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Missouri

Recent Reforms Enacted (since 2003) Joint and Several Liability protection for defendants not more than 50% at fault. Affidavit of merit required from expert in the same specialty as defendant. Periodic payments. I’m sorry protection for expressions of sympathy but not fault. For injuries that occur in Missouri, plaintiffs would have to file suit in the county w  the alleged wrongful act or negligence first occurred. (2005) Requires insurance companies to base their medical liability rates on their loss-experience within the state, not losses in other states. Insurers must also give a 180-day notice if they plan to stop doing business in the state. (2006)
Emergency Care Provision None
Reform Elements In Law Periodic Payments
Expert Witness
Affidavit of Merit
I’m Sorry Law
Joint Liability
Constitutional Status of Reforms In 2010, the state Supreme Court ruled that caps are not retroactive to incidents that occurred before the law was enacted in 2005 (Klotz v. Shapiro). In 2012, the MO Supreme Court ruled in Sanders v. Ahmed that the state's noneconomic damage cap for cases from before 2005 is constitutional. The $350K lower cap created in 2005 was ruled unconstitutional by the Supreme Court as of July 2012 in the case of Watts v. Cox.
Change in Insurance Rates The state insurance dept. reported that total premiums collected incresed from $210.7 million to $243.4 million in 2004, while incurred losses…claims that have been paid or are expected to be in the future…fell from $189.5 million to $126.6 million. The AMA reports at least one insurer raised rates as much as 25-40% in 2004. The state dept. of insurance reported that premiums rose by 121% between 2000 and 2003 while payouts to plaintiffs rose only 14%.
Insurance Availability According to the state medical association, more than 30 insurance companies were licensed to write liability insurance in the state two years ago. Currently, only three write new policies. Three companies (PHICO, Chicago and St. Paul) which accounted for almost one third of Missouri's market in 2001, are gone
Change in Physician Availability Information not available.
Change in Cases Filed/Awards Liability case filings in Jackson Co. swelled to more than 1500 in a week just prior to newly enacted reforms taking effect in 2005.  The avg. number of cases filed in the county was 330 per month. The state dept. of insurance reported new claims filed against providers fell by 20% in 2004 after an 11% drop in 2003.  Claim payments increased in 2004 by 31.5%, but incurred claims...what an insurer expects to pay out in the future...dropped by 39%.  The avg award per claim rose in 2004 from $212,000 to $252,000.   Settlements and jury awards fell 21.2% from 2002.  Avg. payments per claim fell slightly to $207,068, but payments involving physicians rose by 9.1%.   225 paid claims in 2003 or 14.7 per 1000 active nonfederal physicians.  US avg. was 18.8 per 1000.  217 paid claims in 2005 or 14.1 per 1000 active nonfederal physicians.  US avg. was 17.1 per 1000. (Kaiser) 211 total number of paid claims for 2006 or 12.1 per 1,000 active, non-federal physicians.202 paid claims in 2007.
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