Going Bare in Florida: The Real Risks of Practicing Without Malpractice Insurance

Many patients assume every Florida physician carries medical malpractice insurance. That assumption is not always correct.

Florida permits physicians to practice without a traditional malpractice insurance policy under specific conditions. This is commonly called going bare.

Some physicians consider going bare because premiums have increased. Others arrive at the decision after being declined, non-renewed, or priced out of the standard insurance market because of prior claims, board actions, a high-risk specialty, or another underwriting concern.

But legal permission to practice without insurance should not be confused with financial protection. Going bare can leave a physician personally responsible for legal defense costs, settlements, judgments, and other expenses that would ordinarily be handled by an insurance carrier.

This guide explains what going bare means, how Florida’s financial-responsibility law works, and why specialized malpractice coverage may still be available when standard carriers decline.

What Does “Going Bare” Mean in Medical Malpractice Insurance?

Going bare generally means practicing medicine without a medical malpractice insurance policy.

When an insured physician faces a covered malpractice claim, the carrier may appoint defense counsel, pay covered defense expenses, negotiate a settlement, and pay covered damages subject to the policy’s terms and limits.

A physician practicing without insurance does not have that contractual protection. The physician may have to retain and pay defense counsel personally, respond to the claim, fund any settlement, and satisfy applicable judgment obligations using personal or business resources.

Even an allegation that ultimately proves defensible can be expensive. A favorable outcome does not necessarily eliminate attorney fees, expert-witness expenses, discovery costs, lost time, and disruption to the medical practice.

Is Going Bare Legal in Florida?

Going bare can be legal in Florida, but the answer is more complicated than simply deciding not to purchase insurance.

Florida Statute §458.320 generally requires physicians to demonstrate financial responsibility as a condition of maintaining an active medical license. The statute provides several methods for doing so, along with specific exemptions.

The correct path depends on factors such as whether the physician maintains hospital staff privileges, performs surgery at an ambulatory surgical center, qualifies for an exemption, or practices within another protected arrangement.

Florida’s Basic Financial-Responsibility Requirements

For physicians subject to the general requirement, Florida law provides several ways to demonstrate financial responsibility. These include:

• Maintaining an escrow account containing qualifying cash or assets;
• Maintaining professional liability insurance;
• Maintaining a qualifying irrevocable letter of credit; or
• Using another qualifying insurance or self-insurance arrangement recognized by the statute.

For professional liability insurance, the general statutory minimum is:

• $100,000 per claim; and
• $300,000 in annual aggregate coverage.

The statute provides corresponding amounts for qualifying escrow accounts and letters of credit.

These statutory figures are minimum financial-responsibility amounts. They should not automatically be treated as recommended insurance limits. A malpractice allegation, settlement, or judgment can substantially exceed $100,000.

Requirements for Hospital-Privileged Physicians and ASC Surgery

Higher statutory amounts apply to physicians who perform surgery in a licensed ambulatory surgical center and, as a continuing condition of hospital staff privileges, physicians who maintain hospital staff privileges.

For professional liability insurance, the applicable statutory minimum is generally:

• $250,000 per claim; and
• $750,000 in annual aggregate coverage.

Corresponding escrow and letter-of-credit options are also addressed in the statute.

Hospitals, surgery centers, medical groups, employers, landlords, and healthcare contracts may impose requirements exceeding these statutory minimums. Meeting the licensing statute therefore does not necessarily mean a physician meets every contractual or credentialing obligation.

Florida’s Uninsured-Physician Exemption

Florida law also provides a pathway through which an eligible physician may practice without malpractice insurance, an escrow account, or a letter of credit.

Under this route, the physician agrees to comply with statutory conditions after an adverse final malpractice judgment. The statute generally requires payment within 60 days of the lesser of the judgment plus accrued interest or:

• $100,000 for a physician who does not maintain hospital staff privileges; or
• $250,000 for a physician who maintains hospital staff privileges.

The physician must also complete the forms required by the Florida Department of Health. Failure to satisfy the statutory obligation can result in disciplinary action, restrictions, probation, or suspension of the physician’s license.

Most importantly, these amounts should not be mistaken for automatic liability caps. Compliance with a licensing requirement does not necessarily extinguish the balance of a civil judgment or prevent efforts to collect against legally available assets. Physicians considering this route should obtain individualized legal advice about judgment exposure and Florida asset-protection law.

Do Uninsured Florida Physicians Have to Notify Patients?

Yes. A physician relying on the applicable uninsured exemption must either:

• Display the required notice prominently in the reception area where patients can clearly see it; or
• Provide the required written statement directly to patients receiving medical services.

The statutory notice informs patients that the physician has decided not to carry medical malpractice insurance and that Florida permits the decision subject to certain conditions.

This is more than an administrative formality. The disclosure can affect how patients perceive the practice. Some patients may view the lack of coverage as a warning sign, even when the physician has complied with Florida law.

Referral partners, employers, hospitals, managed-care organizations, and other contracting parties may also consider insurance status when deciding whether to credential or work with a physician.

Why Do Some Florida Physicians Go Bare?

Physicians usually consider going bare for one of two very different reasons.

1. The physician wants to avoid the premium

A physician may believe the cost of malpractice insurance exceeds the perceived benefit, particularly after years without a claim. Some also believe that not carrying insurance makes them a less attractive target for litigation.

That strategy is highly uncertain. A claimant may still pursue a physician believed to have recoverable income, practice assets, investment assets, business interests, or other collectible resources. The absence of insurance also means the physician may lose the carrier-funded legal defense that can be valuable even when a claim lacks merit.

2. The physician believes coverage is unavailable

This is the more urgent situation.

A physician may have been declined or non-renewed because of:

• One or more paid malpractice claims;
• An open lawsuit or substantial outstanding reserve;
• A cluster of claims within a short period;
• A Florida Board of Medicine complaint or disciplinary action;
• A high-risk specialty or procedure;
• A previous lapse in coverage;
• A nonstandard practice arrangement; or
• Regulatory, billing, or healthcare-fraud concerns.

A rejection from one carrier—or even several standard carriers—does not establish that the physician is uninsurable. It may mean the submission belongs in a different insurance market.

Physicians with claims or disciplinary histories can review our complete guide to malpractice insurance for physicians with prior claims.

The Real Financial Risks of Going Bare

Paying for the legal defense

Medical malpractice litigation can require experienced defense counsel, medical experts, depositions, record review, motions, mediation, trial preparation, and appeals. Without insurance, the physician may have to fund those expenses directly.

Personal and business asset exposure

An uninsured physician may face collection efforts against assets legally available to satisfy a settlement or judgment. Florida provides important protections for certain assets, but those protections are fact-specific and are not a substitute for liability insurance.

Entity formation also does not automatically protect a physician from liability arising from the physician’s own professional services.

No carrier managing the claim

A malpractice carrier provides more than indemnity. It can coordinate defense strategy, retain experienced counsel, evaluate experts, manage deadlines, negotiate settlements, and respond to reporting requirements.

A physician going bare assumes responsibility for organizing and financing that process.

Credentialing and contract limitations

Hospitals, surgery centers, staffing companies, employers, medical groups, and commercial contracts may require malpractice limits exceeding Florida’s statutory minimums. Going bare can therefore limit professional opportunities even when it is permissible for licensing purposes.

Damage to patient confidence

The required patient notice puts the insurance decision directly in front of the patient. A practice should consider whether the potential premium savings justify the reputational effect of announcing that the physician does not carry malpractice insurance.

A future policy may not cover the uninsured period

Purchasing insurance later does not automatically protect medical services performed during an earlier uninsured period. Coverage depends on the new policy’s retroactive date, prior-acts provisions, known-claim exclusions, and reporting requirements.

A physician should never assume that a future policy will repair an existing coverage gap.

Being Declined Is a Market-Access Problem—not Necessarily a Dead End

If you are considering going bare because a standard carrier declined or non-renewed you, the problem may be market access rather than insurability.

The excess and surplus lines market—often called the E&S or non-admitted market—can evaluate risks that do not fit standard carrier guidelines. These insurers may consider the complete underwriting story rather than applying an automatic rejection based on a single answer.

Possible E&S candidates can include physicians with prior claims, board actions, open litigation, coverage gaps, non-renewals, unusual procedures, or high-risk specialties.

Learn how this market works in our guide to excess and surplus lines malpractice insurance.

E&S coverage is not guaranteed, and it may include higher premiums, deductibles, exclusions, or different policy conditions. However, obtaining an individually underwritten policy may still be preferable to personally absorbing defense expenses and an uncapped liability exposure.

Coverage Options for Physicians Across South Florida

Island Insurance Group helps physicians evaluate medical malpractice options throughout Florida, including practices in Miami-Dade, Broward, and Palm Beach counties.

Whether you practice in Miami, Fort Lauderdale, Boca Raton, Delray Beach, West Palm Beach, or another Florida community, a prior claim or non-renewal does not automatically mean going bare is your only option.

Visit IslandInsuranceGroup.com to learn more about specialized medical malpractice coverage.

Frequently Asked Questions

Is going bare legal for physicians in Florida?

Florida permits eligible physicians to practice without a traditional malpractice policy under specific conditions. Physicians must satisfy an applicable financial-responsibility method or qualify for an exemption under Florida Statute §458.320. Facility, employment, and contractual requirements may still require insurance.

How much financial responsibility must a Florida physician demonstrate?

The general professional liability insurance minimum under §458.320 is $100,000 per claim and $300,000 annually. Physicians performing surgery in a licensed ambulatory surgical center and physicians maintaining hospital staff privileges are generally subject to $250,000 per claim and $750,000 annually. Other qualifying methods and exemptions are available under the statute.

Does the $100,000 or $250,000 amount cap the physician’s liability?

Physicians should not treat the statutory amount as an automatic cap on civil liability. A judgment can exceed the financial-responsibility amount, and the legal consequences depend on the physician’s circumstances. Obtain advice from qualified Florida counsel before relying on an exemption.

Can I get malpractice insurance after being declined?

Possibly. A decline from a standard carrier does not mean every market will decline. E&S insurers can evaluate prior claims, board actions, open suits, non-renewals, and other difficult circumstances individually. Availability and terms remain subject to underwriting.

Do physicians going bare have to tell their patients?

Yes. Physicians relying on the applicable uninsured exemption must prominently display the statutory notice in the reception area or provide the required written statement to patients receiving medical services.

Will a future malpractice policy cover care provided while I was uninsured?

Not automatically. The answer depends on the new policy’s retroactive date, prior-acts coverage, exclusions, and known-circumstance provisions. Confirm the coverage timeline in writing before relying on a future policy.

Sources and Further Reading

• Florida Statute §458.320 — Financial Responsibility
• Excess & Surplus Lines Malpractice Insurance Explained
• Malpractice Insurance for Physicians With Prior Claims