A sharply divided task force, charged with finding ways to cut the rising cost of medical malpractice insurance in Maryland, today proposed a package of two dozen reforms, including new restrictions on certain damage awards.

Several of the proposals were adopted by one-vote margins in the 28-member task force, causing some members of the group to file two dissenting opinions.

Among the most controversial recommendations was the proposal that noneconomic awards -- sometimes called "pain and suffering" awards for damages that cannot be tied directly to financial loss -- be limited to $250,000. The group suggested that minors, currently given three years after the age of 16 in which to file a malpractice suit based on injuries sustained while they were minors, be allowed to do so only until age 13. After the age of 13, the youths would be subject to adult restrictions.

The group sought an arrangement that would prevent lump sum payments to injured persons for medical care that they might not actually need or receive. It proposed that verdicts specify costs of future medical care expected. But the panel said that payment would be authorized only if the expenses are actually incurred.Rejected by the task force were proposals to curb lawyers fees, place caps on all damage awards and change the so-called "collateral source rule" that allows persons to sue even though they have already been compensated for damages by a third party, such as an insurance company.

In a controversial move, the task force voted not to change the rule, although 16 members later signed a letter saying they supported abolition of the rule. But the task force chairman, retired judge James MacGill, refused to allow reconsideration of the vote.

Several of the members of the task force, which included representatives for doctors, lawyers, nurse-midwives, insurance companies and consumers, hailed the package as an important step toward curing the problem of expensive medical malpractice insurance, which increased as much as 250 percent for some professionals in the last year.

Others sharply criticized the document, which will be presented to Gov. Harry Hughes for review and possible inclusion in his legislative package this winter. Critics said the recommendations, if enacted, either would not address the causes of the problem or would not go far enough. George Shadoan, a Rockville attorney, wrote a minority report criticizing the document. "It really does not address and will have no effect on the problem of the burden of insurance premiums, particularly on obstetricians . . . ," he wrote. Moreover, Shadoan contended, some of the recommendations go too far in limiting the rights of some injured people to recover.

J. John Spillane, head of an insurance company for physicians, also criticized the proposals, saying they do not go far enough to curb increasing jury awards and might even contribute to increased premiums.