In 2025, a total of 1,223 Florida medical malpractice claims resulted in payouts, according to the National Practitioner Data Bank. For the five years from 2021 to 2025, Florida had the fourth highest number of malpractice reports per 1,000 practitioners: 96.86, behind only New Mexico, New York, and Pennsylvania. The same study found that when it came to the raw number of malpractice reports, Florida ranked number two, with 5,875, just behind New York.
The state’s large population of older adults, who are more likely than the general population to require healthcare procedures, is one reason medical malpractice cases in Florida outnumber those of more-populous California and Texas. Florida also ranked third for medical malpractice payouts by state in 2023, behind Pennsylvania and New York. Two years later, it was second with payouts totaling $421.24 million. The lack of statutory caps on economic and noneconomic damages contributes to the high sum.
Below, we’ll look at the specifics of medical malpractice in Florida and how they affect physicians, including whether malpractice insurance is mandatory, the processes prospective plaintiffs must follow before filing a suit, and the “free kill” rule.
Physicians are not required to carry medical malpractice insurance in Florida. Should they choose to “go bare,” however, Florida Statute 458.320 requires them to demonstrate financial responsibility for medical malpractice claims or qualify for a statutory exemption.
Many physicians carry insurance, and hospitals, employers, and other credentialing entities may require coverage exceeding Florida’s statutory minimums. The two principal forms of malpractice insurance are claims-made and occurrence coverage, and premiums vary substantially by specialty, location, coverage limits, and claims history.
Most physicians may satisfy the requirement by maintaining professional-liability insurance of at least $100,000 per claim and $300,000 annually, establishing an escrow account in the required amount, or maintaining an irrevocable letter of credit providing equivalent protection. Physicians with hospital staff privileges and those performing surgery at licensed ambulatory surgical centers generally must maintain at least $250,000 per claim and $750,000 annually.
Florida also permits certain physicians to practice without malpractice insurance or prefunded security if they comply with statutory conditions, including notifying patients that they do not carry insurance and agreeing to satisfy specified amounts following an adverse malpractice judgment. These statutory amounts should not be confused with an overall limit on liability; a physician may remain personally responsible for a judgment exceeding the required financial-responsibility amount. Physicians evaluating insurance should therefore consider appropriate liability limits, defense coverage, policy form, exclusions, tail coverage, and consent-to-settle provisions—not merely the statutory minimum.
Given that the average medical malpractice payout in the state was $371,000 in 2025, an escrow account or bond of $100,000 might not be enough to prevent a physician from having to sell assets or declare bankruptcy in the face of a settlement or court decision. For that reason, medical malpractice insurance for physicians in Florida is highly advised. In fact, nearly 95% of physicians in the state do carry malpractice insurance.
The basics of medical malpractice lawsuits in Florida are similar to those in other states. The plaintiff must establish four elements:
Several statutes and regulations, however, make Florida malpractice claims different from those of other jurisdictions:
The medical malpractice statute of limitations for Florida malpractice claims is two years from the date of the event or two years from when injury was discovered or should have been discovered. There is also a four-year repose period: A claimant cannot file suit more than four years after the event, regardless of when they discover the injury. So if a patient discovers an injury three years after a surgery, they would actually have just one year to file a claim in order to fit within the repose period.
A few states, such as Tennessee, do have more-stringent limitations. Many more, however, are more lenient. Alaska, Indiana, and Oklahoma, for example, have no statute of repose, so patients can still sue if they discover the injury a decade or more after the event. Others including Texas and Wyoming have a 10-year statute of repose.
Under Florida law, with the governing deadlines set out in the relevant Florida statutes, Florida has several exceptions to these statutes.
Florida Statute 766.106 requires claimants to follow a process that includes Florida’s mandatory 90-day investigation period before a lawsuit can be filed. This is perhaps the most significant way in which Florida malpractice claims differ from those in other states.
Prospective plaintiffs must conduct a thorough investigation. Required documentation includes a review of the patient’s medical records by a qualified expert witness practicing in the same field as the prospective defendant and an opinion from that expert that the defendant breached the standard of care, causing injury to the patient.
The notice of intent must be delivered to each prospective defendant by an authorized verifiable method, such as certified mail with return receipt, trackable mail, commercial delivery service, or service by a person authorized to serve the process. It must be accompanied by a verified written opinion from a qualified medical expert corroborating reasonable grounds for the claim and an executed statutory authorization for the release of relevant protected health information.
If available, the notice must also include the medical records relied upon by the expert and lists of the claimant’s known healthcare providers who treated the claimed injuries after the alleged negligence or treated or evaluated the claimant during the preceding two years. Counsel’s good-faith certificate is included in the complaint or initial pleading, not the notice of intent.
Once the notice of intent to sue has been delivered, each prospective defendant and their insurers have 90 days to conduct their own investigation. Informal discovery requests between the parties are allowed at this time, and the prospective plaintiffs and defendants are expected to cooperate. Materials requested during this period, such as interviews with healthcare providers treating the patient or the results of a physical or mental exam of the claimant, cannot be used as evidence by the opposing side.
By the end of the 90-day review period, the provider or its insurance company can 1) reject the claim, 2) make a written offer to settle, or 3) accept fault while offering arbitration on damages. Upon receiving the provider’s decision, the claimant can accept any offers made or opt to sue.
Florida Statute § 768.21(8), sometimes referred to by critics as the “Free Kill” rule, limits noneconomic damages available to certain survivors when an adult dies from medical negligence. Adult children may not recover damages for lost parental companionship, instruction, and guidance or for their own mental pain and suffering. Likewise, parents may not recover mental-pain-and-suffering damages for the medical-negligence death of an adult child. The restriction is particularly consequential when the decedent has no surviving spouse or minor children.
A wrongful-death action may still be brought, and recoverable damages may include lost support and services, medical and funeral expenses, lost earnings, and, in qualifying circumstances, the estate’s prospective net accumulations. But, these damages may be modest or unavailable in cases involving an adult who had limited income or no financial dependents, making some claims economically difficult to pursue.
Critics use the term “Free Kill” to argue that the restriction undervalues the lives of unmarried adults without minor children. In 2025, the Florida Legislature passed HB 6017, which would have repealed the restriction, by votes of 104–6 in the House and 33–4 in the Senate. Governor Ron DeSantis vetoed the bill on May 29, 2025, leaving the restriction in effect.
The “free kill” rule could be considered a legislative exemption specific to malpractice cases in Florida, in that the parents or adult offspring of unmarried adults without minor children can recover noneconomic damages in cases involving car crashes, slip-and-falls, and other causes of wrongful death.
Medical malpractice is also exempt from the so-called 51% rule. Signed into law in 2023, Florida Statute 768.81 declares that if a victim is found to be more than 50% at fault for their own injuries, they cannot recover any damages in a medical negligence suit. However, it does make an exception for medical malpractice. In malpractice cases, the pre-2023 comparative negligence standard applies. Within that framework, if the plaintiff is found to be, say, 60% at fault and the healthcare provider 40% at fault, the plaintiff can still recover 40% of damages.
Florida has no cap on economic and noneconomic damages in malpractice suits. The state legislature did pass a limitation on noneconomic damages, which remains codified as Florida Statute 766.118, but the state’s Supreme Court ruled it unconstitutional. There are caps, however, in claims against government-operated public facilities.
There are also caps on punitive damages: generally three times the economic and noneconomic damages or $500,000, whichever is greater. But if “unreasonable financial gain,” as stated in Florida Statute 768.73, motivated the healthcare provider’s wrongful conduct, the cap is raised to four times the compensatory damages or $2 million, whichever is greater. And the cap is removed if the defendant is found to have intended to harm the victim.
That said, punitive damages are rarely granted in Florida malpractice suits. Even proving gross negligence on the defendant’s part is not always sufficient. Proving intentional misconduct or gross reckless behavior by the defendant is often required as well.
The case: After receiving spinal surgery, Michael Gerlach reported classic symptoms of spinal cord compression from a hematoma, but staff was found to have failed to properly follow up. Although Gerlach did eventually have a second surgery, the delay left him partially paralyzed with severe pain. In December 2025, after seven years of litigation, the jury awarded Gerlach and his wife $27 million, including $5 million to Lisa for loss of consortium.
Of note: The jury found Holmes Regional 75% responsible for the injury, and therefore liable for $20.25 million of the damages. The surgical team was held 25% responsible and liable for the remaining $6.75 million.
The case: In September 2025, a jury awarded Stewart $70.8 million in damages after a contracted nurse practitioner in a hospital ER failed to order a CT scan or consult with a neurologist, despite the plaintiff describing the severity of her headache. This failure to diagnose and treat led to Stewart suffering a stroke shortly after being discharged, leaving her blind, paralyzed on one side, and with severe cognitive deficits and other permanent disabilities.
Of note: Because the plaintiff was a Medicaid patient, the defense argued that the damages should be reduced in keeping with Florida Statute 766.118, which typically limits noneconomic damages for such patients to $200,000. Nonetheless, the court upheld the verdict, stating that a patient’s insurance status or income should not affect what they receive in damages. The payout was the second highest malpractice verdict nationwide in 2025.
The case: A jury in April 2025 awarded $15 million each to James Sada’s widow and his two children under the age of 25, for a total of $45 million, after finding that Orlando Health fatally delayed his treatment for a myocardial infarction by transferring him from a satellite hospital unequipped to handle his case to another facility in its network rather than to a nearer but out-of-network hospital.
Of note: To mitigate damages, Orlando Health cited Florida’s Good Samaritan Act, which protects hospitals and providers from civil liability in instances of emergency stabilization unless they showed reckless disregard or gross negligence. The jury, however, considered the hospital’s prioritization of its network and profits over the patient’s needs to be reckless disregard.
The case: A jury in August 2024 awarded a young boy and his parents $25 million for past damages and $75 million for future damages regarding severe permanent injuries he suffered from his circumcision as an infant. Defendant Dr. Berto Lopez, who had no legal counsel, was found liable for, among other charges, negligent performance, failure to obtain proper informed consent, and failure to disclose that his Florida medical license had been revoked 10 days prior to the procedure.
Of note: Although the Florida Board of Medicine revoked his license on Feb. 5, 2021, the order taking away his license was not filed until Feb. 22. The $100 million award was the country’s third largest for 2024.
The case: Despite being admitted to the Cleveland Clinic ER with severe back pain, a UTI, and symptoms suggesting he was at a high risk of septic shock, Saverio Sasso was not placed in ICU and did not receive continuous cardiac monitoring. After his condition worsened overnight, multiple staff members tried unsuccessfully to intubate him, during which time his brain was deprived of oxygen for nearly 15 minutes. Sasso was removed from life support a week later. A jury awarded his estate $31.9 million.
Of note: Although a lower court allowed the plaintiff to seek punitive damages, the appellate court ruled there was not enough evidence of gross negligence or intentional misconduct.
The case: In February 2024, a jury awarded the parents of Hannah Waite $30 million for emotional pain and suffering after her doctors at a long-term care facility failed to diagnose and treat her for an ulcer. This was despite a discharge summary from the hospital that had treated her prior to her transfer labeling the ulcer as her most urgent medical issue and ordering an endoscopy to be performed. During Waite’s two months at the care facility, her doctors unsuccessfully treated Waite’s nausea without diagnosing or treating its underlying cause. This led to Waite’s malnutrition and death.
Of note: Dr. Rabia Shaikh was held responsible for 70% of the damages and Dr. Andrew Daley for 30%.
In Florida, medical malpractice insurance is not required. However, given the state’s high number of malpractice claims and payouts, most physicians still carry liability insurance. Those who don’t must provide an alternative proof of coverage. Florida physicians typically choose between two main types of malpractice coverage, and premiums vary significantly by specialty.
Physicians who don't carry malpractice insurance can satisfy Florida's financial-responsibility requirement by maintaining professional-liability insurance of at least $100,000 per claim and $300,000 annually, establishing an escrow account in the required amount, or maintaining an irrevocable letter of credit providing equivalent protection. When shopping, physicians should compare coverage options and liability limits, not just whether a policy meets minimum proof-of-coverage rules.
Physicians with hospital staff privileges or who perform surgery in an ambulatory surgical center generally must maintain at least $250,000 per claim and $750,000 annually. Given that settling malpractice claims in Florida costs 2.9 times the national average, physicians should also weigh policies with a consent-to-settle provision.
As of 2026, there are no caps on economic and noneconomic damages for most malpractice suits. Punitive damages, which are rarely granted, are capped, at generally three times the economic and noneconomic damages or $500,000, whichever is greater.
If “unreasonable financial gain,” as stated in Florida Statute 768.73, motivated the healthcare provider’s wrongful conduct, the cap is raised to four times the compensatory damages or $2 million, whichever is greater, and the cap is removed if the defendant is found to have intended to harm the victim.
In most cases, the statute of limitations for Florida malpractice claims is two years from the date of the event or two years from when injury was discovered or should have been discovered. The corresponding statute of repose states a claimant cannot file suit more than four years after the event, even if they don’t discover the injury until after that period.
Before plaintiffs can file a malpractice suit, they must send each named healthcare provider formal notification of their intention to do so. The notice must include a medical expert’s opinion of merit, copies of the medical records they reviewed, a list of providers who treated the plaintiff following the incident as well as in the two years prior to it, and signed authorization allowing the prospective defendants to access and review protected patient records.
Once a physician has received a notice of intent to litigate, they have 90 days to conduct an internal review. By the end of the review period, the provider can reject the claim, make a written offer to settle, or accept fault while offering arbitration on damages. Upon receiving the provider’s decision, the claimant can accept any offers made or opt to sue.
Florida is among the top states in terms of malpractice reports and payouts, outranking more populous states. Its aging, high-needs population and a lack of caps on economic and noneconomic damages contribute to this status. Meanwhile, requirements for both prospective plaintiffs and defendants prior to the filing of suits add to the complexity of navigating litigation.
Although physician malpractice insurance in Florida is not mandatory, providers are still legally required to prove they can cover potential malpractice claims; by 2015, Florida had the highest loss rate for malpractice claims, and settling these cases costs 2.9 times the national average. Given the state’s unique population and statutes, it’s no surprise that just 5% of Florida physicians opt to go bare.
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