California Orthopedic Surgeons Guide to Medical Malpractice Insurance

If you are a California orthopedic surgeon in private practice, or planning to open a new practice in California, use this guide prepared by independent SURGPLI insurance brokers to give you a concise overview of medical malpractice insurance. Then contact a SURGPLI insurance broker to discuss your coverage needs and get a quote.

California has the largest number of orthopedic surgeons in the U.S., according to 2023 data from the U.S. Bureau of Labor Statistics. Also, six California healthcare systems were named as “best for orthopedics” among the 65 recipients of the 2023 Choice Awards by Medscape and WebMD.

While California is a destination for orthopedic surgery, it is also a highly litigious state with approximately 16.9 medical malpractice lawsuits brought for every 100,000 residents (Source: National Practitioner Data Bank). That’s why California orthopedic surgeons need robust medical malpractice insurance.

As your only trusted broker, SURGPLI will help you find the right coverage at the best rate in California.

California orthopedic surgeons are not legally required to carry medical malpractice insurance. However, many California hospitals and health centers require physicians and surgeons to carry medical malpractice insurance if they want admitting privileges. The standard limits of liability in California are $1,000,000 Each Claim / $3,000,000 Aggregate per year in coverage.

SURGPLI strongly recommends securing coverage from an A-rated carrier as the most cost-effective way to protect against devastating financial loss if you are sued for malpractice in California. As an independent broker, we specialize in medical malpractice insurance for orthopedic surgeons. We can help you find the best coverage at a great price.

Each insurance carrier uses its own proprietary methods of setting the cost of medical malpractice insurance for orthopedic surgeons. Carriers consider factors such as practice location, surgical specialty, and past claims history.

The following are approximate medical malpractice insurance premium rates for orthopedic surgeons across all California areas:

*Using the CA standard limits of $1,000,000 Each Claim / $3,000,000 Aggregate per year in coverage

SURGPLI insurance brokers will obtain quotes from medical malpractice insurance from carriers rated “A” by A.M. Best for their long-term financial solvency and robust legal support of policyholders. Some of the top carriers include:

• The Doctors Company
• Medical Protective
• Coverys Group
• Lone Star Alliance RRG

• CAP MPT
• MIEC
• NORCAL Group (A Part of ProAssurance)

Here is a brief overview of the most common types of medical malpractice insurance for orthopedic surgeons in California:

Claims Made Insurance
Claims-made malpractice insurance provides coverage if the policy is in effect both when the incident took place AND when the claim is filed. If a claim is filed after the end of the policy date, the claim is NOT covered. With a claims-made policy you need tail malpractice insurance, which is a separately purchased insurance policy or endorsement, to make sure you have full protection

Occurrence Insurance
Occurrence malpractice insurance provides coverage for incidents that occurred during the policy year, regardless of when a claim is reported to the carrier. Occurrence policies are more costly at the start of the policy, but the rate does not “step up”, and there is no need for tail coverage when the policy ends.

Tail Insurance
Since most malpractice insurance policies are underwritten on a claims-made basis, you will be exposed to a lawsuit if a former patient files a claim against you and you do not secure tail coverage. When you are preparing to leave your employer, you should seek tail coverage options with an independent broker like SURGPLI. Tail insurance covers you for a specific time period. The new employer’s policy is not going to cover you for prior acts of a former practice, hence tail coverage is needed. Read more about tail malpractice insurance for orthopedic surgeons.

Reach out to an experienced SURGPLI insurance broker who will the legwork for you to find a tail policy at a great price.

A review of malpractice claims by The Doctors Company, an “A” rated medical malpractice insurance carrier, found that the top three major orthopedic surgical injuries were related to “an aggravated or worsened preoperative condition”, including increased pain, decreased mobility, nerve damage, and postoperative pain. Other potential orthopedic errors that most often trigger malpractice litigation include:

• Surgical site infections causing post-operative complications
• Extensive bleeding in spinal procedures
• Major blood vessel injury
• Deep vein thrombosis and pulmonary embolism post-operative

In addition, some of the most often cited allegations in California orthopedic surgery medical malpractice cases include:

• Misdiagnosis of ACL tear
• Delayed diagnosis of Achilles tendon rupture
• Failure to recognize and/or treat post-surgical infections
• Surgical injuries leading to permanent disability
• Implant failure leading to infection

Orthopedic surgeons can reduce their risk of a malpractice lawsuit by implementing a comprehensive risk management strategy.

The 2023 passing of Assembly Bill 35 (AB35) modified California’s Medical Injury Compensation Reform Act (MICRA) and mandated the state’s first cap adjustments for non-economic medical malpractice damages since 1975:

• As of January 1, 2023, AB35 raised the previous limit of $250,000 on non-economic damages for non-death cases to $350,000. Incremental increases over the next 10 years will raise the cap to $750,000, followed by a 2% annual adjustment for inflation in subsequent years.
• The limit for malpractice cases involving wrongful deaths has increased to $500,000 and will rise incrementally to $1 million over the next 10 years. The subsequent 2% annual adjustment for inflation will also apply.
• Additional mandates in AB35 now allow patients to sue and collect compensation for economic damages from three separate sources – doctors, hospitals, and “separate, unaffiliated” providers such as specialty surgeons in private practice.

In California there is no limit on the amount of compensation a plaintiff can recover for economic damages, such as actual costs of the medical care necessitated by the malpractice, lost income, lost future earning capacity, and any other measurable economic losses attributable to the defendant’s malpractice.

The following are the major guidelines for California’s statute of limitations for medical malpractice claims:

• A medical malpractice lawsuit must be filed within three years after the date of injury or one year after the injury is discovered (or should have been discovered), whichever occurs first
• There is no filing deadline for cases where a foreign object was left in the patient
• Exceptions to the deadline (for both minors and adults) can be made when the health care provider intentionally acts to defraud the patient or hide a mistake
• Claims filed by or on or behalf of minors under the age of six must be filed “within three years of the occurrence of the malpractice, or prior to the child’s eighth birthday, whichever timeline provides a larger filing window”
• Claims filed by or on or behalf of minors over the age of six must be filed within three years of the date of malpractice

With no cap on economic damages, and incremental increases of the cap on non-economic damages over the next 10 years, orthopedic surgeons in California are more vulnerable to personal financial loss if they do not have robust medical malpractice coverage. The total medical malpractice payout in California was $184,773,750 in 2022. The following examples of California medical malpractice lawsuits found in favor of the plaintiff, or paid as a settlement, show the critical need for orthopedic surgeons to have strong liability coverage:

Jury Awards $1.2 Million
The jury found that the surgeon was negligent in performing ACL surgery, which resulted in the patient needing vascular surgery for an aneurysm that cut off blood circulation to the leg and foot. The patient required three additional vascular surgeries.

Jury Awards $532,521
The plaintiff suffered the amputation of the left leg above the knee as a result of the surgeon’s misdiagnosis of a post-surgical infection, which led to necrotizing fasciitis.

Working with SURGPLI as your trusted broker takes the guesswork and effort out of trying to get the right coverage at the best rate on your own. We help you save time and money by:

• Researching your best coverage, rate, and “A” rated carrier options that specifically meet the requirements of your specialty and practice location in California.
• You fill out one application and we provide multiple quotes.
• Asking about any policy discounts offered for a new practice, medical association members, or physicians with no previous claims, for example.
• Researching flexible payment options offered by carriers to best fit the budget for your practice.
• Reviewing and consulting with you on quotes, payment options, and possible discounts to help you make the best choice of coverage and rate for your needs.

SURGPLI insurance brokers are ready to help you navigate the complexities of California’s MICRA medical malpractice tort reforms and secure the right amount of coverage for your orthopedic surgery practice. From submitting your application, obtaining the best rates for new policies and renewals from “A” rated carriers, and more, SURGPLI is the only medical malpractice insurance broker you’ll need.

Get a fast quote for medical malpractice insurance or call us at 1-800-969-1339

Max Schloemann is a medical malpractice insurance broker, focused on helping physicians secure Medical Professional Liability coverage. He helps Doctors and Surgeons, as well as Physician Assistants, Nurse Practitioners, and healthcare entrepreneurs launch new medical practices across the country. Max graduated Magna cum Laude from Southern Illinois University College of Business and was named the Outstanding Management Senior. Max’s career in medical malpractice insurance began in 2008 with an industry-leading firm. Max founded SURGPLI in 2023 to help surgeons navigate the complexities of medical malpractice insurance in the new era of healthcare. Max’s wife, Kristen, a Physician Assistant, and their 4 kids (plus 1 dog) enjoy hiking, golf, and cooking.