10-6-05 - LIABILITY UPDATE -  "Healthy recovery since...legislature passed medical liability reform"
by Donna Baver Rovito, Editor, "Liability Update"
Author, "Pennsylvania's Disappearing Doctors"


This LIABILITY UPDATE "newsletter" is a free service which I provide, as a volunteer, to help provide medical liability reform and crisis information to physicians, patients and physician advocates.  I do not work for any physician advocacy organization.

Opinions and clarifications are my own, and do NOT reflect the official position of any physician or patient advocacy organization unless stated as such.  Opinions are placed in double parentheses ((xxxxxx)), italicized and appear in blue. 

This Update is emailed to approximately 7,500 health professionals and physician and patient advocates.


PLEASE FORWARD THIS IMPORTANT INFORMATION TO EVERY HEALTH CARE PROFESSIONAL YOU KNOW AND SEND ME MORE EMAIL ADDRESSES

1...Commentary
2....Best's Review
Doctors' Orders
3....Congressional Record
Success of the Texas Medical Liability Trust
4...Best Wire
Gains Realized With Texas Med-Mal Reforms  
5....WSJ Opinion Journal
In Mississippi, tort reform works.
6....Modern Physician.com
W.Va. med mal insurers seek rate cuts as lawsuits decline
7...Atlanta Business Chronicle
Tort reform expected to bring more specialists to Georgia
8....Arkansas Democrat Gazette
Arkansas medical malpractice rate slows



1...Commentary

There's a LOT of good news in this Update, as well as ammunition for you to use when the Dark Side argues against liability reform "because it won't work anyway," or when they blame the medical liability crisis on those evil, greedy insurance companies.  Because in states where substantive reforms have been passed, medical liability premiums HAVE started to go down.  It's hard to argue with facts - but don't worry, those who oppose reform don't let facts get in the way of their profits....

DBR

2....Best's Review
Doctors' Orders
September 2005 Issue

Physicians have wielded their clout to bring about medical-liability reform, but what lies beyond caps on damages?

In early 2002, the medical-legal framework in Texas was strained to the limit. On one side were personal injury lawyers advertising heavily and juries returning awards in medical-malpractice lawsuits that ranged into the millions of dollars. On the other were trauma centers closing their doors, medical-liability insurers rapidly exiting the market and doctors retiring early or moving their practices elsewhere.

Across the state, there were murmurings of a doctors' strike.

"We had reached a breaking point," recalls Corpus Christi radiologist Burk Strong. "But we decided we needed to do something else."

So instead of striking, the doctors ordered up a cure.

Armed with bumper stickers and buttons, pamphlets to distribute in their waiting rooms and yard signs to post on the lawns of their homes, medical professionals affiliated with the 50,000-member Texas Medical Association joined others in a rally for change. In Strong's region, 200 doctors, with busloads of supporters and friendly legislators in tow, held an awareness day at the Nueces County Courthouse. At the Texas Capitol, 180 miles away in Austin, doctors began showing up on the first Tuesday of each month, donning white coats and meeting with policymakers to state their cause.

The efforts "paid off big time," said Strong, who was president of the Nueces County Medical Society at the time. On June 11, 2003, Gov. Rick Perry signed into law House Bill 4, which contained sweeping tort reforms, including a $250,000 limit on noneconomic, or "pain and suffering" damages and a $750,000 overall limit per case. The public backed up the bill by approving Proposition 12, which allowed liability insurance premiums to immediately decrease by circumventing a possible 10-year wait for the state Supreme Court to determine whether caps were permitted under the Texas Constitution. Washed out with the turning of the tide were huge jury awards, including one that topped out at $10.5 million in 2000.

So far, the doctors' activities helped to drive an initial 12% cut in medical-liability premiums by the Texas Medical Liability Trust and a subsequent 5% reduction. In addition, 11 new insurers have entered the Texas medical-liability market.

What happened in Texas is just one example of how, in recent years, doctors across the country have set the stage for legislative reform, particularly in the area of capping noneconomic damages. Since 2002 alone, those efforts, coupled with advocacy by the insurance industry and other groups, have led to reforms in a number of states, including Alaska, Arkansas, Connecticut, Florida, Georgia, Idaho, Illinois, Missouri, Nevada, Ohio, Oklahoma, South Carolina and West Virginia.

The lobbying skills used to get there, however, weren't something doctors picked up in medical school.

"A lot of doctors had always hated bringing politics into the office. The doctor and patient relationship is very important," Strong said. "But most of them realized the importance of doing that. So doctors began talking to patients."

National Efforts

Christian Shalgain, manager of legislative affairs for the American College of Surgeons, said those efforts have been felt at home as well as on Capitol Hill, where federal medical-liability reforms are currently on the burner.

"We have seen doctors become much more active in the political process and getting medical-liability reform," Shalgain said. "They've come to testify, bringing their patients with them and meeting representatives. The combination of the doctors' stories and the patients' stories (in terms of scarcity of access) have gone to show legislators what the true need for medical-liability reform is."

And while the need for reform has been subject to great debate, with some blaming the current medical-liability crisis on exorbitant jury awards and others alleging profiteering by liability insurance companies, one thing most agree upon is that doctors are facing a problem, Shalgain said.

According to the American Hospital Association, 45% of hospitals reported that the professional-liability crisis has resulted in the loss of physicians or reduced coverage in emergency departments. Moreover, a Harris Poll found that more than 75% of doctors believe medical-liability litigation has negatively affected their ability to provide quality care in recent years.

In response to the argument that medical-malpractice insurers are swimming in reserves, Connecticut Insurance Commissioner Susan Cogswell wonders why the number of such insurers doing business in her state dropped in the past decade from 19 to the current three. "Many insurers are leaving the market either because they can't provide at profitable rates or because they are going insolvent," she said.

According to A.M. Best Co.'s 2004 Best's Aggregates & Averages, over the past decade the profitability of medical-liability insurers has been on the decline and was lower than that of other property/casualty insurers. Between 1996 and 2003, the combined ratio of medical-liability insurers increased from 106.6 to 136.9, meaning that for every $1 insurers received in premiums in 2003, they paid out about $1.37 in claims and expenses. In contrast, the 2003 combined ratio of all property/casualty insurers was 100.1.

Caps or No Caps

However, as doctors go about trying to solve the issue of soaring medical-liability premiums, those in line for harm are the innocent victims of medical malpractice, represented by lawyers, said Carlton Carl, spokesman for the Association of Trial Lawyers of America.

"Who does tort reform hurt? It hurts people injured by, not the fault of their own, but by the neglect or greed of others. The proposal to cap damages applies to every case, no matter how severe the injury, no matter how outrageous the neglect of the doctor or hospital or nursing home or drug company," Carl said. "It would, in fact, apply to the mother whose child is killed as a result of malpractice and the children whose parent is killed in a nursing home.

"Caps on damages don't improve the quality of health care, they don't minimize instances of mistakes, they don't increase the availability of health care and they don't reduce premiums. The only thing they do is to put more money back in the pockets of the insurance companies," he said.
((...whereas unlimited jury awards "don't minimize instances of mistakes, they don't increase the availability of health care and they don't reduce premiums. The only thing they do is to put more money back in the pockets of the" trial lawyers...." ))

Robert Detlefsen, public policy director for the National Association of Mutual Insurance Companies, said the bulk of insurers' expenses originate not so much from hefty jury awards -- the average of which, according to the American Medical Association, has doubled in recent years -- but from legal expenses and settlements that are made under the threat of such awards.

"The slogan about the insurance industry deciding on the value of a person's life is really sort of a canard," Detlefsen said. "You're leaving it up to a jury to decide what noneconomic damages to a plaintiff have occurred based on the evidence presented. But the question becomes, should juries have unlimited power to award intangible things such as pain and suffering? The fact is, as long as there's a potential for these very large jury awards, the existence of that phenomenon influences the entire settlement process."

"If you just focus on the parade of horribles, you find yourself on a slippery slope that leads to the situation that we're in today, where doctors are subject to potential ruinous litigation expenses and damage awards to the point where it becomes next to impossible for them to obtain affordable malpractice insurance, and they have to shut down their practices," Detlefsen said.

As doctors continue their quest, the legal landscape will likely change as well, said John Salvucci, an insurance lawyer for the Philadelphia-based law firm Cozen O'Connor. No longer will a $250-an-hour defense lawyer be up against a $2,500-an-hour plaintiff's lawyer who collects medical-malpractice cases as an investor does stocks and bonds, knowing that the risk is bound to pay off in at least a few cases, Salvucci said.

"If you put caps in place on medical-malpractice cases, that ends. The plaintiff's attorney who is used to making multimillions of dollars, they're going to switch and do something else," Salvucci said. "Lawyers are fighting these measures through political action committees, but states are passing laws anyway. There has been a change in the philosophy of the consuming public, led by the disenfranchisement of physicians."

And while caps may accomplish a certain result for insureds as well as insurers, and physicians are likely to remain vocal on the topic, in the end, alternate reforms may be necessary to usher in a lasting cure.

One option, Detlefsen said, may be the adoption of "loser pays" rules, which exist in Europe and Japan and require a losing party in a lawsuit, whether it be the defendant or plaintiff, to pay the legal expenses incurred by the other side. Another answer may come though creating medical-malpractice courts, which so far have seen consideration in Pennsylvania, Illinois, Maryland and Massachusetts.

"Logic will tell if (placement of caps for noneconomic damages) is an effective remedy. But experience doesn't always follow logic. We haven't accumulated enough experience yet to know just how effective caps are going to be," Detlefsen said.



3....Congressional Record
Success of the Texas Medical Liability Trust
Michael Burgess (R-TX)
September 21, 2005

Mr. BURGESS. Madam Speaker, just a little over 2 years ago Texas passed a constitutional amendment that allowed for caps on noneconomic damages in medical liability lawsuits. And what has been the experience in Texas over those 2 years?

Well, we have seen insurance and doctors come back to the State. Texas had gone from 17 down to two medical insurance companies, and now they are back up to 12. Not-for-profit hospitals have seen significant increases in the money that they are now able to invest in plants and equipment, money that otherwise would have gone for their self-insurance programs.

And perhaps most importantly, the rates of liability insurance for Texas doctors has come down. Texas Medical Liability Trust has reduced rates three times since the passage of House bill 4 and proposition 12, 12 percent in 2004, 5 percent in 2005, and now a recently announced 5 percent decrease in 2006, and, coupled with that, a 5 percent dividend rebate. So that now there is a total of 27 percent insurance savings for Texas doctors in medical liability.

Speaking to physicians of the Texas Medical Association just last weekend, Dr. Dennis Factor said, “Access to health care and the malpractice environment in Texas has made a healthy recovery since the Texas legislature passed medical liability reform.''

I urge this body to take it up and get it done.


4...Best Wire
Report: Gains Realized With Texas Med-Mal Reforms  
August 3, 2006

AUSTIN, Texas - According to a 357-page article in the latest edition of Texas Tech Law Review, Texas' two-year-old House Bill 4 and Proposition 12 reform measures could turn the tide toward sanity and stability in the state's medical liability system.

"We believe the law review article will undergird the work of the legislators and probably dissuade appeals, as the legislative intent is made clear," said Jon Opelt, executive director of Texas Alliance for Patient Access, which, along with its 300 affiliate organizations, pushed for the landmark liability reforms in 2003.
((That's what we need here in PA and at the national level - 300 affiliate organizations!  They did it RIGHT in Texas....))

"On the surface, House Bill 4 had more than 200 changes in the law. So it's a dramatic rewrite," Opelt said. "As such, it's difficult for practitioners to understand all of the changes, and so they set out to produce a reference guide to help (the legal community) better understand the changes."

On June 11, 2003, Gov. Rick Perry signed into law House Bill 4, which introduced a $250,000 limit on noneconomic, or "pain and suffering" damages, as well as a $750,000 overall limit per case. The public backed up the bill by approving the state constitutional amendment Proposition 12, which allowed liability insurance premiums to immediately decrease by circumventing a possible 10-year wait for the state Supreme Court to determine whether caps were permitted under the Texas Constitution.

"Two years ago, Texas lawmakers passed arguably the most expansive rewrite of the state's civil justice laws since the adoption of the Texas constitution 140 years ago," Walter Huffman, dean of the Texas Tech University School of Law said in a statement. The law review article "is intended as ... a road map to what lawmakers intended to enact," he said.

The review, written by six Texas attorneys, weaves together legislative testimony and debate, commentary during floor votes, and research submitted for the record to capture what legislators had in mind when they made the decisions they did.

State Rep. Joe Nixon, a civil litigation attorney who co-authored the article, said the reforms put in place by HB 4 went beyond medical-malpractice liability, to include everything from class action and product liability to emergency-room care and immunity for school teachers. Nixon often travels the United States, giving speeches and visiting legislators on the subject of tort reform.

What happened in Texas, Nixon said, proves civil justice reforms work to the benefit of insureds as well as insurers.

"I do think it's that big of a deal. If you saw how hard it was fought by trial attorneys, you would understand," Nixon said. "Over the years, things slowly eroded in Texas. We had 40% to 60% of all asbestos claims in the United States filed here. Since the reforms, we have seen a 50% drop in civil lawsuits."

From the perspective of how bad things were prior to the reforms, the article cites the hospitals that were turning away ambulances due to a shortage of doctors and nurses; a quadrupling of the average medial liability awards, from $472,932 in 1989 to $2 million in 1999; a departure of 13 carriers from the market between 1999 and 2003, and a legal system in which 85% of medical-liability claims against Texas physicians were closed with no payment made to the patient.

Early returns show a growing list of benefits that are being realized as a result of the reforms, according to the report. These include:

- Since May 2003, more than 3,000 new doctors have established practice in Texas

- From four carriers in 2002, the market has seen the arrival of 22 new carriers

- The number of physicians enrolled in the Joint Underwriting Association, the state pool of last resort, has seen a steady decline, while the number of practicing neurosurgeons and emergency care, orthopedic physicians has grown dramatically

-The Texas Medical Liability Trust, the largest physician liability insurer in Texas, experienced a total rate reduction of 16.4%, representing a $34 million rate savings for doctors   
((Math 101 - Keep in mind that a previous 100% INCREASE in premiums is wiped out by a 50% DECREASE....))


5....WSJ Opinion Journal
In Mississippi, tort reform works.
BY CHARLIE ROSS
September 15, 2005 

Legislative battles over tort reform are being waged in statehouses across the country. Congress, too, is fighting out the issue in the form of proposed legislation to cap medical malpractice damage awards and to reform asbestosis litigation. Always hotly debated in such contests is whether tort reform accomplishes its purported goals. Does it make the legal system more predictable and more credible? Does it positively affect insurance costs and availability? Does it reduce litigation expenditures? More broadly, does it improve the economic well-being of the citizens?

In 2004, a long hard battle in the Mississippi Legislature over a comprehensive Tort Reform Bill came to a close, during which the same questions arose. Opponents claimed that the bill was unnecessary, and that, even if it passed, it would not make a difference. Still, we were able to get it through. In many respects, the bill is considered model legislation. Among other provisions, it included venue reform (so trial lawyers cannot shop around for favorable courts) and caps on subjective noneconomic damages (such as pain and suffering). Now, a year has passed since the legislation took effect, and the Mississippi experience is instructive. Tort reform works.

Prior to the legislation, Mississippi was known as the "jackpot justice capital of America." The American Tort Reform Association had labeled certain jurisdictions "judicial hellholes." A survey of more than 1,200 senior in-house counsels for the U.S. Chamber Commerce ranked Mississippi 50th in virtually every category of judicial system nationwide. Insurance companies were fleeing the state. Others were refusing to write new policies. The medical field was particularly strained: Liability insurance was in many cases unaffordable, and in some cases unavailable. One year later, the story is very different. Mass Mutual Insurance Group, St. Paul Travelers, World Insurance Co. and Equitable Life Insurance Co. are returning to Mississippi. State Farm Insurance eased its growth restrictions for homeowners' insurance and lowered its rates on property insurance.

The Medical Assurance Company of Mississippi, which writes 60% of the medical malpractice coverage for doctors in the state, had raised its rates 20% the year prior to the tort reform legislation. After its passage, MACM did not raise its rates at all. "Those people who said tort reform would not work and actively fought any civil justice reform," Mississippi Insurance Commissioner George Dale said. "I think this indicates they were wrong." MACM also recently announced an end to its moratorium on new business; it also just declared it will cut its rates for 2006.

Insurance was becoming less available and less affordable prior to the passage of the tort reform legislation. Now, the opposite is true. Some plaintiff lawyers and some consumer groups still contend that tort reform doesn't work--but it does not take a rocket scientist to understand that when liability exposure is made predictable and governed by reasonable rules, risk can be better assessed, and insurance companies are more likely to offer coverage.

Gov. Haley Barbour attributes the successful recruitment of new business to Mississippi to the lower cost of doing business in the state. Texatron has invested $35 million and Kingsford Charcoal $20 million; we have coaxed back Winchester Ammunition and its $3.5 million payroll, as well FedEx Ground, as part of a $1.8 billion expansion.

Our reform package also virtually eliminated the mass-tort industry in Mississippi. This change came about not only because the legislation provided that venues for lawsuits must be established independently for each plaintiff, but also because Mississippi Supreme Court decisions reinstated the traditional rules of joinder of plaintiffs. These two changes went hand in hand, since the process of passing tort reform (which lasted four years) raised public awareness of the problem, which in turn affected judicial elections. This has provided for a more balanced judiciary.

As a result of these procedural changes, pending mass-tort cases are being split up. The cases of out-of-state plaintiffs are being dismissed, and the cases of in-state plaintiffs are being transferred to the proper venues for trial. Lawsuits in Mississippi are returning to what they are supposed to be--and used to be--about: one plaintiff, or a very small group of plaintiffs, suing a defendant, or a very small group of defendants, for a single cause of action. Common sense has made a comeback.

Not surprisingly, the demise of mass-tort litigation has resulted in a decrease in litigation costs. The CEO of one Mississippi company recently told me that his company's legal bills were reduced by $70,000 a month as a result of the reform. Litigation expense does not produce value for most members of our society. It is merely a transaction cost in the transfer of wealth to compensate injured persons. To be justified, the transfer process must be fair.

Mississippi's mass-tort system was anything but fair, and in many cases it resulted in patently unjustified awards. And people had lost confidence in getting a fair hearing at the trial court level. There was no confidence that the appellate courts would correct abuses. In essence, there was total unpredictability. The sky was the limit on damages. There was even a perception that fundamentals of the rule of law were being threatened. Since the passage of tort reform and the changes implemented by judicial decisions, both perception and reality have changed. We have begun to restore credibility to Mississippi courts in the mind of the public and business, and have thus restored trust to government in Mississippi in general.

Since only a year has passed, the long-term consequences of tort reform cannot be known. There are thousands of cases in the system still governed by the old rules. There is enough information, however, to state unequivocally that tort reform has made the Mississippi legal environment more fair, more predictable and less expensive. For now, that is more than enough.

Mr. Ross is a Mississippi state senator and chairman of the senate judiciary A committee.




6....Modern Physician.com
W.Va. med mal insurers seek rate cuts as lawsuits decline
August 12, 2005

West Virginia's two largest medical malpractice insurers are asking the state Insurance Commission for permission to reduce their rates. The board of not-for-profit West Virginia Physicians' Mutual Insurance Co., the largest medical malpractice insurer in the state, voted Thursday to seek a 5% rate reduction, effective Jan. 1, said President David Rader. Woodbrook Casualty Insurance, the state's largest private malpractice insurer, is asking for a 3.9% decrease, effective Oct. 20.

The number of malpractice lawsuits has declined since the state Legislature changed laws regarding medical malpractice lawsuits, starting in 2001, said Bill Kenney, deputy insurance commissioner.

Rader said his company also is aggressively working with injured patients to try to prevent lawsuits. For example, the insurer is encouraging physicians to apologize for mistakes and are offering to pay for certain costs for injured patients immediately, no questions asked, he said.



7...Atlanta Business Chronicle
Experts: State should expect healthy influx of doctors
Tort reform expected to bring more specialists to Georgia

Lori Johnston
September 12, 2005

As she faces the challenge of recruiting physicians to WellStar Health System, Dee Hammond has seen encouraging signs recently. At a job fair in Texas, she noticed physicians completing their residency were considering positions in Georgia. She's also had calls from physicians working in states with medical malpractice crises interested in relocating to Georgia. The state's new tort reform laws have given Georgia an edge in trying to attract physicians, especially in high-demand specialty areas like surgery and obstetrics, Hammond said.

The biggest provision affecting the medical field in the law was a cap on noneconomic damages of $250,000, or $750,000 if there are multiple defendants.

"We wouldn't be getting calls from Pennsylvania and Florida if we had not had tort reform in Georgia," said Hammond, director of provider services at WellStar.

Some doctors in Georgia already have seen a positive impact from the law, which supporters hope will drive down the high cost of malpractice insurance.

"Now we've got hope of some more doctors coming into the state," said Dr. Kay Kirkpatrick, co-president of Resurgens Orthopaedics P.C.

Kirkpatrick said her insurer already has frozen rates and plans to roll rates back if the law survives legal challenges..

Kirkpatrick also notes how tort reform laws passed in Texas in 2003 are having an effect in that state, with the number of insurance carriers growing from four to 22, and the largest insurer in Texas issuing a 16 percent rate reduction.

If Georgia's law withstands court challenges, Dr. Don Campbell, medical director for Cobb Hospital and the WellStar Physicians Group, expects to see more carriers entering the Georgia market, driving down costs.

"I think it will make it easier for us to keep doctors in Georgia who train here and easier for us to attract doctors to Georgia," he said.

If that happens, metro Atlanta may be able to fill the need for obstetricians, neurosurgeons and other specialists by attracting them away from states that have not yet passed tort reform, Campbell said. He expects to see the influx of physicians by late 2006.

Another need in Georgia is for hospitalists, also known as inpatient physicians, whose primary focus is the care of hospitalized patients. Hammond said she has seen figures that indicate as many as 80 percent of hospitals are recruiting for hospitalists.

WellStar has hospitalist programs at its Kennestone, Cobb and Paulding hospitals and is establishing a program at its Douglas Hospital. Over the next year, Hammond anticipates hiring 10 hospitalists and another 15 to 20 physicians.



8....Arkansas Democrat Gazette
Arkansas medical malpractice rate slows

LITTLE ROCK — Doctors in Arkansas saw the smallest jump in medical malpractice premiums this year, largely due to the ability of insurance companies to balance their books after huge increases in previous years, the state Insurance Department says.

State Volunteer Insurance Co., which covers about 75 percent of Arkansas doctors who buy their own insurance, had a 5.5 percent increase in premiums this year, down from a 13.6 percent increase in 2004, the department said in an annual report required by a 2003 state law.

"It seems to go in waves," said Steve Williams, chief executive officer of State Volunteer Mutual. "(Premiums) go up for a while and plateau, go up for a while and plateau. It never really goes all the way back down."

The report said greater increases in the recent past allowed insurers to balance their books in 2004 after years of losses. For every dollar collected in premiums last year, malpractice insurers spent 97 cents in claims. In 2003, insurers spent $1.32 for every dollar taken in.

Between 1999 and 2005, State Volunteer Mutual's malpractice premiums for internal medicine shot up 240 percent. In 2004, the American Medical Association labeled Arkansas one of 15 "crisis states," saying that rising malpractice premiums and the lack of restrictions on the size of jury awards in malpractice lawsuits were driving doctors out of the state.

But David Wroten, executive vice president of the Arkansas Medical Society, said that hasn't happened.

"When (State Volunteer Mutual) only gives a 5 percent rate increase, no one's going to go shopping for another carrier," he said. "A lot of states have it a lot worse than we do."

Much of the increase came in 2002, after The St. Paul Cos. left the malpractice market. The company insured 51 percent of Arkansas doctors. With more claims, State Volunteer then raised premiums by 49 percent over the course of the year and other insurers increased rates by as much as 97.5 percent.

St. Paul wasn't the only company to leave the market. In 1996, 81 companies offered malpractice insurance in Arkansas, said Charlye Woodard, an Insurance Department spokeswoman. Today there are six.

"The loss of even one more medical malpractice insurer will result in significant declines in both availability and affordability of coverage for the medical community," the department report said. The 3,100 internists insured by State Volunteer now pay $6,100 annually for coverage, Williams said. Doctors in many other states pay more, though.

In 2003, the state Legislature passed a law to limit punitive damages in medical malpractice lawsuits and place tougher evidence requirements on plaintiffs. The number of claims fell and insurance rate increases slowed. But the Insurance Department says the law is too new to credit it with the relatively small jump in medical malpractice premiums. 
((Evidence from other states indicates that even a NEW law will help to reduce premiums....of course, everyone understands that the cases which are "in the hopper" aren't subject to the new laws and that it will take a few years for the full effect to be felt....especially if there are possible constitutional challenges....but I think this signals a positive trend for Arkansas, due largely to medical liability reform and a cap on pain and suffering...))

"Act 649 of 2003 has only been in effect since March 25, 2003, so it would still be premature to expect it to have had a significant impact on rates," the report said.

An opponent of the 2003 law, lawyer Morgan E. "Chip" Welch of Little Rock predicts the tort changes actually will have no effect on the behavior of insurance companies.

"It doesn't affect the ability of insurance companies to charge an arm and a leg for coverage," he said. "They do that because they can. They will raise rates."



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