Legal Reform Affecting Medical Malpractice Lawsuits

Due to a perceived crisis in payouts on medical malpractice claims, many states have enacted laws that limit an injured patient's options for recovery in a lawsuit.

The rules regulating medical malpractice lawsuits in the U.S. are quite complex. This complexity is partially the result of state legislative medical malpractice reform that started in the 1970’s in response to a so-called malpractice liability insurance crisis. One of the most significant reforms adopted by many states came in the form of damage caps, which place restrictions on just how much money an injured patient (the plaintiff) can collect from a liable medical provider (the defendant). This article discusses how the various damage caps function, and their effect on the typical malpractice case.

Medical Malpractice Reform

A number of decades ago, a “medical malpractice liability insurance crisis” began to get attention from state legislatures. The crisis was that medical malpractice insurance premiums had become prohibitively expensive because insurance companies were being required to defend and pay for too many high damage awards in  medical malpractice cases.

In response to the high cost or unavailability of insurance, doctors were charging more, practicing without insurance or ceasing to practice altogether. The true scope and nature of the crisis remains controversial, but states enacted, and continue to enact, a variety of statutes aimed at curbing the number and expense of medical malpractice cases. Depending on the state, these changes include, among other things, a very short statute of limitations, pre-suit review panels and expert assessment, very strict notice of suit requirements, and damage caps.

How Damage Caps Work

All damage caps are designed to limit the amount a losing defendant physician, hospital or other medical provider is required to pay to the plaintiff. This means that regardless of how much the jury decides that the defendant owes the plaintiff, the plaintiff cannot collect more than the maximum amount allowed by statute.

One approach is to simply limit the total amount of damages a plaintiff can collect, for example no more than $250, 000. Another approach is to only limit non-economic damages, like pain and suffering and loss of quality of life, but to allow the full amount of economic damages like medical bills and lost wages.

In the instance of a plaintiff alleging multiple acts of malpractice against the same defendant health care provider, some states apply the damage cap to each act separately and others apply the cap to the total of all the acts combined. When there are multiple defendants and one plaintiff, some states limit the total amount a plaintiff can recover from all the defendants combined, while other states limit the amount that can be collected from each defendant separately.

Other Rules Affecting or Relating to Damages

A variety of other rules affect available  damages in medical malpractice cases. Some states require that a defendant argue to the court that a damage cap applies (i.e. raise the damage cap as an affirmative defense). Some states do not allow the jury to be informed of the damage cap rules and maximum damage amount allowable, or to be informed of how much the plaintiff is suing for. Many states have rules that reduce the amount a defendant health care provider must pay out if the plaintiff has collected damages from other defendants in the same case.

Examples of Different States’ Damage Caps

Here's a look at the medical malpractice damage caps in place in a handful of states:


A plaintiff’s non-economic damages are limited to $250,000 in California medical malpractice cases. The cap applies to the total amount of non-economic damages a plaintiff can recover in any one malpractice case regardless of the number of defendants. This cap is not adjusted for inflation, so it remains the same as it has since passage of the law in 1975.


A plaintiff in Idaho cannot collect more than $400,000 in non-economic damages in a medical malpractice case. The damage limit applies to the total amount the plaintiff can collect, regardless of the number of defendants. The jury cannot be told about the damage limitation. The damage cap does  not  apply if the defendant acted recklessly or willfully or if the acts would be a felony under criminal law.


Non-economic damages are limited to $500,000 in Florida med mal cases. The cap applies to the total amount a defendant is required to pay out in the case, regardless of the number of plaintiffs. The cap goes up to $1,000,000 if the malpractice resulted in death or a vegetative state. A court can override the cap and award up to $1,000,000 to an individual plaintiff if the injury is catastrophic and the circumstances of the case would make it unjust to apply the standard damage case. Other damage cap rules apply to hospitals and emergency care providers.

To find the damage cap in your state, along with other rules in these types of cases, see your state’s civil injury laws.

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