The ‘Frequency of Severity’ Is Reshaping the MPL Verdict Environment
Recent medical professional liability (MPL) verdict data suggest the industry’s severity challenge extends well beyond the occasional headline-making nuclear verdict. Data compiled by Rich Henderson of TransRe show that the number of large verdicts has remained elevated. During 2022-2024, there were 169 verdicts of $10 million or more, including 79 verdicts of $25 million or more. The pattern continued into 2025, when there were 58 verdicts of $10 million or more, of which 27 verdicts reached or exceeded $25 million. In each year from 2023 through 2025, nearly half of all verdicts of at least $10 million also reached or surpassed $25 million—a trend Henderson characterizes as the “frequency of severity.”
The data also indicate that severity is extending further throughout the verdict distribution and is not being driven by a few exceptionally large awards. Although the average of the 50 largest verdicts declined almost 13% from $56 million in 2024 to $49 million in 2025, it remained substantially above earlier years. Possible explanations for the decrease range from a decreased risk tolerance on the part of insurers which has led to more claims being settled as opposed to being entrusted in a jury’s hands. In other words, the drop in the average value of large verdicts may not mean a decrease in indemnity payouts. The drop could also be the result of “smarter” claim/legal practices which may have held down some verdict amounts. At the same time, the median verdict among awards of at least $5 million increased from approximately 45% from $11 million in 2019, to $16 million in 2025. These measures suggest that elevated severity has become more widespread across significant MPL verdicts, even when the very largest awards fluctuate from year to year.
The largest verdicts remain concentrated in several high-risk clinical areas. Among the 100 top 10 annual verdicts from 2016 through 2025, surgery, birth-related claims, and failure to diagnose represented 80 of the 100 cases. The geographic picture is more mixed: Florida, Georgia, Illinois, and New York accounted for 46 of the largest verdicts, while the remaining 54 were distributed across other states. This combination and dispersion suggest that insurers should continue to monitor high-severity jurisdictions and claim outcomes while recognizing that extreme verdict exposure is not limited to a small number of markets. Further, the spread of large verdicts across the United States could support the belief that plaintiff attorneys communicate across state lines and are actively sharing tactics on how to drive larger verdicts even in historically conservative jurisdictions.
Verdict amounts do not necessarily translate dollar-for-dollar into ultimate insurer payments. The data show considerable variation between jury awards and the amounts paid on claims that have closed. There are also several recent large verdicts that remain open. As these cases develop through post-trial motions, appeals, settlements, and coverage determinations, their ultimate values may change. Nevertheless, the growing number of cases reaching higher verdict thresholds is an important leading indicator for MPL loss costs, reserving, reinsurance, limits management, and future pricing. Looking at the percentage of verdicts paid in the years 2016 and 2017 (49% and 45%, respectively), we see that the same percentages were paid in 2025 and year-to-date 2026. On
the surface, this might suggest a flat trend line. However, because the underlying verdict amounts were considerably higher in 2025 and 2026, in dollars, the amounts paid have risen considerably.
Through June 30, 2026, the partial-year data included 26 verdicts of $10 million or more, 10 verdicts of $25 million or more, 4 verdicts of $50 million or more, and 2 verdicts of at least $100 million. Using data from TransRe for prior years, we note that as of June 30, 2026, the number of verdicts of at least $10 million (26) is comparable to the number of verdicts of this size as of June 30 for the years 2023 (29), 2024 (24), and 2025 (28). We also observe that from 6 to 12 months, the numbers of verdicts of at least $10 million for these three years increased by an average factor of 2.16x. This suggests that the 26 verdicts as of June will increase to approximately 56 verdicts as of December 31, 2026.