“The Medical Liability industry has always been cyclical,” said Atchinson, “with periods of time in which losses, loss costs and claims frequency have all soared.”

But, he said, for a variety of reasons, there has been more stability recently as insurers, practitioners and states have taken actions designed to reduce claims and the associated costs.

When the PIAA was founded more than 30 years ago, Medical Liability insurers began to focus on quality health care and patient safety because Medical Liability policies offered by the commercial market were becoming so expensive that health-care providers were being priced out of the market, Atchinson said. Today's Medical Liability market, which is driven principally by PIAA carriers, is still focused on improving health-care practices, promoting patient safety, and reducing the cost of insurance, he added.

The fact that PIAA represents about 60 to 70 percent of the private practicing physicians in the United States, as well as many community hospitals, has allowed its members to be industry leaders, said Atchinson—who noted that its members are mostly mutual insurers or self-retention groups focused on reducing claims and their own costs.

Another reason for this rebound, Atchinson said, is government efforts to improve health-care research and quality.