James H. Blume Jr., a West Virginia physician, received an all-too-familiar message from his medical malpractice insurance carrier in January: Your policy has been canceled.
The letter marked the third time in four years that an insurance carrier bailed on him. The first one went bankrupt. Another pulled out of West Virginia all together. And in January, Washington-based NCRIC Inc. said it wanted out of the state as well.
Doctors marched in Richmond in February, calling for tougher caps on court awards.
(Bob Brown -- Richmond Times-dispatch)
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"A lot of people are trying to paint [NCRIC] out to be the bad guys but I don't think so," said Blume, who opened a family practice in the tiny community of Forest Hill 13 years ago. "They thought they could not make money in this market, so they want to leave. Who can blame them?"
NCRIC's decision put the company in the middle of a heated debate on the affordability and availability of medical liability insurance in West Virginia. Last month, NCRIC decided to stay in West Virginia after state insurance officials agreed to let it raise the fees charged to doctors for coverage.
Across the country, states are struggling with similar issues. In Maryland, a request by the state's largest malpractice insurer, Medical Mutual Liability Insurance Society of Maryland, to raise premiums an average of 41 percent has triggered a fierce debate. Maryland Senate President Thomas V. Mike Miller Jr. (D) called for the General Assembly to hold a special session this fall on rising costs. Gov. Robert L. Ehrlich Jr. (R) has set up a task force onthe issue.
Several thousand Virginia physicians marched on the state Capitol in February, calling for tougher caps on "pain and suffering" awards and stiff limits on plaintiff lawyers fees. And D.C. Mayor Anthony A. Williams (D) has advocated changes in the District's medical malpractice laws, which have no caps on damages against doctors or hospitals.
Malpractice carriers argue that high jury awards mean premiums don't cover claims. NCRIC said it paid out $1.07 in claims for every $1 it got in premiums last year.
An obvious quick fix for the industry: raise premiums, which is what NCRIC and its competitors have done. But that, according to the American Medical Association, has resulted in a liability crisis in 20 states and "problem signs" in Virginia, Maryland and the District.
The medical community cites anecdotes about doctors dropping "risky" procedures, such as delivering babies, or practicing without insurance, as doctors at Prince George's Hospital Center sought to do.
Who is to blame?