The Jury Is Still In: Florida's Birth-Related Neurological Injury Compensation Plan after a Decade

by David M. Studdert, Lori A. Fritz, Troyen A. Brennan


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Florida's Birth-Related Neurological Injury Compensation Plan (NICA) is the most significant experiment with compensation for medical injury yet undertaken in the United States. As NICA enters its second decade of operation, maintaining the scheme's jurisdictional integrity has emerged as a key challenge for policy makers in Florida. The authors explore the relationship that has emerged between NICA and the tort system as competing avenues for families to obtain compensation for severe birth-related neurological injury. By linking NICA claims data with data on malpractice claims filed in Florida, they found a lively persistence of "bad baby" litigation despite NICA's implementation. Many families pursued claims in both fora. An explanation for these results can be traced to key features of the plan's design--primarily, the way in which "exclusive" jurisdiction over injuries is determined and the restrictive nature of the compensation criteria used. The authors' findings may help efforts to consolidate NICA's role in injury compensation and inform future design of alternative compensation systems.

Originally published in: Journal of Health Politics, Policy and Law, v. 25, no. 3, June 2000, pp. 499-526.

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