The Maryland Senate approved legislation today aimed at curbing the skyrocketing costs of medical malpractice insurance that have forced some physicians out of business and caused others to limit their practices.

The most controversial piece of legislation would place a $350,000 limit on the amount of money that can be awarded for injuries in which economic loss is not a factor, such as disfigurement. Some senators said the bill would benefit doctors at the expense of the victims of malpractice.

The measure was approved 36 to 9 after a long floor debate that focused on the question that no one has been able to answer during the protracted hearings on the subject this session: Would setting limits on the amount that insurance companies are forced to pay guarantee a decrease in insurance costs?

"To pass a serious bill like this on the basis of hope alone with no factual evidence at all that it will work is unfair to the victim of negligence," said Sen. Margaret Schweinhaut (D-Montgomery), who voted against the Senate bill. "If we had any assurance from the insurance companies that this bill would [affect] the cost of medical malpractice insurance, I would vote for this bill."

Even Sen. John C. Coolahan (D-Baltimore County), who voted in favor of the bill, denounced it during floor debate. "We haven't found out what caused the problem," he complained.

He added afterward that he voted for the bill because positive Senate action on the measure would give the public the impression that something is being done. "Perception becomes reality," he said.

The Senate bill now goes to the House of Delegates, which has its own version of an insurance industry reform bill awaiting action in its Judiciary Committee. The vice chairman of that committee already has said that the Senate's decision to limit proposed reforms to medical insurance only may be unconstitutional.

Three other medical insurance bills also passed unanimously in the Senate with no debate. They would modify peer review procedures for doctors, decrease the statute of limitations under which minors can sue for malpractice and require that victims present evidence that malpractice may have occurred before they can formally file suit.

Another bill, the only one approved today that applies to all civil actions, would bar attorneys from stating in court papers how much they are suing for. Sponsors said that such figures are usually inflated.

"This [malpractice] crisis is real,"said Sen. Thomas V. Mike Miller Jr. (D-Prince George's), the chairman of the committee that heard the bill. "There are places in Maryland where obstetricians are not practicing their specialty for fear of malpractice suits."

John Sellinger, vice president of the Maryland Trial Lawyers Association, criticized the Senate action today. "They did the wrong thing for all the wrong reasons, which was pointed out on the floor," he said. "The House, I'm sure, will address the merits of the bill."

Voting to curb medical malpractice fees:

From Prince George's County: Arthur Dorman, B.W. Mike Donovan, Leo Green, Frank Komenda, Thomas V. Mike Miller Jr., Thomas O'Reilly, Decatur Trotter, Thomas Yeager (All D).

From Montgomery: Stewart Bainum (D), James Clark (D), Howard Denis (R), Sidney Kramer (D), Frank Shore (D).

Voting against the limit:

From Prince George's County: None.

From Montgomery: Laurence Levitan, Margaret Schweinhaut (Both D).