Nevada Med-Mal Rates Stabilizing

Approval of a 2004 ballot question and action by state lawmakers two years before that are stabilizing medical malpractice insurance rates in Nevada, legislators were told recently.

Question 3, the Keep Our Doctors in Nevada initiative, garnered nearly 60 percent of voters’ support last year. It puts a cap of $350,000 on pain and suffering awards in medical malpractice lawsuits. It also limits the fees attorneys can get for representing patients in those cases.

“We believe that the reforms adopted with the passage of ballot Question 3 will be successful,” said Michael Fischer, president of the Nevada State Medical Association. “(It will) restore confidence in Nevada as a good place to live and practice medicine.”

Cliff King, chief insurance assistant for the Nevada Division of Insurance, said malpractice rates have been stabilizing and requests for rate increases have become fewer and smaller since 2002, when state lawmakers approved the $350,000 cap on noneconomic damages. But the Legislature included two circumstances allowing litigants to receive more than $350,000: if the wrongdoer committed gross malpractice or there were exceptional circumstances.

Doctors who thought legislators didn’t go far enough worked to put Question 3 on the ballot to remove the exceptions.

“Right now I think the market’s looking a lot better to everybody,” said Scott Craigie of Keep Our Doctors in Nevada. “We are recovering and I do believe a major reason for that is what’s happened in this past election cycle.”

But Bill Bradley of the Nevada Trial Lawyers Association told the Senate Judiciary Committee that ballot questions like the one passed here last fall have had “catastrophic impacts on victims’ rights.”

“Under this law, victims will potentially not be allowed to recover medical bills and wage losses,” he said.

Nevada has six major malpractice insurance providers representing 3,247 doctors, but Sens. Terry Care, D-Las Vegas, and Mark Amodei, R-Carson City, worried that just two providers, Nevada Mutual Insurance Company and the Medical Liability Association of Nevada, insure two-thirds of the state’s doctors.

“We just want to know what’s going on in terms of our vulnerabilities,” said Amodei, the committee’s chairman. “Do we live with this and cross our fingers?”

King said Nevada Mutual is owned and operated by Nevada doctors and so wouldn’t pull out. MLAN cannot pull out because it is a government-supervised and created organization. He said the priority is to make sure those two carriers remain solid.

“We do not want to have to cross our fingers with any carrier,” King said. “We do not anticipate losing any carriers.”

King said Nevada also is in a better position than other states, such as Oregon, which has just two providers.

Sen. Dennis Nolan, R-Las Vegas, said he thought the best way to prevent a carrier from pulling out of the market would be to create a positive environment for them in the state.

“Without being Draconian or doing something that would have an adverse effect for attracting or maintaining insurance carriers, is there anything we should be doing to prevent a catastrophe?” he asked.

King said he’s received positive feedback from the carriers with smaller loads indicating they would be willing to increase their market shares in the state and reduce rates if the 2002 legislation is upheld.

But the legislation has not been challenged in court yet, King said.

Amodei wondered if there’s a way to test the legislation through the attorney general’s office without waiting for a lawsuit.

“What I hear you saying is some of these rate decisions are going to be based on how the courts rule,” he said. “I would think instead of thinking, ‘When is someone going to file a piece of litigation,’ that we could be proactive.”

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