If the premiums were simply rising because of the amount of money given in a malpractice judgment, we would not see that. Therefore, malpractice premiums are not -- in any meaningful sense -- tied to malpractice award amounts. Typically, the gigantic spikes in premiums seen over the past couple of decades are attributed to other factors in the insurance industry, including the need to make up for investment losses and for losses from other sectors of insurance (i.e., market crashes + 9/11 were not kind to insurers).