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The story of TMLT 

In 1979, TMLT was created by physician members of the Texas Medical Association as a source of affordable and stable malpractice insurance in Texas. Today, led by a Board of Trustees whose members are all physicians, TMLT sets the standard for coverage and service.

The history of TMLT is a story of vision, creativity, dedication, and courage. The idea of forming a self-insurance trust led by physicians sprang from a handful of physicians and a young Austin attorney in the mid-1970s. They wanted to create their own company that would provide the kind of service and support Texas physicians deserved.

These same physician leaders recruited experienced insurance professionals to lead the new company. Working together, the physician governing board and TMLT staff took the company from a fledgling start up with a handful of employees and a few hundred policyholders, to the leading writer of medical liability insurance in the state of Texas today.

With more than 20,000 policyholders, TMLT is the largest and most respected medical liability insurance provider in Texas.

TMLT has a long-standing record of advocating for physicians and the medical community. We recognize the impact legislation and regulation have on your practice. With our advocacy efforts, our goal is to protect tort reform, reduce red tape, and mitigate the burden of regulatory compliance.

Liability reform 

In the late 1990s, the number of medical liability claims filed against Texas physicians was increasing at an alarming rate. Though the vast majority of these claims were non-meritorious, defending them was costly, as was the drain on the time and resources of the physicians involved.

Disproportionately high jury verdicts and rising legal costs led many insurers to withdraw from Texas, and some went out of business altogether. The crisis forced the few remaining malpractice insurers to raise rates.

With declining reimbursements already taking a bite out of their incomes, rising premiums placed another difficult burden on Texas physicians. Many retired early, stopped taking high-risk patients, or moved out of the state. The result was restricted access to health care.

TMLT was one of founding members of the Texas Alliance for Patient Access (TAPA), which grew into a statewide coalition of more than 200 physicians, hospitals, nursing homes, and physician liability carriers. TAPA researched, helped draft, and successfully lobbied for the passage of Texas’ landmark medical liability reforms in 2003. TMLT was engaged throughout the tort reform process, continuing the effort it had been working on since 1993.

 After an intense campaign that included physicians marching on courthouses in Corpus Christi and the Rio Grande Valley, House Bill 4 passed. TAPA and its supporters achieved the “ten gallon tort reform” often touted nationwide as the gold standard for others seeking to pass similar legislation.  

The cornerstone of the reforms — the $250,000 cap on non-economic damages for physicians and a maximum of $750,000 including hospitals and institutions — substantially reduced lawsuits and liability costs without limiting the rights of plaintiffs to collect economic damages for meritorious claims. Other provisions of the bill included expert witness reforms, heightened protections for emergency care, periodic payment of future medical expenses, and limiting economic damages to those actually paid or incurred.

To ensure the legality of the caps, Texas voters passed Proposition 12, a constitutional amendment giving the Texas Legislature the authority to set damage caps in health care liability lawsuits.

TMLT was the first carrier to reduce rates following the passage of Proposition 12. A steady stream of rate reductions followed that initial 12 percent reduction in 2004. In addition, we enhanced our coverage to include cyber liability and employment practices liability insurance. All of this was made possible by the passage of historic reforms.