Looking ahead, risk managers, brokers and insurers alike see new exposures buffeting the medical professional liability insurance market.

“Telemedicine will create new risks,” said Rebecca Cady, vice president and chief risk officer at Children’s National Medical Center in Washington. “It will make it easier to spread claims across more players.” There is also the issue of how the internet of things will affect medical devices.

“We’re just scratching the surface on that,” Ms. Cady said. She added that if she were on the insurer side, “I’d be worried about how would I get roped into a claim that looks like a cyber claim but gets treated as a health professional liability claim.” Cyber is still a “significant issue,” said Martha Jacobs, national health care industry practice leader for Aon Risk Solutions in Pittsburgh. People have remote device technology, and there is concern about if those medical devices can be hacked, she said.

The move toward more telemedicine brings in more technology as well.

“Carriers are interested in the levels of telemedicine and how it might be provided,” said John Geisbush, managing director at Marsh L.L.C. in Phoenix. “All of us are monitoring the Affordable Care Act and how things may change.”

“We are also seeing a rise in the number of medical malpractice cases involving nurse practitioners and physician assistants, collectively known as advanced practice clinicians or APCs,” Joanne Gundersen, vice president and medical malpractice lead for QBE North America in Simsbury, Connecticut, said in an email. “The industry is making greater use of APCs to counter the growing physician shortage and manage the cost of care. The increased use adds complexity to liability risks because it triggers a variety of additional issues, such as proper training, certification and supervision. Moreover, rules and regulations governing these issues are constantly evolving and vary by state.”

Events with no direct connection to medical malpractice could also affect the marketplace, said Mr. Geisbush, who added that even though the catastrophe property losses of $100 billion didn’t directly affect med mal, those losses could leak into other lines of coverage.