Why the Birth-Injury Program

With soaring medical malpractice insurance rates and insurance companies on the brink of eliminating coverage in the mid-1980s, up to one-quarter of the state’s obstetricians were threatened with having to close their office doors. To alleviate this crisis, Virginia worked with all stakeholders – including physicians, associations, insurers, lawyers and others – to develop an innovative solution – the Virginia Birth-Related Neurological Injury Compensation Program. The Program was a first of its kind nationally.

By keeping many of the most expensive cases out of the court system, combined with a medical malpractice award cap, the medical malpractice insurance industry has been reasonably stabilized in Virginia (especially when compared to other states) allowing physicians to do what they do best – treat patients.

Once again, the JLARC report cites the Program’s success:

Although malpractice premiums have increased significantly in the past couple of years, it does not negate the fact that the malpractice cap and birth injury program appear to have had a positive effect on claims costs, and subsequent malpractice premiums. (JLARC Review, Page 52)

Since formation, more than 150 claimants – about two-thirds of those filing petitions to enter – have been admitted into the Program. Admission is solely through and by the Virginia Workers’ Compensation Commission (WCC).

No State Funds Involved

Today the Program’s reserve fund stands at about $400 million. No state funds are involved in providing services to claimants. Funding is derived only from legislatively allowed sources that include:
  • Participating physician fees
  • Participating hospital fees
  • Non-participating physician assessments
  • Liability insurer assessments

Currently, actuarial studies show the Program is financially sound for the next 20 years. However, they also note a possible shortfall in reserve funds after that point. The Board of Directors is working with state authorities to assure long-term financial soundness. An actuarial study is completed at least every two years under the auspices of the State Corporation Commission’s Bureau of Insurance.


With offices just outside Richmond, Virginia, a nine-member volunteer board of directors governs the organization. The Governor of Virginia appoints all board members. Although started by the Virginia General Assembly, the Birth-Injury Program is an independent organization.

Additional Information

Year after year, the Birth-Injury Program continues to fulfill its original purposes – holding down malpractice insurance costs, assuring access to obstetrical services and high quality care for the children.

For additional information please see the rest of this website and/or contact us.

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