How Often Do Doctors Settle Out of Court in Medical Malpractice Cases?
If you’ve been harmed by medical negligence, one of your first questions may be: “Will this case go to trial, or will the doctor settle out of court?” It’s a fair question—and an important one. Most people understandably want justice, but they also want closure, financial recovery, and to avoid a lengthy and uncertain court battle.
The good news? Most medical malpractice cases are resolved through out-of-court settlements. In this article, we break down how often doctors settle, why they do (or don’t), and what it means for patients seeking compensation in Pennsylvania and beyond.
How Common Are Medical Malpractice Settlements?
According to multiple national studies and insurance industry data:
- About 90–95% of all medical malpractice cases are resolved before trial, with the majority ending in a settlement.
- Only 5–10% of cases go all the way to a jury verdict.
- Of those that do go to trial, physicians win about 70–80% of the time, especially in borderline or complex cases. Though at Lupetin & Unatin, our track record for winning medical malpractice verdicts is MUCH higher than the state average. In other words, we win a trial much more frequently than do most law firms.
This data highlights a key point: most doctors, hospitals, and their insurers prefer to settle when there is clear evidence of negligence or a high risk of a jury award.
Why Doctors (and Their Insurers) Settle Out of Court
Doctors and healthcare providers don’t make settlement decisions entirely on their own. These cases are typically handled—and financially covered—by malpractice insurance companies, which use legal and financial risk calculations to guide their decisions.
Here are the most common reasons a doctor (via their insurer) may settle a case out of court:
- Avoiding the Uncertainty of Trial
Even in cases with defensible care, juries are unpredictable. Insurers often prefer the certainty of a negotiated settlement to the risk of a multi-million-dollar verdict.
- Reducing Legal Costs
Going to trial can take years and cost tens of thousands of dollars in expert fees, depositions, and trial preparation. Settling early avoids these expenses.
- Protecting the Doctor’s Reputation
While settlements are sometimes confidential and don’t require an admission of wrongdoing, trials are public and can attract media attention. A quiet settlement can help limit reputational damage.
- Strong Evidence of Negligence
When the plaintiff has strong expert support, clear proof of a breach in the standard of care, and significant damages, a settlement is often the most rational financial decision.
Why Some Doctors Don’t Settle
Despite the high percentage of cases that settle, there are situations where doctors—and their insurers—refuse to do so:
- They believe the care was appropriate, and they want to defend their medical judgment.
- The injuries are minor, and the cost of settling may not be justified.
- They want to send a message to deter frivolous claims or set precedent.
- They are confident in the jury pool or the defense expert testimony.
In Pennsylvania, particularly in counties with more conservative juries, defense lawyers and insurers may feel confident rolling the dice in court. But in plaintiff-friendly venues like Philadelphia, settlement may be more likely.
What Is a “Hammer Clause” in a Doctor’s Malpractice Insurance Policy?
One lesser-known factor that can influence whether a case settles is something called a “hammer clause” in a doctor’s malpractice insurance policy.
What is a Hammer Clause?
A hammer clause gives the doctor the final say on whether to approve or reject a settlement offer—even if their insurance company wants to settle the case.
In most medical malpractice policies, the insurance company controls settlement decisions. But some doctors (especially those concerned about their professional reputation or licensing implications) pay extra to include a hammer clause, which allows them to refuse to settle if they believe they did nothing wrong.
How a Hammer Clause Works
If a hammer clause is in effect, and the doctor refuses to settle:
- The case can go to trial, even if the insurer recommends settlement.
- If the case goes to trial and the verdict exceeds the proposed settlement, the doctor may be personally responsible for the additional amount—depending on how the clause is written.
- This financial risk often pressures doctors to reconsider and agree to settle, especially if the potential damages are high.
Why the Hammer Clause Matters to Patients
For patients bringing a claim, hammer clauses can sometimes delay or complicate settlements—especially when the insurer sees clear liability but the physician wants to defend their reputation in court.
However, experienced medical malpractice lawyers are familiar with these dynamics and know how to navigate them during negotiations. At Lupetin & Unatin, we’ve encountered and overcome these issues many times, ensuring that our clients’ interests stay front and center.
Pennsylvania Medical Malpractice Settlement Trends
In Pennsylvania, the majority of medical malpractice claims are resolved without trial, in line with national trends. According to the Pennsylvania Unified Judicial System:
- Of the 1,485 medical malpractice cases filed in 2023, only a small percentage reached a jury verdict.
- Many claims are dismissed or withdrawn early—often after expert review shows no viable claim.
- A large number are settled during the litigation process, especially after depositions and expert reports are exchanged.
At Lupetin & Unatin, we work hard to investigate and prepare every case as if it will go to trial. This preparation often leads to better settlement outcomes—because insurers know we’re ready to go the distance if necessary.
What This Means for You
If you’re pursuing a medical malpractice claim, here’s what you should expect when it comes to settlements:
Most Strong Cases Settle
If your case has solid medical expert support and involves serious injury or death, there’s a good chance it will settle—sometimes before a lawsuit is even filed.
Timing Matters
Settlements can happen at many stages:
- Before a lawsuit is filed (pre-suit settlement)
- During litigation, after depositions and expert reports
- Shortly before trial, when both sides reassess risks
The Right Law Firm Makes a Difference
Insurance companies don’t just evaluate the facts—they evaluate the lawyers. A firm with a track record of success in medical malpractice trials is more likely to get a fair settlement offer. That’s why having experienced trial lawyers matters, even if your goal is to settle.
Final Thoughts: Settlements Offer a Path to Justice
While headlines often focus on dramatic jury verdicts, the truth is that most medical malpractice cases are resolved out of court—quietly, efficiently, and with meaningful compensation for the injured patient or their family.
At Lupetin & Unatin, we understand how overwhelming the legal process can feel. Our team is here to give you honest answers, compassionate guidance, and fierce advocacy—whether your case settles or goes to trial.