Medical Malpractice Statistics (2026): Payouts, Caps & Claims by State

In 2023, 11,440 medical malpractice payments were reported to the federal National Practitioner Data Bank (NPDB), totaling roughly $4.8 billion, an average of about $420,000 per paid claim. But that average hides almost everything that matters: most claims pay under $100,000, a small number exceed $1 million, and payouts swing widely by state, specialty, and whether the state caps damages. Just as important is what the data leaves out, the NPDB only records claims that were paid by an individual practitioner, so it misses dismissed cases, hospital-only payments, and the vast majority of medical errors that never become claims at all. Here is what the numbers actually show, with every figure sourced.

Medical malpractice statistics are some of the most misquoted numbers in law. A single "average payout" gets repeated across hundreds of pages, often without a date or a source, and almost never with the caveats that make it meaningful. This report pulls the most reliable public data, chiefly the NPDB, which the federal government has maintained since 1990, and lays out what it can and cannot tell you about how often claims happen, what they pay, and why the same injury is worth far more in one state than another.

U.S. medical malpractice at a glance (most recent data). Sources: National Practitioner Data Bank (2023, via Miller & Zois analysis); Physicians Thrive (2014–2023). Figures describe paid claims, not all malpractice.
11,440paid malpracticeclaims, 2023 (NPDB) $4.8Btotal paid outon those claims, 2023 ~$420Kaverage perpaid claim, 2023 ~28%of paid claims wereunder $100,000 26 statescap non-economicmalpractice damages ~1–2%of medical errorsever lead to a payout The NPDB captures paid claims against individual practitioners, not dismissed cases, hospital-only payments, or unreported errors.

The national picture: claims and payouts

The federal NPDB recorded 11,440 paid malpractice claims in 2023, paying out about $4.8 billion, an average near $420,000 per claim. But the distribution is highly skewed: roughly 3,200 claims (about 28%) paid under $100,000, while only about 1,300 (11%) exceeded $1 million. The "average" is pulled upward by a relatively small number of catastrophic cases.

Every malpractice payment made on behalf of a licensed practitioner must, by law, be reported to the NPDB. That makes it the closest thing the United States has to a national malpractice database, but it is a record of payments, not of lawsuits filed, cases won, or errors committed. Verdicts paid directly are reported, but cases that are dismissed or that resolve with no payment are not, and payments made solely by a hospital or corporation (with no named practitioner) can fall outside it. So when you read "the average malpractice payout is $420,000," the accurate version is: the average paid claim reported to the NPDB in 2023 was about $420,000.

How 2023 paid malpractice claims were distributed. Most payments are modest; a small share of severe cases drives the dollar total. Source: NPDB (2023), via Miller & Zois analysis. Shares are approximate.
Under $100K~3,200 claims (~28%) $100K–$1M~6,900 claims (~61%) Over $1M~1,300 claims (~11%) Why this matters Because a small number of multimillion-dollar cases lift the mean, the "average payout" is far higher than the typical claim. A median, which the NPDB does not publish, would be substantially lower, likely in the low six figures.

Medical malpractice payouts by state

Total malpractice payouts vary enormously by state, from over $6.2 billion in New York to under $25 million in North Dakota over the decade from 2014 to 2023. But raw state totals mostly track population and reporting volume, not how dangerous a state's medicine is. The more meaningful number is the average per claim, which is shaped heavily by each state's damage-cap law.

The tables below use NPDB-derived data compiled by Physicians Thrive for 2014–2023. Read them as a measure of total dollars and claim volume, not of malpractice risk: New York and California lead largely because they are big states with many physicians and patients.

Top 10 states by total medical malpractice payout, 2014–2023. Source: Physicians Thrive analysis of NPDB data.
StateTotal payoutNumber of claimsApprox. avg. per claim
New York$6.298 billion14,359~$439,000
Pennsylvania$3.176 billion7,687~$413,000
Florida$3.080 billion11,247~$274,000
California$2.438 billion11,183~$218,000
New Jersey$2.373 billion5,539~$428,000
Illinois$2.336 billion3,809~$613,000
Massachusetts$1.626 billion2,624~$620,000
Georgia$1.405 billion3,004~$468,000
Texas$1.086 billion5,583~$195,000
Maryland$944.62 million2,311~$409,000
Total medical malpractice payouts, top states (2014–2023). Source: Physicians Thrive analysis of NPDB data.
NY$6.30B PA$3.18B FL$3.08B CA$2.44B NJ$2.37B IL$2.34B
Bottom 10 states by total medical malpractice payout, 2014–2023. Source: Physicians Thrive analysis of NPDB data.
StateTotal payoutNumber of claims
Idaho$145.06 million357
Alaska$138.35 million193
Puerto Rico$128.53 million2,152
Delaware$114.92 million279
Montana$112.94 million380
South Dakota$97.65 million177
District of Columbia$86.24 million185
Wyoming$55.97 million142
Vermont$55.11 million136
North Dakota$24.89 million88

Notice that the per-claim average can be higher in states with fewer total dollars. Illinois and Massachusetts, neither of which enforces a non-economic damage cap, post some of the highest averages per claim, while Texas and California, both of which cap damages, sit far lower despite large populations. That is not a coincidence. The single biggest structural driver of how much a malpractice claim pays is the state's damage-cap law.

Understand your situation before you call a firm Organize records, bills, malpractice rules, damage caps, and attorney questions in one place.
Try AI Lawyer free

Why the same injury pays differently by state: damage caps

About 26 states cap non-economic damages (pain and suffering) in medical malpractice cases, and a handful cap total damages. Others, including New York, Pennsylvania, Illinois, and Florida, have no cap, either because they never passed one or because their courts struck it down as unconstitutional. The same catastrophic injury can therefore be worth a multiple more in an uncapped state than in a strict-cap state.

A damage cap is a state law that limits how much a patient can recover, usually for non-economic damages such as pain, suffering, and loss of enjoyment of life. Economic damages, medical bills and lost wages, are typically not capped, but the non-economic cap is what limits recovery in the most devastating cases, where the human loss far exceeds the receipts. Caps are the most contested feature of malpractice law, and they keep moving: several states have raised, struck down, or rewritten their caps in just the last few years.

Selected state non-economic damage caps in medical malpractice (as of 2025–2026). Several caps adjust annually for inflation, verify the current figure for your state. Sources: state statutes via Indigo, Expert Institute, Miller & Zois.
StateCap on non-economic damagesNotes
California$350,000 (injury) / $500,000 (death), 2023 startRising $40K/$50K per year to $750K/$1M by 2033, then inflation (AB 35)
Texas$250,000 per provider; $500,000 aggregateFixed since 2003 (HB 4), no inflation adjustment
Wisconsin$750,000Upheld by the state Supreme Court (2018)
Tennessee$750,000; $1,000,000 for catastrophic injury,
Maryland~$755,000 (rises ~$15,000/year)Increases annually; confirm current-year figure
Michigan~$400,000 / ~$700,000 (catastrophic)Base figures adjusted upward for inflation each year
ColoradoRising toward $875,000 by 2029Phased increases (HB24-1472), inflation every 2 years
Louisiana$500,000 total capCaps total damages, not just non-economic; lowest in the U.S.
New YorkNo capNever enacted a cap
PennsylvaniaNo capState constitution bars caps on general damages
IllinoisNo capCap struck down as unconstitutional (2010)
FloridaNo capCap struck down as unconstitutional (2017)

Six states, Colorado, Indiana, Louisiana, Nebraska, New Mexico, and Virginia, cap total damages rather than just the non-economic portion, which can limit even large economic losses. Meanwhile, at least nine states have had malpractice caps declared unconstitutional by their courts, and the trend continues: Arizona's Supreme Court struck down a state cap as recently as 2025. Because these laws change so often, treat any cap figure, including ours, as a snapshot to verify, not a permanent rule. Our medical malpractice settlement calculator applies your state's cap to a rough estimate so you can see the effect for yourself.

Which specialties get sued most

Malpractice risk is highly concentrated by specialty. In career-spanning survey data, roughly 90% of surgeons and 85% of OB/GYNs report having been sued at least once, versus far lower rates for fields like psychiatry and dermatology. Surgical, obstetric, and diagnostic specialties carry the most exposure because their errors tend to cause severe, visible harm.
Share of physicians ever sued for malpractice, by specialty (career-long, self-reported survey data). Source: Physicians Thrive.
Specialty% ever sued
General surgeons90%
OB/GYN & women's health85%
Orthopedic surgeons82%
Otolaryngologists (ENT) / Radiologists / Urologists72%
Emergency medicine71%
Cardiologists / Gastroenterologists64%
Anesthesiologists57%
Dermatologists / PsychiatristsLow

These are lifetime figures, so high percentages partly reflect long careers and the fact that a suit being filed is not a finding of fault. But the pattern is real and consistent across data sources: the most common allegations nationally are diagnostic failure (missed or delayed diagnosis), surgical error, treatment failure, and birth injury, the categories that most often produce permanent harm and, therefore, the largest payouts.

How often claims happen, and how often patients win

Most malpractice claims do not end in a payout. Studies estimate that only about 20% to 30% of cases that reach trial end in a plaintiff verdict, and the large majority of all claims are dropped, dismissed, or settled before trial. At the same time, the rate of paid claims has been falling for years, one analysis found the rate of malpractice claims paid dropped by roughly 55% between 2009 and 2014.

This cuts against the popular image of a litigation explosion. Medical malpractice accounts for less than 5% of all personal-injury cases pending nationwide, and only about 17,000 malpractice suits are filed in a typical year. Set that against estimates of patient harm and the striking finding is the opposite of frivolity: most medical errors never become claims at all. Research suggests only about 1% to 2% of adverse medical events ever lead to a malpractice claim or payout.

The harm side of that ledger is genuinely contested. A widely cited Johns Hopkins analysis put U.S. deaths from medical error around 250,000 per year, which would rank it among the leading causes of death, but that estimate is debated, and other researchers consider it too high because of how it extrapolates from small samples. What is not seriously disputed is the direction: documented patient harm vastly exceeds the number of malpractice claims, so the system compensates only a small fraction of those injured.

Wondering whether what happened to you counts as malpractice? Understand the claim elements, what records to gather, and when to talk to a licensed attorney.
Try AI Lawyer free

What these statistics can, and can't, tell you

Every figure on this page describes paid claims and reported lawsuits, not the true rate of medical error or the value of an individual case. The NPDB undercounts (it excludes dismissed claims, many hospital-only payments, and all unclaimed harm), state totals track population, and "averages" are skewed by rare catastrophic cases. Use these numbers to understand the system, not to predict a specific outcome.

If you take one thing from the data, make it this: the malpractice system is narrow and uneven. It compensates a small share of injured patients, pays most of them modestly, reserves the large numbers for the most catastrophic cases, and lets the dollar value of an identical injury depend heavily on which state line it falls on. For how those forces translate into an actual claim value, see our companion guide to average medical malpractice settlement amounts. For related injury data, see our reports on the average car accident settlement and wrongful death settlements.

Frequently asked questions

What is the average medical malpractice payout?

The average paid malpractice claim reported to the NPDB in 2023 was about $420,000, on roughly 11,440 paid claims totaling $4.8 billion. That average is skewed upward by a small number of multimillion-dollar cases, most paid claims are under $100,000, so the typical (median) claim is considerably lower. The figure also reflects only claims that were paid, not the much larger number of claims that are dismissed or never filed.

Which state has the most medical malpractice payouts?

By total dollars, New York leads, about $6.3 billion across 14,359 paid claims from 2014 to 2023, followed by Pennsylvania, Florida, and California. But these totals mostly reflect population and the number of physicians and patients, not how risky a state's medicine is. States without damage caps, such as Illinois and Massachusetts, tend to post the highest average payout per claim.

Which states have no cap on medical malpractice damages?

As of 2025–2026, several states do not enforce a cap on non-economic malpractice damages, either because they never enacted one or because courts struck it down. These include New York, Pennsylvania, Illinois, Florida, and Washington, among others. In these states a jury's award is generally not reduced by a statutory cap, which is one reason average payouts there run higher.

What specialty gets sued for malpractice most often?

Surgical and obstetric specialties carry the highest lifetime risk. In survey data, roughly 90% of general surgeons and 85% of OB/GYNs report having been sued at least once, compared with much lower rates in fields like psychiatry and dermatology. The most common allegations are diagnostic failure, surgical error, treatment failure, and birth injury.

How often do patients win medical malpractice cases?

Not often. Only about 20% to 30% of malpractice cases that go to trial end in a plaintiff verdict, and most claims are dropped, dismissed, or settled before trial. The rate of paid claims has also declined over the past decade. Malpractice is, on the data, under-litigated rather than over-litigated: only an estimated 1% to 2% of medical errors ever result in a claim.

Is the NPDB a complete record of medical malpractice?

No. The National Practitioner Data Bank records malpractice payments made on behalf of licensed practitioners, so it captures settlements and paid verdicts but excludes cases that are dismissed or resolved without payment, and it can miss payments made solely by a hospital or corporation with no named practitioner. It is the best national source available, but it understates both the number of claims and the amount of underlying patient harm.


This report is for general informational purposes and is not legal or medical advice. Figures are drawn from the public sources cited above and reflect paid claims and reported lawsuits, which understate true rates of medical error; your situation may differ substantially. Damage-cap laws change frequently, verify the current rule in your state. If you believe you or a family member was harmed by medical negligence, consult a licensed medical malpractice attorney about your specific facts and your state's filing deadline. An AI Lawyer can help you understand the process and organize your records, but it does not replace professional legal counsel.