1. HOLBORN CORPORATION Established 1920 Employee Owned Frivolous Lawsuits Fact or Fiction? Bill Burns Holborn Corporation September 23, 2002

2. HOLBORN CORPORATION 2 “The _____ doth protest too much, methinks”  Doctors  Insurance Industry  Lawyers  All of the above

3. HOLBORN CORPORATION 3 Ground Rules Malpractice DOES happen and comes with a price Malpractice DOES happen and comes with a price Insurance companies DID make mistakes in the 90’s (Remember the soft market?) Insurance companies DID make mistakes in the 90’s (Remember the soft market?)

4. HOLBORN CORPORATION 4 “The fundamental assumptions upon which the ‘tort reform’ movement is based (i.e., that an uncontrollable tide of ‘frivolous lawsuits’ is flooding the nation) is a fiction that is unsupported by the facts. (cont’d) What Do Plaintiff Attorneys Say?

5. HOLBORN CORPORATION 5 “So where is the litigation explosion? Only in the minds and skewed statistics proffered by insurance industry spokespersons and lobbyists.” Bucks County (PA) attorney August 2002

6. HOLBORN CORPORATION 6 Frivolous Lawsuits? – You Be the Judge Big Guy vs Big Food Big Guy vs Big Food Man Who Thought He Was Dead Sues Airline Man Who Thought He Was Dead Sues Airline Beagle Bites Back Beagle Bites Back Louisville Slugger Louisville Slugger

7. HOLBORN CORPORATION 7 Definition Medical malpractice is the failure of a health care provider to exercise the degree of care required of a professional in the same type of practice rendering comparable care under similar circumstances and that proximately causes injury to a patient.

8. HOLBORN CORPORATION 8 For there to be a finding of malpractice the plaintiff must show: Existence of legal duty Existence of legal duty Breach of duty Breach of duty Nonfeasance Nonfeasance Malfeasance Malfeasance Proximate cause Proximate cause Damages sustained Damages sustained

9. HOLBORN CORPORATION 9 You Be the Judge II You Mean I’m Suing that Nice Doctor? You Mean I’m Suing that Nice Doctor? Doctor Strikes Back Doctor Strikes Back Secret Deal Unraveled Secret Deal Unraveled

10. HOLBORN CORPORATION 10 More From Plaintiff Attorneys “Med mal insurers are making a profit” “Med mal insurers are making a profit” “There are far fewer lawsuits than there could be” “There are far fewer lawsuits than there could be” “It doesn’t have to be negligence – it just has to look that way” “It doesn’t have to be negligence – it just has to look that way”

11. HOLBORN CORPORATION 11 AMA Study Released June 2002 showing medical liability insurance has: Reached crisis proportions in 12 statesReached crisis proportions in 12 states Is “OK” in 6 statesIs “OK” in 6 states Is showing problem signs in all other statesIs showing problem signs in all other states

12. HOLBORN CORPORATION 12 Crisis States Florida Florida Georgia Georgia Mississippi Mississippi Nevada Nevada New Jersey New Jersey New York New York Ohio Ohio Oregon Oregon Pennsylvania Pennsylvania Texas Texas Washington Washington West Virginia West Virginia

13. HOLBORN CORPORATION 13 “OK” States California California Colorado Colorado Indiana Indiana Louisiana Louisiana New Mexico New Mexico Wisconsin Wisconsin

14. HOLBORN CORPORATION 14 Medical Economics Study Identified states with the highest and lowest number of lawyers per capita, who have won $1M jury verdicts in civil litigation including malpractice. Identified states with the highest and lowest number of lawyers per capita, who have won $1M jury verdicts in civil litigation including malpractice. Source: Million-Dollar Advocate Forum – U.S. Census Bureau Source: Million-Dollar Advocate Forum – U.S. Census Bureau

15. HOLBORN CORPORATION 15 Highest Number of $1M Lawyers (#) District of Columbia (15.7) District of Columbia (15.7) Florida (17.6) Florida (17.6) Hawaii (10.6) Hawaii (10.6) Missouri (12.4) Missouri (12.4) Mississippi (11.9) Mississippi (11.9) Nevada (19.5) Nevada (19.5) New Jersey (12.4) New Jersey (12.4) Ohio (10.7) Ohio (10.7) Pennsylvania (16) Pennsylvania (16) West Virginia (13.3) West Virginia (13.3)

16. HOLBORN CORPORATION 16 Lowest Number of $1M Lawyers (#) Colorado (1.6) Colorado (1.6) Idaho (1.5) Idaho (1.5) Indiana (2.1) Indiana (2.1) Nebraska (1.8) Nebraska (1.8) New Mexico (1.6) New Mexico (1.6) North Dakota (0) North Dakota (0) Oregon (2.0) Oregon (2.0) South Dakota (1.3) South Dakota (1.3) Utah (3.1) Utah (3.1) Wisconsin (2.2) Wisconsin (2.2)

17. HOLBORN CORPORATION 17 So What’s the Answer? Tort reform? Tort reform? Who decides what is fair? Who decides what is fair? What if it happened to you? What if it happened to you? Are we overlooking other solutions? Are we overlooking other solutions?

18. HOLBORN CORPORATION 18 Something To Think About What is the role of managed care in this mess? What is the role of managed care in this mess?