Can the No-Fault Approach Contain Malpractice Insurance Costs?

From 1995 to 1997, researchers from Duke University Medical Center evaluated the Florida and Virginia administrative no-fault medical malpractice compensation programs for birth-related neurological injuries.

The programs, enacted by the two states in the late 1980s, were the first medical malpractice no-fault programs in the United States. Thus, they offered an opportunity for investigation of the practical issues encountered in implementing what some critics of the tort system view as a leading alternative.

The research team surveyed plaintiffs' attorneys, obstetricians and parents, and examined maternal and infant medical records.

The project was part of the Robert Wood Johnson Foundation (RWJF) Improving Malpractice Prevention and Compensation Systems national program.

Key Findings

  • The two programs achieved their primary objective of maintaining the availability of affordable obstetrical liability coverage for physicians.

  • The administration of no-fault was less expensive than the tort system, and the speed of resolving no-fault cases was very high.

  • Only a small portion of potential claimants sought compensation.

  • The Florida and Virginia programs were too limited in scope to achieve many of the goals that proponents ascribe to the no-fault system—such as broader access to compensation and increased prevention of medical injuries.