A new report from S&P Global Market Intelligence, covered this week by Insurance Journal, reinforces what claims professionals have been saying for years: medical professional liability is the most severity-pressured line in casualty insurance. Severity, in this context, is payout per claim. The trend has not been kind to carriers, providers, or anyone trying to set reserves with yesterday's comparables.

What the S&P Report Found

The S&P Global Market Intelligence analysis frames medical professional liability as distinct from other casualty lines in one specific way: compounding factors are pushing severity higher at a rate that outpaces general casualty inflation. The report identifies medical malpractice as "the most severity-pressured line in casualty insurance, with the highest figure across all lines."

The $151,768 figure above is the 2018 accident-year number for occurrence coverage. That is not a verdict average or a settlement average. It is the severity metric S&P uses to benchmark how much each open claim is actually costing the industry when the dust settles. In a field where verdict-era headlines can obscure the working math, this is the number professionals use to set prices and reserves.

Why Recent Years Look Deceptively Calm

Here is the part of the report that most summaries skip, and it matters if you are pricing, reserving, or valuing cases right now.

S&P notes that the "moderation in newer years" in the severity data is largely an artifact of claim immaturity. Malpractice claims take years to resolve. A case filed in 2023 may not produce a payout number until 2027 or later. When analysts look at recent accident years, they see what appears to be softening severity. What they are actually seeing is the early, pre-resolution slice of a population of claims that will keep moving upward as more cases mature into judgments and settlements.

Translated: the recent-year numbers understate the trend. Anyone benchmarking a current case against 2022 or 2023 accident-year severity is working from incomplete data. The full picture will not be visible for another three to five years, and based on every historical pattern, that picture will be worse than the raw recent figures suggest.

Why This Matters If You Value Cases

For plaintiff attorneys, the implication is straightforward. Cases being evaluated today should not be benchmarked against softening recent-year averages. The comparables that matter are mature cases from earlier accident years, adjusted to current dollars and calibrated to the specific jurisdiction, allegation type, injury severity, and practitioner factors.

For defense attorneys and insurance adjusters, the same logic applies in reverse. Reserves set against recent-year severity benchmarks will almost certainly be too low. Case valuations anchored to "what similar claims settled for last year" ignore that last year has not fully resolved yet.

For injured patients and their attorneys evaluating whether to pursue a claim, the severity trend argues for more analysis, not less. The gap between a poorly valued case and a properly valued case has widened as severity has risen, and that gap is measured in hundreds of thousands of dollars per matter.

How the Hooper Engine Accounts for This

MedMalPredict is built around the Hooper Engine, the proprietary prediction system that ingests more than 220,000 historical malpractice cases spanning 2004 to 2025 and produces jurisdiction-aware predictions for payment probability, payout range, and outcome severity.

Severity trends over time are not a complication the Hooper Engine handles after the fact. They are a primary input. The engine adjusts comparables to current dollars, weights mature and immature accident years differently to account for exactly the immaturity issue S&P identifies, and produces a statistically grounded range for any given case profile rather than a national average that papers over jurisdiction and severity differences.

The goal is not to produce optimistic numbers or pessimistic numbers. It is to produce honest numbers: what cases with these characteristics have actually paid, adjusted for what the same characteristics are paying now.

Reading the Room in 2026

Malpractice severity is rising, and the recent data understates how much. That is the real takeaway from this week's S&P coverage, and it is the reason case-specific, data-backed valuation is more valuable now than it has ever been. A national-average mindset was never adequate for med mal. In an environment where severity is compounding and the headline data is lagging the real trend, it is a liability.

Try It

If you have a case under evaluation, run it through MedMalPredict and see what the Hooper Engine says. Single reports, five-packs, and annual subscriptions are available.

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Source: "Claim Severity Trends for Medical Malpractice 'Stand Out': S&P GMI", Insurance Journal, April 22, 2026. Underlying data: S&P Global Market Intelligence.

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