Allied health Increase (Purple triangle pointing up) Flat to 15%
Physicians Increase (Purple triangle pointing up) +5% to +15%
Senior living Increase (Purple triangle pointing up) Flat to 10%
Hospital professional liability Increase (Purple triangle pointing up) +5% to +20%

The medical malpractice market continues to experience challenges driven by systemic risks, such as rolling back of tort reforms in key states (California, New York, Pennsylvania) and increasing severity of claims. Furthermore, antitrust and class action claims continue to be problematic while social inflation and economic inflation add an additional wrinkle to the market dynamic. We are beginning to see batch claims creating additional pressure in the market. Overall rate increases appear to be stabilizing; however, rate decreases are not expected in the short term. Carriers are indicating they will need consistent rate and retention increases given the current market trends, especially for health systems, loss-affected accounts, and clients with exposure in challenged venues. Frequently, excess layer increases can outpace lead layer increases due to the larger impact of trend and severity on higher layers. The market continues to experiece:

  • Increases in client retentions
  • Sexual abuse
  • Capacity crunch (while some of the excess capacity that was lost has been restored with new entrants, carriers continue to deploy their capacity judiciously)
  • Communicable disease exclusions, mainly for senior living and certain segments of allied health

Mergers and acquisitions

The number and size of acquisitions declined in 2022, largely due to the pandemic; however, combinations continue to be a common practice in healthcare. While the impact of M&A is debatable, some key points that can impact market response:

  • Does M&A activity impact quality of patient care?
  • With continuing workplace shortages, does M&A activity increase worker burn out?
  • Does pre-acquisition due diligence provide enough accurate data to adequately underwrite M&A risks?
  • Physicians’ risks are impacted positively because the use of MSOs help manage the backroom, including loss data, credentialing.

Nuclear verdicts

Increasing frequency of substantial and oversized verdicts will continue to cause turbulence in the marketplace by driving further deterioration in the loss. environment.

  • The cost of nuclear verdicts directly impacts the cost of healthcare insurance.
  • As verdicts continue to grow, carriers will seek to increase premiums and attachment points.
  • Jurors continue to hold defendants accountable to society for perceived unsafe practices.


Willis Towers Watson hopes you found the general information provided in this publication informative and helpful. The information contained herein is not intended to constitute legal or other professional advice and should not be relied upon in lieu of consultation with your own legal advisors. In the event you would like more information regarding your insurance coverage, please do not hesitate to reach out to us. In North America, Willis Towers Watson offers insurance products through licensed entities, including Willis Towers Watson Northeast, Inc. (in the United States) and Willis Canada Inc. (in Canada).


Healthcare Broking Leader, North America

Daniel Markosky
Senior Healthcare Broker

Laura Coombs, RPLU, CPLP
National Physicians Broking Leader

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