To compare the malpractice claims experience of physicians in a high malpractice risk population to those in a normal population, the authors used claims data from one national surplus lines malpractice insurer and one large standard lines malpractice insurer. In addition, a second surplus lines insurer supplied data on policyholder characteristics that was used to compare the characteristics of physicians across populations. Surplus lines insured physicians had frequencies of claims filed of over twice as high as doctors in comparable specialties insured by the standard lines insurer. Surplus lines insureds had much shorter coverage periods (72% leaving within a year or less) as compared to those with conventional coverage (less than 11% leaving within a year or less). Surplus lines insureds were somewhat older, more frequently board certified and were proportionately more in high risk specialties than the physician population of the country.