The Basics
- The top five malpractice providers account for approximately 84% of the market
- Number of medical professional liability insurers in the state in 2013: 97
- Total number of active physicians as of September 2014: 24,476
Tort Reform
In 2011 North Carolina enacted tort reform legislation which became effective on October 1, 2011. This bill limited non-economic damages to $500,000 and, beginning in 2014, this amount will be adjusted upward for inflation each year. The cap will not apply in cases where the injured patient suffered disfiguring or permanent injury and the defendants conduct was considered reckless, grossly negligent, intentional or malicious.
Like most states, North Carolina does not limit economic damages, those that cover actual losses. However, there is a requirement that there be two trials if the amount of damages claimed is greater than $150,000, unless the judge finds reason to combine them. Both trials are heard by the same judge but one focuses on liability while the other focuses on the amount of damages.
North Carolina also incorporated a severability clause into their damage limit which allows that if the damage cap is ever held to be unconstitutional by the court, the remainder of the act will not be affected.
Finally, North Carolina mandates a pre-trial mediated settlement conference for all civil cases.
Statue of Limitations
In North Carolina the basic statute of limitations is three years from the date of the alleged injury, or the date of the last treatment for the issue that gave rise to the alleged injury. If the injury was not immediately discovered the claimant has up to an additional year to bring a claim, but no claim can be brought more than four years after the date of the alleged injury.
An exception to the above is that in cases where a foreign object was left in the body, a claim must be brought within one year from the date of discovery but can be brought up to 10 years from the date of the injury.
In cases where the injured party is a minor under the age of 10 years old, a claim can be brought on the child’s behalf any time prior to their 10th birthday. And as in most states, the statute may be tolled, or paused, during a period where a claimant is mentally incompetent to bring a claim.
Finally, wrongful death actions must be brought within 2 years of the death of the patient.
Summary of the North Carolina Medical Malpractice Insurance Market
Since 2003 malpractice insurance rates in North Carolina have stabilized and are now considered fairly moderate. In the last 5-10 years, this state has seen an increase in competition between insurance carriers, which in turn, has furthered rate reductions. In addition, the proactive approach to increasing damage caps with inflation may help insulate the provision from the legal challenges we’ve seen in so many other states. Overall, North Carolina’s risk environment and medical malpractice insurance market appear to be stable for the foreseeable future.