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 more than $470 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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