The estimate is arithmetic on two reference tables: the specialty premium range and tail multiple in the specialty benchmark data, and the state liability multiplier in the state climate table. A carrier sets the real price from the policy's own premium and claim history.
Specialty baselines
National estimates before the state multiplier. The tail multiple is the planning assumption; the carrier sets the actual multiple.
| Specialty | Median annual premium | Tail multiple | National tail estimate | Action |
|---|---|---|---|---|
| Psychiatry | $8,000 | 2.0× | $16,000 | Breakdown → |
| Pediatrics (General) | $10,000 | 2.0× | $20,000 | Breakdown → |
| Family Medicine | $12,000 | 2.0× | $24,000 | Breakdown → |
| Internal Medicine (Outpatient) | $13,000 | 2.0× | $26,000 | Breakdown → |
| Dermatology | $16,000 | 2.0× | $32,000 | Breakdown → |
| Hospitalist (Internal Medicine) | $18,000 | 2.0× | $36,000 | Breakdown → |
| Ophthalmology | $18,000 | 2.0× | $36,000 | Breakdown → |
| Anesthesiology | $28,000 | 2.0× | $56,000 | Breakdown → |
| Gastroenterology | $28,000 | 2.0× | $56,000 | Breakdown → |
| Emergency Medicine | $34,000 | 2.0× | $68,000 | Breakdown → |
| Cardiology (Interventional) | $38,000 | 2.0× | $76,000 | Breakdown → |
| General Surgery | $48,000 | 2.0× | $96,000 | Breakdown → |
| Orthopedic Surgery | $55,000 | 2.0× | $110,000 | Breakdown → |
| OB/GYN | $68,000 | 2.0× | $136,000 | Breakdown → |
| Neurosurgery | $95,000 | 2.0× | $190,000 | Breakdown → |
Example valuesjoinandwise.com/malpracticeAndwise specialty benchmarks and state liability climatechecked November 2, 2026amounts entered are masked
State liability climates
The multiplier is a planning estimate for the state's claims climate, not a rate filed by a carrier. The OB/GYN column prices the highest-liability common specialty in that state. In the cap column, “Yes” means a statutory cap on some damages; the state page names it.
| State | Climate | Multiplier | Damages cap | OB/GYN tail | Action |
|---|---|---|---|---|---|
| Alabama | Standard liability environment | 1.00× | No | $136,000 | By specialty → |
| Alaska | Tort-reform statutory cap state | 0.85× | Yes | $115,600 | By specialty → |
| Arizona | Standard liability environment | 1.00× | No | $136,000 | By specialty → |
| Arkansas | Standard liability environment | 1.00× | No | $136,000 | By specialty → |
| California | Tort-reform statutory cap state | 0.80× | Yes | $108,800 | By specialty → |
| Colorado | Tort-reform statutory cap state | 0.80× | Yes | $108,800 | By specialty → |
| Connecticut | High-liability venue | 1.20× | No | $163,200 | By specialty → |
| Delaware | High-liability venue | 1.20× | No | $163,200 | By specialty → |
| District of Columbia | High-liability venue | 1.30× | No | $176,800 | By specialty → |
| Florida | High-liability venue | 1.35× | No | $183,600 | By specialty → |
| Georgia | High-liability venue | 1.25× | No | $170,000 | By specialty → |
| Hawaii | Standard liability environment | 1.00× | Yes | $136,000 | By specialty → |
| Idaho | Tort-reform statutory cap state | 0.80× | Yes | $108,800 | By specialty → |
| Illinois | High-liability venue | 1.30× | No | $176,800 | By specialty → |
| Indiana | Tort-reform statutory cap state | 0.70× | Yes | $95,200 | By specialty → |
| Iowa | Tort-reform statutory cap state | 0.80× | Yes | $108,800 | By specialty → |
| Kansas | Tort-reform statutory cap state | 0.75× | Yes | $102,000 | By specialty → |
| Kentucky | Standard liability environment | 1.05× | No | $142,800 | By specialty → |
| Louisiana | Tort-reform statutory cap state | 0.75× | Yes | $102,000 | By specialty → |
| Maine | Tort-reform statutory cap state | 0.85× | Yes | $115,600 | By specialty → |
| Maryland | High-liability venue | 1.20× | Yes | $163,200 | By specialty → |
| Massachusetts | Standard liability environment | 1.05× | Yes | $142,800 | By specialty → |
| Michigan | High-liability venue | 1.20× | Yes | $163,200 | By specialty → |
| Minnesota | Standard liability environment | 0.95× | No | $129,200 | By specialty → |
| Mississippi | Tort-reform statutory cap state | 0.75× | Yes | $102,000 | By specialty → |
| Missouri | Standard liability environment | 1.05× | Yes | $142,800 | By specialty → |
| Montana | Standard liability environment | 1.00× | Yes | $136,000 | By specialty → |
| Nebraska | Tort-reform statutory cap state | 0.70× | Yes | $95,200 | By specialty → |
| Nevada | High-liability venue | 1.20× | Yes | $163,200 | By specialty → |
| New Hampshire | Standard liability environment | 0.95× | No | $129,200 | By specialty → |
| New Jersey | High-liability venue | 1.25× | No | $170,000 | By specialty → |
| New Mexico | High-liability venue | 1.25× | Yes | $170,000 | By specialty → |
| New York | High-liability venue | 1.40× | No | $190,400 | By specialty → |
| North Carolina | Tort-reform statutory cap state | 0.80× | Yes | $108,800 | By specialty → |
| North Dakota | Tort-reform statutory cap state | 0.80× | Yes | $108,800 | By specialty → |
| Ohio | Standard liability environment | 1.00× | Yes | $136,000 | By specialty → |
| Oklahoma | Standard liability environment | 1.00× | No | $136,000 | By specialty → |
| Oregon | Standard liability environment | 1.00× | Yes | $136,000 | By specialty → |
| Pennsylvania | High-liability venue | 1.30× | No | $176,800 | By specialty → |
| Rhode Island | High-liability venue | 1.20× | No | $163,200 | By specialty → |
| South Carolina | Tort-reform statutory cap state | 0.80× | Yes | $108,800 | By specialty → |
| South Dakota | Tort-reform statutory cap state | 0.80× | Yes | $108,800 | By specialty → |
| Tennessee | Standard liability environment | 1.00× | Yes | $136,000 | By specialty → |
| Texas | Tort-reform statutory cap state | 0.75× | Yes | $102,000 | By specialty → |
| Utah | Tort-reform statutory cap state | 0.75× | Yes | $102,000 | By specialty → |
| Vermont | Standard liability environment | 0.95× | No | $129,200 | By specialty → |
| Virginia | Standard liability environment | 1.00× | Yes | $136,000 | By specialty → |
| Washington | High-liability venue | 1.20× | No | $163,200 | By specialty → |
| West Virginia | Tort-reform statutory cap state | 0.85× | Yes | $115,600 | By specialty → |
| Wisconsin | Tort-reform statutory cap state | 0.75× | Yes | $102,000 | By specialty → |
| Wyoming | Standard liability environment | 0.95× | No | $129,200 | By specialty → |
Example valuesjoinandwise.com/malpracticeState medical liability statutes, NAIC loss-ratio filings and AMA liability tableschecked November 2, 2026amounts entered are masked
How the estimate is built
- The specialty table gives a mature annual premium range and a tail multiple.
- The state climate table gives a multiplier for the state's claims environment.
- The premium is multiplied by the state multiplier, then by the tail multiple. The result is a planning estimate, not a quote.
The multiplier is above the national baseline in high-liability venues, near it in standard states, and below it in most tort-reform states. Some states with a cap still carry a multiplier above 1.00× because claim frequency or venue keeps the premium high. A cap limits damages; it does not set the premium. Two policies with the same limits can still price differently by carrier, claim history and part-time status.
The specialty benchmark pages price each specialty nationally. The state pages below price the same specialty in one jurisdiction.
Sources
- SourceAndwise specialty malpractice and wRVU benchmarkschecked October 21, 2026/data/specialty-benchmarks.json
- SourceState medical liability statutes, NAIC loss-ratio filings and AMA liability tableschecked November 2, 2026
- SourceIndiana State Medical Association e-Report, Negotiating tail coverage in your employment agreement (September 2026)checked October 26, 2026https://ismanet.org/ISMA/Resources/e-Reports/9-3-26/Negotiating_Tail_Coverage.aspx