Diagnostic Errors Caused Most Inpatient Claims
Coverys reported that diagnostic failures in medical-surgical units drove the majority of malpractice claims.
Updated on Oct. 6, 2026 in Healthcare
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A review of 403 closed inpatient diagnostic error events between 2021 and 2025 found that diagnostic failures accounted for 28% of all closed claims. These errors were particularly prevalent in general medical-surgical units, which were responsible for 68% of the documented incidents.
Why it matters
Inpatient diagnostic errors stem from breakdowns in information and communication, often exacerbated by high patient complexity and heavy staff workloads. These incidents frequently lead to severe patient outcomes, with 55% of the analyzed cases resulting in death and 19% resulting in permanent injury.
Diagnostic errors accounted for 43% of total indemnity paid by Coverys. Hospitalist medicine was involved in 37% of these inpatient diagnostic events.
The players
Coverys
Coverys is a Massachusetts-based medical professional liability insurer that holds a 3.8% share of the medical malpractice insurance market.
The details
Over 90% of reviewed events involved factors in clinical decision-making, while more than 75% involved patients with underlying comorbidities. Periodic rather than continuous monitoring on general wards creates gaps in oversight that contribute to systemic diagnostic problems.
Timeline
The analysis covered 403 closed diagnostic error events occurring between 2021 and 2025.
In 2025, the medical professional liability combined ratio exceeded 105%.
Market Landscape
This study follows the warning of the 2015 National Academies report on Improving Diagnosis in Health Care by providing specific claims-based data on diagnostic failure outcomes. The findings highlight the financial and clinical pressure facing medical malpractice insurers, as premium costs rose for nearly 40% of the market in 2025.
Rising medical malpractice costs may lead to further premium increases for providers, potentially impacting patient care access and clinic resources. Patients with complex comorbidities should remain vigilant about communication between their various care team members during hospital stays.
The takeaway
Diagnostic errors represent a significant systemic risk, with the vast majority of cases involving complex clinical decision-making factors. Reducing these incidents requires hospitals to prioritize continuous patient monitoring and standardized communication protocols across all ward levels.
Further reading
For more on industry safety trends, visit Healthcare.
Source note: This article includes information reported by Insurance Business.
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Do you feel confident in the quality of care provided in general hospital medical-surgical units?
