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As legislators discovered during the recent controversy over skyrocketing medical malpractice insurance rates, attempts to examine the causes of insurance rate increases, and to find potential remedies, can open a pandora’s box of conflicting reports and allegations.

So far, the insurance industry and proponents of adopting provisions to limit lawsuits have been the most vocal, and during the 2003 session, the Legislature adopted sweeping legislation to limit damages in medical malpractice lawsuits.

But during a recent interim legislative meeting I attended, we received a great deal of information from those who question whether taking further steps to quell lawsuits would actually stem what some people say are overly high automobile and homeowner insurance rates.

According to information provided to the committee, the national Center for Justice & Democracy conducted a study of insurance rate changes in every state from 1985 through 1988, then compared the data between states that had enacted tort reform and those that had not. The Center found that tort law limits enacted in response to the insurance crisis of the mid-1980s have not lowered insurance rates, and that states which adopted little or no tort law restrictions have experienced the same level of insurance rates as those which enacted severe restrictions.

“The ‘liability insurance crisis’ of the mid-1980s was ultimately found to be caused not by legal system excesses but by the economic cycle of the insurance industry,” the Center reported.

In West Virginia, the Legislature responded to the outcry over rising medical malpractice insurance rates – and the reported potential loss of our physicians – by adopting significant changes to our tort system.

Our new law imposes a general $250,000 cap on non-economic damages. In cases involving three sets of circumstances – wrongful death; permanent physical deformity, loss or use of a limb or loss of bodily organ system; or permanent physical or mental impairment preventing patients from independent care – the cap is set at $500,000. Trauma care damages are also capped at $500,000. The Legislature abolished “joint liability ,” a state provision that made any defendant who was at least 25 percent negligent liable for more than their share of damages.

Now, the Center for Justice and Democracy is pointing to a study conducted by the U.S. General Accounting Office at the request of Republican congressmen. The study found that in West Virginia, although health care access problems “reportedly developed because two hospital obstetrics units closed due to malpractice pressures, officials at both of these hospitals told (federal officials) that a variety of factors, including low service volume and physician departures unrelated to malpractice, contributed to the decisions to close these units.”

The General Accounting Office also noted that the number of physicians in West Virginia per capita increased slightly between 1997 and 2002.

The General Accounting Office also concluded that “state laws and regulations unrelated to tort reforms, such as premium rate regulations, vary widely and can influence premium rates” and that premium prices are greatly affected by income from investments and market conditions.

Insurance industry representatives now want the Legislature to enact greater restrictions on lawsuits. They would like to see the elimination of West Virginia’s “third-party bad faith” provision. Through this law, a person suing an insurance policyholder can also sue the insurance company, alleging that company failed to deal with them fairly. Insurance companies question why a non-policy holder can sue an insurer and point to that provision as being a major factor causing West Virginia to have overly high automobile and homeowner insurance rates.

Insurance representatives also said that some of our state’s consumer protection-related laws are stifling the industry. One state law requires companies to base payouts on the face value of a policy, rather than the replacement value of the insurance property. The other limits when insurers can refuse to renew home or automobile policies.

It is a complex question, one that may take a great deal of time to sift through. While opponents of further tort reform maintain that West Virginia’s insurance rates are below the national average, lawmakers have certainly heard many complaints from residents facing rising costs or having difficulty obtaining policies. As a member of the Joint Insurance Availability and Medical Malpractice Insurance Committee, I will continue to study the issue and report on the committee’s progress.

I welcome and appreciate your input on these issues, or any other legislative matter. Please call me at (304)340-3106 or write to Delegate Virginia Mahan, 215-E, Capitol Complex, Charleston, WV 25305.