Missouri Medical Malpractice: What Are the Chances Your Case Settles Versus Going to Trial?
If you are asking whether your medical malpractice case will settle or go to trial, you are not alone. This is one of the most common questions clients want answered early in the process. The honest reality is this:
Most Legitimate Medical Malpractice Cases in Missouri Settle Before Trial
In Missouri, the vast majority of properly prepared medical malpractice cases do settle after a lawsuit is filed and before going to trial. Once a lawsuit has been filed, the evidence is laid bare, experts weigh in, and insurers begin to assess actual exposure. At that point most defendants and their carriers prefer to resolve the case rather than take the unpredictable—and expensive—risk of trial.
Clients often think settlement is automatic. It is not. But with solid evidence, credible experts, and damages that insurers can quantify, settlements are the norm, not the exception.
Pre-Suit Settlements Happen, But They Are Rare
A few clients hope to avoid filing a lawsuit altogether and resolve their claim before litigation. That can occur, but it is not common in Missouri medical malpractice claims. Insurance companies and providers often have little incentive to settle before a lawsuit is filed because they face minimal risk until litigation begins.
Pre-suit settlements typically only happen when:
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liability is obvious and undisputed,
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damages are clear and catastrophic, or
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the provider wants to avoid publicity or legal costs.
But in most cases, filing a lawsuit is what brings the defense to the table with serious offers.
Missouri’s Non-Economic Damage Caps Affect Settlement Value
Missouri law places statutory limits on noneconomic damages in medical malpractice cases. Noneconomic damages include pain, suffering, emotional distress, and loss of enjoyment of life, and these caps shape the realistic top end of recovery in settled cases and verdicts.
Under Missouri Revised Statutes § 538.210:
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Non-economic damages are capped at a statutory amount (adjusted annually for inflation). In recent years this has been around $470,000 for non-catastrophic injuries and over $800,000 for catastrophic injuries or wrongful death.
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The cap applies per case, not per defendant, and the cap applies only to noneconomic damages. Economic damages (e.g., medical bills, lost wages, future medical care) are not capped under Missouri law.
That means even if a jury verdict is large, the portion for pain and suffering is limited. Insurance companies know this and it affects how they value cases in settlement negotiations.
Understanding these limits early can stop clients from hanging their hopes on an unrealistic verdict figure. Judges, insurers, defense counsel, and juries factor these limits into their risk calculus at every phase of litigation.
Why Defendant Consent Can Block Settlement
Another Missouri reality many clients do not anticipate is this: some doctors must consent personally to any settlement—even if the insurer wants to settle.
This is especially true when:
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the doctor is in private practice,
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the doctor carries their own malpractice policy, or
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they have personal financial exposure beyond institutional coverage.
In those cases, an unreasonable doctor who refuses to sign off on a settlement can force the defense into trial or into continuing litigation, even when the evidence is strong. This happens more often than clients expect and can slow down resolution.
When the doctor is employed by a hospital system or university provider group, decision-making is often more business-oriented and less emotional, so settlements tend to make more sense earlier.
So What Are the Odds of Settlement Versus Trial?
Realistically, in Missouri:
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Most valid medical malpractice claims settle after filing, before trial.
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Pre-suit settlements are possible but uncommon.
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Statutory caps on noneconomic damages shape how insurers value cases.
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Unreasonable doctor decisions can push cases toward trial.
Trials still happen—and when they do, they can take longer, carry more risk, and cost more. But the preparedness to go to trial is often what makes a settlement realistic.
Bottom Line for Missouri Clients
Don’t buy into either extreme—don’t assume every case will settle, and don’t assume every case will result in a huge verdict. The reality in Missouri is nuanced:
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settlement is typical,
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statutory caps limit some damages,
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economic losses remain fully compensable,
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and the willingness of all parties—including the doctor—to settle shapes the trajectory of your case.
