American College of Emergency Physicians

North Carolina

Recent Reforms Enacted (since 2003)	In 2011, the legislature overrode the governor's veto of SB33 and enacted reforms that include a $500K cap on non-economic damages (indexed for inflation) except in cases involving death, dismemberment when gross negligence occurred. Emergency care provision was also enacted.
Emergency Care Provision	Requires proof of negligence through "clear and convincing evidence" in cases involving the treatment of EMTALA-related emergency medical conditions.
Reform Elements In Law	500K Cap on Non-Economic Damages in Most Cases Clear and Convincing Standard for EMTALA Care Expert Witness I’m Sorry Law
Constitutional Status of Reforms	Information not available.
Change in Insurance Rates	AMA reports at least one insurer raised rates as much as 40 to 100% in 2004.
Insurance Availability	Of the 4 primary insurers in the state, two stopped writing new policies for emergency physicians in 2003 and two have restricted coverage for emergency physicians.
Change in Physician Availability	Information not available.
Change in Cases Filed/Awards	The annual number of medical liability settlements greater than $1 million has more than tripled between 1993 and 2002 from 6 to 19. (N.C. Lawyer's Weekly) 209 paid claims in 2003 or 9.9 per 1000 active nonfederal physicians. US avg. was 18.8 per 1000. 195 paid claims in 2005 or 9.1 per 1000 active nonfederal physicians. US avg. was 17.1 per 1000. (Kaiser) 152 total number of paid claims for 2006 or 6.0 per 1,000 active, non-federal physicians. 134 paid claims in 2007.