Physicians across the United States know malpractice coverage is a nonnegotiable cost of practicing medicine, but not all doctors pay the same price. Premiums can vary dramatically depending on specialty, location and risk exposure. Understanding who has the most expensive malpractice insurance – and why – can help physicians better anticipate expenses and make informed coverage decisions.

Medical malpractice insurance is a core safeguard designed to protect physicians against claims of negligence, errors or omissions. Choosing the right coverage—and provider—can have long-term financial implications, which is why many doctors research the top 10 medical malpractice insurance companies before selecting a policy.

Who has the most expensive malpractice insurance?

When looking at the highest malpractice insurance by specialty, surgical and high-risk procedural fields consistently top the list. These specialties face greater exposure to severe patient outcomes, which increases the likelihood and cost of claims.

Specialties that typically pay the most include:

• Neurosurgery
• Obstetrics and gynecology (OB-GYN)
• Orthopedic surgery
• Cardiothoracic surgery
• General surgery

Neurosurgeons are widely cited as having the most expensive malpractice insurance premiums in the country. The combination of complex procedures, high-stakes outcomes and costly litigation makes this specialty the riskiest to insure.

How much do US doctors pay for malpractice insurance?

So, how much is malpractice insurance per year for the average physician? The answer depends heavily on specialty and geography, but national averages provide helpful context.

Across all specialties, U.S. physicians typically pay anywhere from $7,500 to over $50,000 annually for malpractice coverage. Primary care physicians often fall on the lower end of the spectrum, while surgeons and procedural specialists sit at the higher end.

• Family medicine and pediatrics may average $6,000–$10,000 per year
• Emergency medicine often ranges between $15,000–$25,000 per year
• OB-GYN and surgical specialties can exceed $30,000–$50,000+ per year

State tort laws, claims history and policy limits also play major roles in determining annual premiums.

How much is malpractice insurance per month?

Breaking premiums down further, many physicians want to know the average cost of malpractice insurance for doctors on a monthly basis to better manage cash flow.

Monthly malpractice insurance costs often range from:

• $500–$800 per month for low-risk specialties
• $1,500–$3,000 per month for moderate-risk specialties
• $4,000+ per month for high-risk surgical fields

These monthly figures can fluctuate based on whether a physician is early career or established, employed or independent and practicing in a high-litigation state. Claims-made versus occurrence policies can also influence monthly pricing.

Which doctors pay the highest malpractice insurance?

When evaluating malpractice insurance cost by specialty, a clear hierarchy emerges. Physicians who perform invasive procedures or deliver babies face the highest premiums due to increased claim frequency and severity.

Doctors who typically pay the highest malpractice insurance include:

1. Neurosurgeons
2. OB-GYNs
3. Orthopedic surgeons
4. General surgeons
5. Cardiothoracic surgeons

By contrast, psychiatrists, pathologists and family medicine physicians generally experience some of the lowest malpractice insurance costs. While no specialty is immune to lawsuits, the financial risk profile varies widely across the medical profession.

Understanding these differences is especially important for residents and fellows choosing a specialty as malpractice premiums can significantly impact long-term earning potential.

Malpractice insurance costs are far from uniform, and specialty choice plays a major role in determining how much a physician will pay. High-risk procedural specialties consistently face the most expensive premiums, while primary care and non-procedural fields enjoy lower costs.

If you’re comparing coverage options or evaluating providers, start by reviewing the top medical malpractice insurers and understanding how policy structure affects pricing. Choosing the right coverage now can protect both your practice and your financial future.

Ready to explore your options? Review trusted malpractice providers and compare coverage features to find the policy that best fits your specialty and career stage with resources in the PracticeLink Resource Center.