From 2005 through 2012, Missouri had a cap on non-economic damages of $350,000; however in 2012 the Missouri Supreme Court determined the cap to be unconstitutional and the limit was removed. In 2013 the Missouri House passed a new bill reinstituting the $350,000 noneconomic damage cap which it was hoped would stand up to constitutional challenges. However, that bill did not make it through the Senate. Again, in March of 2014 the Missouri House passed a bill to cap noneconomic damages at $350,000. This bill has not been voted on by the Senate as of July 2014.
Missouri’s basic liability limit for medical malpractice insurance is $1M per occurrence and $3M aggregate per policy period (1 year). The $1M/$3M limit is fairly standard across most of the U.S. In some states physicians are allowed to carry lower limits, but most physicians are not comfortable with doing so, and rightly so. The argument for lower limits is that in the case of a lawsuit attorneys will only go after the amount of the policy limit, so the higher the limit the more money they will sue for. But this has not always proven to be the case, and in today’s litigious environment the $1M/$3M minimum is recommended
In Missouri, medical malpractice claims must be brought within two years of the date of occurrence of the alleged negligent act. There are a few exceptions including cases in which foreign objects were left in the body, failure to inform patients of results of medical tests, and cases where the claimant was a minor at the time of the alleged malpractice. In the case of foreign objects left in the body, the action needs to be brought within two years of discovery of the alleged negligent act. If the alleged negligent act involved failure to inform a patient of results of medical tests, that action must be brought within two years of the date of discovery of the failure to inform. Lastly, if the case involves a minor, the person has until his or her twentieth birthday to bring an action against the provider. No action for damages can be brought more than 10 years from the date of the alleged negligent act.
Due to the 2012 ruling finding the law that provided for caps on non-economic damages unconstitutional, the Missouri market may prove to be unstable in the near future. However, if the proposed revised statute that has passed the House (Missouri HB 1173) makes it through the Senate and avoids a veto by the governor a measure of stability may be regained.
Even given the tenuous status of tort reform however, there are some factors that serve to minimize the risk of malpractice litigation in Missouri. For one thing, Missouri law does not invite frivolous or wantonly filed malpractice lawsuits. To avoid having a suit dismissed claimants are required to submit an affidavit or certificate of merit within 90 days of filing a malpractice complaint and they are required to retain an expert witness. Additionally, the large number of insurance providers and diversity of the market has helped to keep rates low even during times of legislative and judicial uncertainty, as evidenced by a 6.63% premium drop from 2012-2013.