Medical Professional Liability Insurance Loss Ratios by State (2026): Where Catastrophes Hit | GBC
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Medical Professional Liability Insurance Loss Ratios by State: 2026

Medical professional liability — malpractice coverage for physicians, hospitals, and other healthcare providers — earned $10.9B in 2023 premium. Nationally it runs a 57.6% loss ratio and a -10.0% underwriting loss — and results swing hard by state: loss ratios range from 14.2% in WY to 194.3% in NM.

National loss ratio (2023)
57.6%
Claims paid per $100 of premium (before insurer expenses)
Underwriting profit
-10.0%
Negative = insurers lost money on the line
Premiums earned (2023)
$10.9B
51 states ranked below

Source: NAIC 2023 Report on Profitability by Line by State (public regulator data). Loss ratio = incurred losses ÷ premiums earned. Medical malpractice is a long-tailed, volatile line — claims can take years to develop and a few large verdicts can swing a state's results dramatically.

Commercial property loss ratio by state — worst first

Click a column heading to re-sort.

# State Loss ratio Premiums earned Underwriting profit
1 NM 194.3% $83.3M -165.8%
2 ID 149.6% $44.4M -117.6%
3 OR 96.6% $117.1M -52.2%
4 SC 93.1% $97.4M -54.7%
5 ME 86.1% $55.7M -29.6%
6 ND 86.0% $11.3M -37.1%
7 HI 80.2% $40.8M -29.1%
8 CT 77.4% $253.8M -18.7%
9 MT 76.1% $41.1M -32.1%
10 RI 71.9% $38.6M -14.2%
11 SD 70.8% $18.9M -27.4%
12 IA 70.3% $78.6M -25.1%
13 NY 69.6% $1.8B -14.9%
14 MN 68.1% $103.4M -20.4%
15 UT 67.5% $86.7M -30.7%
16 IL 66.9% $575.2M -25.8%
17 AK 65.7% $25.4M -21.6%
18 WA 65.7% $229.3M -13.4%
19 PA 63.7% $831.5M -11.9%
20 VT 60.3% $20.2M -23.5%
21 MA 59.8% $376.4M -13.7%
22 OK 59.5% $117.8M -4.7%
23 AL 55.7% $165.6M -23.5%
24 NH 55.7% $56.3M -3.0%
25 NV 55.7% $102.6M -18.2%
26 CA 55.5% $1.0B -1.9%
27 KY 55.3% $142.7M -11.9%
28 GA 54.6% $417.4M -3.7%
29 FL 53.5% $931.5M 2.5%
30 IN 49.8% $171.0M 9.7%
31 AZ 48.0% $259.5M 2.2%
32 MI 47.9% $249.6M 4.2%
33 DE 46.1% $46.8M 14.1%
34 TN 45.0% $265.5M 6.4%
35 CO 44.8% $183.4M 7.2%
36 DC 43.1% $29.4M 17.0%
37 NJ 41.9% $546.6M 13.9%
38 TX 41.1% $533.4M 14.7%
39 MD 40.4% $326.9M 10.3%
40 WI 39.7% $92.9M 7.7%
41 NC 39.5% $205.7M 17.6%
42 MO 37.1% $221.8M 12.4%
43 WV 33.1% $71.6M 32.1%
44 NE 29.0% $58.8M 29.1%
45 AR 27.8% $86.3M 34.7%
46 VA 25.7% $237.2M 25.0%
47 MS 23.7% $61.0M 40.1%
48 LA 23.5% $115.2M 26.5%
49 OH 23.2% $272.9M 36.4%
50 KS 16.1% $101.5M 35.9%
51 WY 14.2% $23.0M 41.2%

Loss ratio by state — charted

NM194.3%ID149.6%OR96.6%SC93.1%ME86.1%ND86.0%HI80.2%CT77.4%MT76.1%RI71.9%SD70.8%IA70.3%NY69.6%MN68.1%UT67.5%IL66.9%AK65.7%WA65.7%PA63.7%VT60.3%MA59.8%OK59.5%AL55.7%NH55.7%NV55.7%CA55.5%KY55.3%GA54.6%FL53.5%IN49.8%AZ48.0%MI47.9%DE46.1%TN45.0%CO44.8%DC43.1%NJ41.9%TX41.1%MD40.4%WI39.7%NC39.5%MO37.1%WV33.1%NE29.0%AR27.8%VA25.7%MS23.7%LA23.5%OH23.2%KS16.1%WY14.2%
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How medical professional liability compares to other commercial lines

National 2023 loss ratio by line — medical professional liability highlighted. Higher = less profitable for carriers.

Commercial lineNational loss ratio (2023)
Commercial Auto 74.4%
Commercial Multiple Peril 62.6%
Commercial General Liability 60.2%
Medical Professional Liability ← this study 57.6%
Product Liability 49.3%
Commercial Property 46.0%
Workers Compensation 45.1%
Inland Marine 45.0%

Frequently asked questions

What is medical professional liability insurance?
It is malpractice coverage — protection for physicians, hospitals, and other healthcare providers against claims of negligent care that caused injury.
Is medical malpractice profitable for insurers?
Not in 2023 — the line ran roughly a 58% loss ratio and lost money on underwriting (about -10%) nationally (NAIC). Results are volatile and vary widely by state.
Why does med-mal vary so much by state?
Malpractice outcomes hinge on state tort law, damage caps, and jury environments. New Mexico ran roughly a 194% loss ratio in 2023 while the calmest states stayed well below 30%.
Are these numbers a quote?
No. These are aggregate NAIC industry results by state — not a quote. A provider's actual malpractice rate depends on specialty, claims history, and state.
⬇ Download the data (CSV)
Cite this study
Get Business Coverage. (2026). Medical Professional Liability Insurance Loss Ratios by State: 2026. Retrieved from https://www.getbusinesscoverage.com/research/medical-professional-liability-loss-ratios-by-state-2026

Methodology

Figures are from the NAIC 2023 Report on Profitability by Line by State — the National Association of Insurance Commissioners' public compilation of insurer financial results, for the Medical Professional Liability line. Med-mal is long-tailed — claims often take years to resolve — so a single year's loss ratio can swing sharply and vary widely by state tort environment. Loss ratio is incurred losses divided by premiums earned; underwriting profit reflects the insurance result after expenses. We rank states worst-first by loss ratio. These are aggregate carrier economics, not a quote for any business.

Data Study #7 · Get Business Coverage. Aggregate NAIC industry results, not individual premiums. Compiled 2026 from public regulator data.

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