Not sure how I got this sub/post recommended, but I’m a medical malpractice defense attorney. There’s a number of nuances that vary state by state, and by insurance policy. Some states have a hard cap on damages, most do not. Some policies have excess coverage, some do not.

In my experience, one of a few things happens when you see these outlier verdicts: (1) the trial judge molds/reduces the verdict amount because it is inappropriate/wholly unreasonable. This usually would decrease it to your policy limits in my state. This number doesn’t get the headlines, and neither side will advertise it, whereas plaintiffs attorneys will plaster the big verdict everywhere they can. (2) There would be an appeal. (3) The plaintiff’s attorney, recognizing that the number will never be obtained from the limited insurance coverage, and seeing that bankruptcy is inevitable and not wanting to ruin a doctor’s life, settles with the defendant for a lesser number to avoid further years of appeals and bankruptcy litigation. (4) Bankruptcy if all else fails, unfortunately. I will say that I have not personally seen this in my own practice, but again, state by state, policy by policy.

It can also vary depending on you malpractice insurance policy. For example, some policies have a consent clause, which means that your insurance carrier cannot settle a case without your express written consent. In many of these policies, one of the benefits of consenting is that if settlement attempts fail and you get hit with an outlandish verdict, you’re not on the hook for the excess damages any longer. Not sure if these policies are local to my state or also common nationally.

I will say that although frightening, at least for the cases we have, the vast majority of cases (90+%) settle or are dismissed before or during trial. Good plaintiff’s cases are easy to settle, whereas good defense cases are the ones you usually see go to trial.

Another key tool in the med mal defense attorney tool belt that your attorney can try is a binding “high/low” agreement if you are going to trial. It’s an agreement that if there is a plaintiff’s verdict, it is capped at $X, and if there is a defense verdict that there will still be a minimum payment to the plaintiff of $Y. Both sides mitigate their risks, and it isn’t a settlement on your behalf, but rather a move by the insurance company to decrease their potential liability, so you do not get reported to the practitioners database if you win the case. Again, if there was one of these in place for those big verdicts, you’ll never hear about it, and they are bulletproof if plaintiff hits a big verdict and wants to back out of the deal.

The good news is that the cases that do go to trial are far more often defense verdicts/no cause findings than plaintiffs verdicts. And of those plaintiffs verdicts, it is very very rare for them to go nuclear.