In a medical setting, malpractice occurs when a physician, health care professional or hospital causes an injury to a patient through a negligent act or omission. Medical negligence can occur at any stage in a patient’s care, from diagnosis and treatment, through aftercare or health management.
When this occurs, a medical malpractice lawsuit is generally the patient’s only recourse for recovering financially for expenses and losses incurred. Further, medical malpractice claims may prevent other patients from being injured in especially egregious cases, through the awarding of punitive damages.
However, nearly half of the states in the U.S. have put strict limits on damages in cases involving medical malpractice or negligence. These limits are referred to as damages caps.
What are Damages Caps in Medical Malpractice cases?
Damages caps are tort reform laws that limit the amount of damages that may be awarded in medical malpractice cases. Damages are a legal remedy in the form of financial compensation for loss or injury that is paid out to a claimant in a lawsuit. These caps can limit the total damages, referred to as a total cap, or specific types, – most often in the form of non-economic or general damages.
In short, medical malpractice damage caps limit the amount of money a person can recover if they are injured by a negligent act or preventable medical error.
Why would states and legislators enact such laws?
Generally speaking, medical malpractice damage caps were enacted in response to perceived crises centered around the cost and availability of medical liability insurance. However, their efficacy in both reducing payouts and lowering premiums for medical care providers is dubious at best. Some studies have even shown that medical malpractice damage caps may lead to lower quality of medical care, therefore raising the total payouts due to an increase in total claims.
Another commonly cited impetus for medical malpractice tort reform is to reduce costs associated with defensive medicine. The argument is that, without caps on damages, physicians may recommend tests or treatment that is not necessary or in the patient’s best interest but serves to protect them and the institution against a potential lawsuit.
While there has been surprisingly little in-depth, rigorous research on the subject, those studies that do exist have found modest at best impacts on defensive medicine practices.
One thing is clear, damage caps are not instituted in the best interests of patients. In fact, lowering health care costs should never come at the cost of limiting damages for the most seriously injured victims of medical malpractice. Especially when those injuries are a result of negligent or even criminal actions.
Consider this: According to the National Practitioner Data Bank, over the last 20 years, the total number of medical malpractice claim payouts has dropped by nearly half, from a peak of nearly 20,000 claims in 2001 down to 10,350 in 2019.
During the same time frame, reported adverse actions against health care practitioners have nearly doubled, from 24,381 in 2001 to 46,005 in 2019. Adverse actions are defined as an action taken against a practitioner’s clinical privileges or medical staff membership in a health care organization.
Which states have damages caps on medical malpractice cases? Where have they been ruled unconstitutional? We collaborated with visual data firm 1Point21 Interactive to research the issue and visualize the findings.
What States Have Damages Caps on Medical Malpractice?
According to our research, 29 states currently have damages caps on medical malpractice claims. Those states are: Alaska, California, Colorado, Hawaii, Idaho, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin.
The following interactive maps display information regarding these damages caps; hover over each state for more information.
|State||Cap?||Limits on Damages||Statute|
$400,000 non-economic damages ruled unconstitutional
|Ruled Unconstitutional 2003|
|Alaska||Yes||$250,000 non-economic damages with exceptions to
|AS §09.55.549 Effective 6/7/2005|
|Arizona||No||None (prohibited by state constitution)||N/A|
|Arkansas||No||None (prohibited by state constitution)||N/A|
|California||Yes||$250,000 non-economic damages cap UPHELD Civ. §3333.2 (1975)||CA CIV Code §3333.2 Upheld 1975|
|Colorado||Yes||$300,000 non-economic damages cap; total cap $1 million (with some court discretion on total cap)||C.R.S §13-64-302 Upheld 2003|
|District of Columbia||No||None||N/A|
$500,000 per defendant; $1 million max for severe injury ruled unconstitutional
|Ruled Unconstitutional 6/2017|
$350,000 cap on non-economic damages for all providers/ claimant ruled unconstitutional
|Ruled Unconstitutional 3/2010|
|Hawaii||Yes||$375,000 for non-economic damages §663-8.7 (1986)||Hawaii RS §663-8.7 Effective 1986|
|Idaho||Yes||$372,865 cap on non-economic damages (adjusted annually to average wage index on 7/1)||Idaho Code §6-1603 Effective 7/1/2004|
$500,000/physician and $1 million/hospital cap on non- economic damages ruled unconstitutional
|Ruled Unconstitutional 2/2010|
|Indiana||Yes||$500,000 cap on total damages per provider; $1.8 million cap on total damages for all providers and state fund.||IC §34-18-14-3 Upheld 2016|
|Iowa||Yes||$250,000 cap on non-economic damages (jury may go over cap for severe injuries).||Iowa Code §147.136A Effective 2017|
|Kansas||No||Previous Cap: $325,000 cap on non-economic damages ruled unconstitutional||Ruled Unconstitutional 6/2019|
|Kentucky||No||None (prohibited by state constitution)||N/A|
|Louisiana||Yes||$100,000 cap per provider/ incident, with $500,000 cap on total damages.||LA Rev Stat § 40:1299.42 Effective 1991|
|Maryland||Yes||$815,000 cap on non-economic damages with $15,000 annual increase||Cts. & Jud. Proc. §3- 2A-09 Effective 1/11/2005|
|Massachusetts||Yes||$500,000 cap on non-economic damages (exceptions)||MGLA 231 §60H Effective 1986|
|Michigan||Yes||$465,900 cap on non-economic damages with exceptions reaching $832,000 (all amounts adjusted for inflation on 12/31)||MCL §600.1483 Effective 1994|
|Mississippi||Yes||$500,000 cap on non-economic damages||MISS Code §11-1-60 Effective 9/1/2004|
|Missouri||Yes||$427,901 cap on non-economic damages with exceptions reaching $736,310 for catastrophic injury or death (amounts adjusted by 1.7% annually on 1/1).||MO Rev Stat §538.210 Effectvie 8/28/2017|
|Montana||Yes||$250,000 limit on non- economic damages||MCA §25-9-411 Effective 1997|
|Nebraska||Yes||After December 31, 1992, and on or before December 31, 2003, the cap is $1.25M.
After December 31, 2003, but on or before December 31, 2014, the cap is $1.75M.
After December 31, 2014, the cap is $2.25M.
|NRS 44-2825 Effective 2005|
|Nevada||Yes||$350,000 non-economic damages cap||NV Rev Stat § 41A.035 Effective 11/23/2004|
|New Hampshire||No||Previous Cap:
$250,000 cap on non-economic damages ruled unconstitutional
|Ruled Unconstitutional 1980|
|New Mexico||Yes||$200,000 total cap per provider/ occurrence; $600,000 cap/ occurrence on total damages plus future medical care costs||NM Stat §41-5-6 & §41-5-7 Effective 1992|
|North Carolina||Yes||As of 2018, $545,114 cap on non-economic damages per occurrence, with exception for gross negligence. Adjusted by CPI every 3 years||G.S. §90-21.19 Effective 10/1/2011|
|North Dakota||Yes||$500,000 cap on non-economic damages||CEN CODE §32.42.02 Effective 1995|
|Ohio||Yes||Greater of $250,000 or 3 times economic damages up to max of
$350,000/plaintiff, $500,000/ occurrence ($500,000/plaintiff and $1 million/occurrence in catastrophic cases)
|OH Rev Code §2323.43 Effective 2003|
|Oklahoma||No||Previous cap: $350,000 cap on non-economic damages ruled unconstitutional||Ruled Unconstitutional 4/2019|
|Oregon||Yes||$500,000 cap on non-economic damages, Cap can be adjusted when insubstantial to jury award
(Ruled Unconstitutional in 1999, decision overturned in 2016)
|ORS 31.710 Effective 1987|
|Pennsylvania||No||None (prohibited by state constitution)||N/A|
|South Carolina||Yes||$462,070 cap on non-economic damages per provider/claimant up to $1,386,205 maximum (annually indexed to inflation on 12/31)||S.C. Code §15-32-220 Effective 7/1/2005|
|South Dakota||Yes||$500,000 cap on non-economic damages||SDLRC §21-3-11 Effective 1976|
|Tennessee||Yes||$750,000 cap on non-economic damages per incident with exceptions up to $1 million.||TN Code Ann. 29-39-102 Effective 10/1/2011|
|Texas||Yes||$250,000 cap on non-economic damages per claimant for all physicians; $250,000 cap on non-economic damages per claimant for institution (up to 2)|| Civ. Prac. & Rem. Code Effective 2003
§74.301 Effective 2003
|Utah||Yes||$450,000 cap on non-economic damages for cause of action arising after 5/15/10 ($480,000 for earlier cases)||Utah Code §78B-3-410 Effective 2010|
|Virginia||Yes||$2.4 million cap on total damages (annual increases of
$50,000 from 7/1/2012 through 7/1/2031
|Code of Virginia §8.01-581.15 Effective 2011|
Non-economic damages ruled unconstitutional
|Ruled Unconstitutional 1989|
|West Virginia||Yes||$342,559 cap on non-economic damages per occurrence. Annual adjustment by the CPI on 1/1 up to
$375,000 and $750,000
|West Virginia Code §55-7B-8 Effective 2003|
|Wisconsin||Yes||$750,000 cap on non-economic damages||Wisconsin Statutes §893.55 Effective 1998|
|Wyoming||No||None (prohibited by state constitution)||N/A|
How Many States Have Had Their Malpractice Caps Declared Unconstitutional?
While 21 states and the District of Columbia do not limit medical malpractice damages, only 13 of them have declared caps to be unconstitutional.
Five of the states that do not have medical malpractice damages caps because their state constitution expressly prohibits them:
Several states have enacted malpractice caps, but had them summarily struck down as unconstitutional by their supreme courts. As of 2020, there are eight states who have done so:
- New Hampshire
Kansas is the most recent state ruling against malpractice caps, enacting a decision in July 2019.
What Kind of Medical Malpractice Caps Does Each State Have?
Many states place further restrictions on what types of compensatory damages have caps in medical malpractice claims. While some have laws in place to enforce total caps, the majority of state laws place limits on non-economic damages only.
What Are Non-Economic Damages?
Non-economic damages compensate victims for non-monetary losses – those which cannot be easily quantified by a dollar amount. This is in stark contrast to economic damages, which often include losses that have an apparent dollar amount, such as medical bills and automobile repairs. Non-economic damages include:
- Disability or disfigurement
- Pain and suffering
- Loss of companionship
- Loss of enjoyment of life
Limits are often placed on these damages because they can be incredibly difficult to calculate on a person-by-person basis.
Of the states which have damages caps on medical malpractice claims, 22 place limits on non-economic damages only, while 5 states put a cap on the total damages.
Interestingly, two states stray from those with unique distinctions:
- Colorado places caps on both non-economic damages and total damages.
- Hawaii places a cap on pain and suffering damages only – a narrow subset of non-economic damages.
What Are the Specific Limits to Caps?
Of the 29 states with caps on medical malpractice claims, the specific dollar limits vary wildly from state-to-state.
Common caps for non-economic damages only seem to be either $250,000 or $500,000 – 4 states have the former limit, while 4 states have the latter. Additionally, Louisiana also puts a cap on total damages at $500,000 – the lowest total damage cap on medical malpractice claims in the country.
Do Any States Put Further Considerations into Medical Malpractice Caps?
11 states vary damages caps based on various circumstances. These can include:
- Whether an incident was catastrophic
- Whether a wrongful death occurred
- The number of wrongful deaths that occurred
- The number of plaintiffs involved in the claim
- The number of providers and associated healthcare professional named in the claim
Seven states adjust their damage caps for inflation either every three years: Idaho, Michigan, Maryland, Missouri, North Carolina, South Carolina, and West Virginia. In our table as well as in our maps, each of these state’s cap contains the most up to date information available.
Medical Malpractice Damages Caps in the Washington, D.C. Region
According to the information, each state within the Washington region has widely varying laws on damages caps.
- The District of Columbia has no statutory limits on compensatory damages.
- Maryland only caps non-economic damages only, but the limits can vary based on the severity of the accident.
- Virginia has a total cap on medical malpractice damages, set at a strict $2 million.
Do Medical Malpractice Caps Change?
It’s clear that navigating medical malpractice damages caps may not be as simple or straightforward as some may think. Therefore, it is highly recommended to double-check any information before pursuing the appropriate compensation for your medical malpractice claim. If you or a loved one has any questions regarding medical malpractice claims and caps, it is always highly recommended to consult an attorney who has experience in medical malpractice cases.