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Government Relations

MPL Association’s National Advocacy Initiative in Full Swing

The MPL Association is shifting its focus toward state policy makers with a new program—the National Advocacy Initiative. This comes at an important time for the MPL community as the deteriorating policy environment in the states is resulting in increasing attacks on established reforms.

2018-2022
CARDIOVASCULAR DISEASES

According to the American Heart Association, heart disease has been the leading cause of death in the United States since 1921. Although cardiovascular disease (CVD) rates had been decreasing, they have recently started to rise again due to factors such as diabetes, an aging population, health inequities, and other behavioral and environmental factors.

Claims related to CVD continue to be among the most prevalent patient conditions reported in the MPL Association Data Sharing Project (DSP). A review of this closed claims database shows that approximately 12% of the 29,153 claims and lawsuits closed between 2018 and 2022 involved CVD as the resulting medical condition. This condition refers to what developed following a medical encounter and led to the allegation made in the claim. Cardiac arrest is included in these analyses since heart conditions are the main risk factors for cardiac arrest.

 

 

Cardiac arrest had the highest number of closed claims (1,174), but a lower closed with indemnity payment (CWIP) ratio (22.2%) and average indemnity payment ($393,745) compared to other conditions like cerebrovascular and arterial diseases.

The overall CWIP ratio across all CVD claims is 27.8%, indicating that roughly 1 in 4 claims resulted in an indemnity payment. Although low in claim count, hypertensive diseases had the highest CWIP ratio at 53.3%, showing that over half of the closed claims led to a payment. Congenital heart diseases and ischemic heart diseases also had high CWIP ratios of 42.9% and 37.0%, respectively.

The average indemnity payment across all CVD claims was $446,782. Cerebrovascular diseases reported the highest average indemnity payment of $524,526, followed closely by arterial diseases with an average indemnity of $502,868. The average allocated loss adjustment expense (ALAE) across all CVD claims was $53,913. Congenital heart diseases and cerebrovascular diseases had the highest average ALAE at $94,223 and $60,740, respectively.

MEDICAL SPECIALTIES
 
 
  • Top 6 Specialties in CVD Claims: Internal Medicine (20%), Corporate Entity (13%), Radiology (8%), Family Medicine (8%) and Cardiology (6%), and Emergency Medicine (5%).
  • Highest Total Indemnity: Internal Medicine ($74M) and Radiology ($62M).
  • Largest Indemnity Payment: Radiology ($3.9M).
  • Highest CWIP Ratio: Family Medicine (41%), Emergency Medicine (35%), and Radiology (34%).
  • Highest Average Indemnity Payment: Radiology ($656K), Emergency Medicine ($484K), and Internal Medicine ($445K).
  • Lowest Average Indemnity Payment: Family Medicine ($374K).
  • Highest Average ALAE: Emergency Medicine ($72K) and Family Medicine ($56K).
ALLEGATIONS
 
  • Top 5 Allegations in CVD Claims: Diagnostic (47%), Procedural (26%), Medication/IV Fluids (14%), Administrative and Vicarious Liability tied (4%).
  • Highest Total Indemnity: Internal Medicine ($74M), and Cardiology ($41M).
  • Largest Indemnity Payment: Radiology ($3.9M).
  • Highest CWIP Ratio: Family Medicine (41.2%), and Radiology (33.7%).
  • Highest Average Indemnity Payment: Radiology ($655K), and Internal Medicine ($445K).
  • Lowest Average Indemnity Payment: Family Medicine ($374K).
  • Highest Average ALAE: Family Medicine ($56K), and Radiology ($55K).
SEVERITY OF INJURY
 
  • Severity of Injury in CVD Claims: Mild (4%), Moderate (14%), Severe (15%), Death (67%), Not Specified (<1%).
  • Highest Total Indemnity: Death ($250M), Severe ($106M).
  • Largest Indemnity Payment: Severe ($3.9M).
  • Highest CWIP Ratio: Severe (36%), followed by Death (27%).
  • Highest Average Indemnity Payment: Severe ($574K), Moderate ($496), and Death ($402K).
  • Lowest Average Indemnity Payment: Mild ($403K).
  • Highest Average ALAE: Severe ($66K), Moderate ($56K), and Death ($51K)
RESOLUTION
 
 
  • A significant portion of closed claims (66%) were resolved but later determined to lack merit. These claims were either dropped, withdrawn, or dismissed without any indemnity payment to the claimant, though they incurred an average defense cost of $31,402. In contrast, 5.3% of claims were resolved by a verdict. Overall, judges or juries ruled in favor of the defendant 90% of the time, with an average defense expense of $157,149 for these cases.

 

Contact for more information:
Kwon Miller, Research and Analytics Manager kmiller@MPLassociation.org