North Carolina Surgeons 2024 Buying Guide to Medical Malpractice Insurance

If you are a surgeon needing medical malpractice insurance in North Carolina, SURGPLI will work for you as your only trusted broker. Our brokers have deep knowledge of North Carolina’s medical malpractice insurance marketplace, plus they stay up-to-date on the state’s legislation and tort reforms that affect rates and coverage requirements for your surgical specialty. Use the information in this 2024 Buying Guide to get ready to discuss your medical malpractice insurance needs with a SURGPLI broker.

North Carolina has a stable medical malpractice insurance market and tort reforms, leading to fewer claims in recent years. However, with no caps on economic damages and high caps on non-economic damages in North Carolina, surgeons practicing there need robust medical malpractice coverage. An independent SURGPLI broker will work with you to find the right coverage and carrier at a competitive rate for your surgical specialty.

Although surgeons in North Carolina are not required by law to obtain medical malpractice insurance, SURGPLI advises surgeons – especially in high-risk specialties – to secure and maintain strong liability coverage. Speak with a SURGPLI insurance broker who will help you find the best coverage to reduce risk to your practice and protect against personal financial loss if sued.

Each carrier uses its proprietary methods of setting rates, which vary among carriers and specialties. Each malpractice insurance policy is underwritten individually, but the following are approximate rates across all North Carolina locations to give you an idea of costs by high-risk specialty.

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

North Carolina healthcare facilities typically require surgeons to carry medical malpractice insurance to have admitting privileges. The average requirement for coverage by North Carolina medical facilities is $1,000,000 per claim, $3,000,000 per year.

Also, if you need tail insurance coverage as a contracted surgeon changing jobs, we can help. SURGPLI specializes in medical malpractice insurance for private practices, and tail insurance coverage for North Carolina surgeons, so contact us for a personalized quote based on your unique needs.

Surgeons in North Carolina have many good options for medical liability insurance. SURGPLI recommends carriers rated “A” by A.M. Best. These companies are A-rated because of their long-term financial solvency and a history of providing robust legal support for North Carolina surgeons. Some of the top carriers include:

• The Doctors Company
• MedPro Group
• MagMutual
• Curi (Medical Mutual Insurance Co. of North Carolina)

• ProAssurance
• NORCAL Group (A Part of ProAssurance)
• Coverys Group
• Liberty Mutual Group

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

Claims Made Insurance
Claims-made malpractice insurance provides coverage if the policy is in effect 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 ensure you have full protection. Claims-made insurance policies “step up” as they mature, so the first-year rate is lower than subsequent years.

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 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 won’t cover you for prior acts of former practice, hence tail coverage is needed. Read more about tail malpractice insurance.

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

Although North Carolina is not considered a highly litigious state, it does not cap the amount of economic damages paid to plaintiffs. That’s just one reason why surgeons must have robust medical malpractice coverage. Note that the total medical malpractice payout in North Carolina was $33,670,750 in 2022. Here are some of the most common iatrogenic patient injuries that have been named in medical malpractice lawsuits against surgeons practicing in high-risk specialties:

Neurosurgery – Claims relating to laminectomy surgeries (anterior cervical fusion and posterior lumbar fusion), including improper performance of surgery, retained foreign body, delay in surgery, and unnecessary surgery.

Bariatric Surgery – Lack of identifying and treating complications of laparoscopic sleeve gastrectomy; and bowel perforation during surgery.

Orthopedic Surgery – Post-operative implant and prosthesis infections; sciatic nerve injury in hip replacements; deep vein thrombosis developing into pulmonary embolism.

OB/GYN Surgery – Birth injuries caused by improper use of medical devices or techniques; profound brain injuries at birth; misdiagnosis or delayed diagnosis of fetal distress.

Plastic Surgery – Improper performance and poor outcomes of higher-risk elective cosmetic surgeries; surgical errors and negligence regarding post-operative infections, bad facial filler injections, uneven breast augmentations, and visible scarring.

General Surgery – Surgical errors, such as when surgery is performed on the wrong body part, or when a sponge or surgical instrument is left in the patient’s body leading to a post-operative complication or death; or failing to close a bleeding vein or artery.

Check out the SURGPLI Medical Malpractice Insurance Blog for articles discussing ways private practice surgeons can best manage the risk of being sued for malpractice, as well as other information on medical malpractice insurance trends and legislation.

• North Carolina has a law offering alternative dispute resolution as an additional option to lengthy medical malpractice suits. This includes “mediation, arbitration, a summary jury trial, and early neutral evaluation”. Alternative dispute resolution has helped decrease the state’s cost and length of litigation.
• For parties who choose alternative dispute resolution, there is a $1 million cap on total damages for medical malpractice liability claims, according to the Voluntary Arbitration of Health Care Claims Act, enacted in 2007.
• Additionally, in 2011, North Carolina passed a law capping non-economic damages in most medical malpractice cases at $500,000. In addition to the cap, this law expanded the protection of emergency medical personnel providing care in emergencies.

• North Carolina does not set a cap on economic damages. However, in most cases, the state requires a separate trial to determine the amount of economic damages if they are claimed to be more than $150,000. These two trials may be combined into a single trial if the judge finds good cause.
• North Carolina has a $500,000 cap on non-economic damages in medical malpractice cases, evaluated and possibly increased for inflation every three years since January 1, 2014.
• The $500,000 cap on non-economic damages can be circumvented, however, in cases where the injured party suffered disfigurement, lost the use of a body part, or in the cases of gross negligence or patient death.
• In 2007, the state passed the Voluntary Arbitration of Health Claims Act, “capping total damages at $1 million in medical professional liability claims where both parties agree to use binding arbitration”.

The following guidelines outline the state’s statute of limitations for medical malpractice claims:

• A person in North Carolina has three years from the date of injury to file a medical malpractice claim.
• In cases of wrongful death, claims need to be filed within two years of the death.
• If the injury is not discovered within the two-year deadline, the claim must be filed within one year of the discovery with no more than four years passing from the date the injury was caused.
• In cases where a foreign object was left in the body, patients must file a claim within one year of the discovery and cannot be filed more than ten years after the date the object was left in the body.
• Medical malpractice law for minors in North Carolina is complicated and exceptions to the three-year rule are calculated on several different factors including age, guardianship status, and other legal factors.

The statutes of limitations for medical malpractice can be complex and vary from case to case. Consulting with SURGPLI insurance brokers who understand the ins and outs of this system is an important part of protecting your medical practice with the right amount of medical malpractice insurance coverage.

Reach out to SURGPLI to ensure you have strong medical malpractice coverage for your private surgical practice in North Carolina. Also, we help contracted surgeons secure tail coverage when changing jobs. Whether you’re a plastic surgeon in Charlotte, a neurosurgeon in Raleigh, or an OB/GYN in Greensboro, SURGPLI insurance brokers will help you obtain coverage from an A-rated carrier.

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.