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Survey Report

Insurance Marketplace Realities 2020 Spring update – Health care professional liability

COVID 19 Coronavirus

May 7, 2020

The current health care marketplace is highly fluid; renewals will be challenged by further scrutiny on coverage terms and substantial capacity constraints.
Rate predictions
  Trend Range
Hospital medical malpractice Increase (Purple triangle pointing up) +3% to +15%
Allied health medical malpractice Neutral increase (yellow line with purple triangle pointing up) Flat to +10%
Physicians medical malpractice Increase (Purple triangle pointing up) +3% to +10%
Loss-affected accounts Highly variable rate increases
Primary med mal Increase (Purple triangle pointing up) +5% to +10%
Excess med mal Increase (Purple triangle pointing up) +15%

Key takeaway

The current health care marketplace is highly fluid; renewals will be challenged by further scrutiny on coverage terms and substantial capacity constraints imposed by cautious insurers.

COVID-19 is the topic of the moment.

  • Insurers are gathering underwriting information on the impact of COVID-19 and some have developed applications to help do it. Areas of focus include emergency response and preparedness, infection control/isolation procedures and capacity constraints and the resulting impact on triage protocols.
  • Many insurers are taking a cautious approach to new business. Some insurers have placed a moratorium on new business; others will be attaching a COVID exclusion/limitation.
  • Buyers should ensure that they explore coverage needs in emerging areas: telehealth, daycare and volunteer providers. They should be conversant in their shifting exposure base caused by curtailed elective procedures and expanded surge capacity.
  • Buyers should avail themselves of reliable information on COVID-19 (the CDC, WHO and ECRI Institute) and use the resources that insurer partners can provide.

Coverage will be a key 2020 battleground.

  • Sexual abuse and molestation: Insurers are paying increased attention to sexual abuse and molestation coverage in their forms. Insurers are concerned about batch exposure of sexual abuse claims and are applying sexual abuse language with per-claimant features that limit the ability to group claims together.
  • Opioids: As opioid litigation continues to develop (e.g., countersuits filed by pharmacies against physicians) more insurers are seeking to mitigate their opioid exposure through opioid exclusions (and perhaps even controlled substance exclusions) on health care facility accounts.
  • Punitive damages: We are witnessing a retrenchment in the availability of most favorable venue coverage and punitive damages wrap policies as some U.S. insurers pull back their appetite.
  • Batch coverage: In an effort to fend off the cumulative negative effects on loss ratios caused by systemic exposures (opioids, COVID-19), social inflation, and capacity over-deployment, we may start to see insurers rethinking their batch coverage strategy in terms of scope of coverage, attachment point, pricing, capacity limitations and perhaps even outright exclusions.

Capacity limitations will continue and pressure on SIR(Self-Insured Retention)s will increase.

  • Systemic issues such as opioids and COVID-19 will only reinforce current insurers’ strategies to manage aggregation by limiting their capacity deployment for any one client.
  • The number of markets that have either exited the health care space or bought books of business continues to outpace new entrants and capacity.
  • Vertical pressure on SIRs and deductibles is being driven by the continuing rise in claim severity, social inflation and exposure growth over the last 10 years.


Each applicable policy of insurance must be reviewed to determine the extent, if any, of coverage for COVID-19. Coverage may vary depending on the jurisdiction and circumstances. For global client programs it is critical to consider all local operations and how policies may or may not include COVID-19 coverage. The information contained herein is not intended to constitute legal or other professional advice and should not be relied upon in lieu of consultation with your own legal and/or other professional advisors. Some of the information in this publication may be compiled by third party sources we consider to be reliable, however we do not guarantee and are not responsible for the accuracy of such information. We assume no duty in contract, tort, or otherwise in connection with this publication and expressly disclaim, to the fullest extent permitted by law, any liability in connection with this publication. Willis Towers Watson offers insurance-related services through its appropriately licensed entities in each jurisdiction in which it operates. COVID-19 is a rapidly evolving situation and changes are occurring frequently. Willis Towers Watson does not undertake to update the information included herein after the date of publication. Accordingly, readers should be aware that certain content may have changed since the date of this publication. Please reach out to the author or your Willis Towers Watson contact for more information.

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