Is Medical Professional Liability Insurance Profitable in 2026? Loss Ratios by State
Medical Professional Liability (med-mal) is a volatile, state-driven line — loss ratios vary sharply by state tort environment, which is why premiums differ so widely for healthcare practices.
Source: NAIC 2023 Report on Profitability by Line by State (public regulator data). Loss ratio = incurred losses ÷ premiums earned; lower is more profitable for carriers.
Medical Professional Liability profitability by state (2023)
| State | Loss ratio | Premiums earned | Underwriting profit |
|---|---|---|---|
| NM | 194.3% | $83.3M | -165.8% |
| ID | 149.6% | $44.4M | -117.6% |
| OR | 96.6% | $117.1M | -52.2% |
| SC | 93.1% | $97.4M | -54.7% |
| ME | 86.1% | $55.7M | -29.6% |
| ND | 86.0% | $11.3M | -37.1% |
| HI | 80.2% | $40.8M | -29.1% |
| CT | 77.4% | $253.8M | -18.7% |
| MT | 76.1% | $41.1M | -32.1% |
| RI | 71.9% | $38.6M | -14.2% |
| SD | 70.8% | $18.9M | -27.4% |
| IA | 70.3% | $78.6M | -25.1% |
| NY | 69.6% | $1.8B | -14.9% |
| MN | 68.1% | $103.4M | -20.4% |
| UT | 67.5% | $86.7M | -30.7% |
| IL | 66.9% | $575.2M | -25.8% |
| WA | 65.7% | $229.3M | -13.4% |
| AK | 65.7% | $25.4M | -21.6% |
| PA | 63.7% | $831.5M | -11.9% |
| VT | 60.3% | $20.2M | -23.5% |
| MA | 59.8% | $376.4M | -13.7% |
| OK | 59.5% | $117.8M | -4.7% |
| AL | 55.7% | $165.6M | -23.5% |
| NV | 55.7% | $102.6M | -18.2% |
| NH | 55.7% | $56.3M | -3.0% |
| CA | 55.5% | $1.0B | -1.9% |
| KY | 55.3% | $142.7M | -11.9% |
| GA | 54.6% | $417.4M | -3.7% |
| FL | 53.5% | $931.5M | 2.5% |
| IN | 49.8% | $171.0M | 9.7% |
| AZ | 48.0% | $259.5M | 2.2% |
| MI | 47.9% | $249.6M | 4.2% |
| DE | 46.1% | $46.8M | 14.1% |
| TN | 45.0% | $265.5M | 6.4% |
| CO | 44.8% | $183.4M | 7.2% |
| DC | 43.1% | $29.4M | 17.0% |
| NJ | 41.9% | $546.6M | 13.9% |
| TX | 41.1% | $533.4M | 14.7% |
| MD | 40.4% | $326.9M | 10.3% |
| WI | 39.7% | $92.9M | 7.7% |
| NC | 39.5% | $205.7M | 17.6% |
| MO | 37.1% | $221.8M | 12.4% |
| WV | 33.1% | $71.6M | 32.1% |
| NE | 29.0% | $58.8M | 29.1% |
| AR | 27.8% | $86.3M | 34.7% |
| VA | 25.7% | $237.2M | 25.0% |
| MS | 23.7% | $61.0M | 40.1% |
| LA | 23.5% | $115.2M | 26.5% |
| OH | 23.2% | $272.9M | 36.4% |
| KS | 16.1% | $101.5M | 35.9% |
| WY | 14.2% | $23.0M | 41.2% |
All 51 states/territories with 2023 NAIC data for this line, sorted by loss ratio (highest first). A high loss ratio means carriers pay out more in claims relative to premium — often a signal that rates are rising.
What this means for your business
Loss ratios and underwriting profit shape what carriers charge. Learn how Medical Professional Liability coverage works in our Medical Professional Liability guide, then compare real quotes for your business.
Compare Medical Professional Liability Quotes →