One Way to Avert a Sky-High Malpractice Award

Mark Crane


October 06, 2011

In This Article

Exactly How Does a High-Low Work?

A high-low can be reached any time before a jury verdict, even while the jury is out deliberating. "In some cases, we have had a high-low from the start. In others, they may be reached late in the trial, after the attorneys see how their experts and witnesses did in court," says Leone.

The jury is never informed about the high-low, although the trial judge must approve it on the record in most jurisdictions.

Generally, all payments made on behalf of physicians in malpractice cases must be reported to the National Practitioners Data Bank. However, high-lows have an important exception. If the jury finds no liability on the physician's part, no report is made, even though his insurer will still pay the predetermined low end of the agreement, says Martin Kramer, communications director for Health Resources and Services Administration, which runs the data bank.

Any payment on a physician's behalf, low or high, may affect the doctor's future insurability and may result in premium increases even when no liability is found, says DeKleine. "There is a possibility that the low payment could also subject the physician to a state licensing or disciplinary board investigation."


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