Howard Friedman
Management
Hi, Paul, it's Howard. Yeah, for the history lesson, OK, before my time, but mid-1970s or early to mid-1970s significant increase in the frequency of medical malpractice as it was called on litigation coming after long period of time where medical malpractice was an afterthought for most physicians and sometimes even covered on their personal alliance policies. But there was an increase interest and that's what led to the departure of the commercial carriers at Hartford and other employers of all saw that we're offering that coverage in the late 60s and early 70s. With the increased frequency also came increased severity as well. And ultimately that resulted in a formation of all of the - what's known as the PIA, or mutual type companies, the physician and in some cases, hospital owned carriers in the mid to late 1970s. Things settled down for a while, but if you recall most of the business back then was written on an occurrence basis, and it was just the matter of time before the tail kind of caught up with things. And in the mid-1980s beginning about 1984, so the losses really began to emerge on that business that had been written by these new companies and those losses ripple through the industry and all the way through the reinsurance markets as well and the result of that, the latency of those claims and the increased costs and the adverse loss development resulted in the reinsurance market for occurrence pretty much drawing up and most of the business being converted to claims made. Things kind of settle down because a lot of companies continue to write or continue to charge the occurrence price for their first-year claims made coverage and recovered for several years. And then as the 1990s progress, there was total reform and there was total reform in the mid to late 70s, there was another round of total reform in the mid to late 1980s which in both cases settle things down for a while. And the marketplace became rather competitive in the mid-1990s. I think in our history, what we have seen over the past 10 years or so now, some of the commercial carriers came back in and I think some of the existing carriers got to be a little bit overconfident. And then we saw a big increase in severity in the late 90s, in retrospect 1998, 1999, but really didn't become evident until around early 2000. And again, a fair amount of adverse loss reserve development that was driven by a severity at that point really not by change in frequency, resulted in several insolvencies, resulted in same fall even the marketplace and also resulted in capital calls via a lot of the policyholder own mutual and reciprocals and another round of total reform. So again, so that round of total reform in the early 2000s really had a dramatic affect it appears on frequency. We think it was the total reform, lot of other things that may have caused that as well, and nobody is really clear. And once again things kind of got more competitive. Frequency dropped dramatically. Severities became more moderate. And overall inflation in the economy was rather low as you know from probably 2005 up through the present time. So, in terms of what's happening now, not completely clear yet, some of the severity now we think is being driven by the - I think I mentioned this last call the aggregation of risks positions into hospitals, hospitals acquiring other hospitals and becoming larger. So, essentially larger targets where physicians independently have $1 million policy limits now as part of hospitals and employee physicians really have the whole asset base of the institution behind them. So, I think the expectations and the - certainly our attorneys are looking at larger potential awards and juries are seeing the institutions in many cases as being much larger and more capitalized. So that in itself I think is driving some of the severity that we see in the market. And again, wanted to point out that we're not really seeing this in our paid data, but we're being cautious about it because of what we're seeing in terms of the news the verdicts that have come in other areas of the industry and even in some of the cases that we're seeing and reserving now that have higher damages or higher potential damages. So not sure if that was the history lesson you wanted but.