Texas Medical Malpractice Funding

Texas health care liability claims must be filed within two years under Civil Practice and Remedies Code section 74.251(a). The clock runs from the date of the negligent act or omission, or — where the treatment was a course of care and the date of breach cannot be pinpointed — from the completion of the treatment or hospitalization at issue. Texas does not apply a general discovery rule to med-mal; the open-courts doctrine provides only narrow relief. A ten-year statute of repose in section 74.251(b) bars any claim filed more than ten years after the act regardless of discovery. A child under twelve has until the fourteenth birthday. Two pre-suit gates apply: written notice at least 60 days before filing, with a medical authorization form, under sections 74.051 and 74.052, which tolls limitations for 75 days; and a qualified expert report served within 120 days after each defendant files an answer under section 74.351. Failure to serve a compliant report results in dismissal with prejudice and a fee award to the defendant.

Modified comparative fault with a 51 percent bar under the proportionate responsibility statute, Civil Practice and Remedies Code section 33.001. A med-mal plaintiff found more than 50 percent responsible recovers nothing; at 50 percent or less, the recovery is reduced by that percentage. Arguments that a patient ignored discharge instructions or failed to return for follow-up are litigated under this framework.

Texas caps non-economic damages in health care liability claims under Civil Practice and Remedies Code section 74.301. The limit is $250,000 per claimant against all physicians and individual health care providers combined, plus $250,000 per health care institution, with no more than $500,000 recoverable from all institutions — a maximum non-economic recovery of $750,000 per claimant when both physician and institutional defendants are found liable. These figures are fixed and are not indexed to inflation. The cap was placed beyond state constitutional challenge by Texas Constitution article III, section 66, adopted by voters in 2003 (Proposition 12). A separate, inflation-indexed cap on total damages in wrongful death health care claims applies under section 74.303. Economic damages in injury claims are not capped.

Prejudgment interest is available in Texas med-mal cases under Finance Code section 304.104. It begins accruing on the earlier of the 180th day after the defendant receives written notice of the claim or the date suit is filed, and runs until the day before judgment, as simple interest at the post-judgment rate. Under section 304.1045, prejudgment interest is not assessed on future damages, and sections 304.105 through 304.108 adjust the calculation where a settlement offer was made.

Under Civil Practice and Remedies Code section 15.002, a health care liability claim is filed in the county where all or a substantial part of the events occurred — typically the county of the hospital or clinic — or in the county of a defendant's residence or principal office. Claims against state-affiliated hospitals and university health systems are subject to the Texas Tort Claims Act and its own notice and damages rules.

Texas has no dedicated consumer litigation funding statute. No statutory cap.

Why is the 120-day expert report the key funding milestone in Texas?

Section 74.351 requires a compliant expert report within 120 days of each answer, and a deficient report leads to dismissal with prejudice and fee-shifting. A claim that has survived a report challenge has cleared the largest early risk in Texas med-mal litigation, which changes how it is underwritten.

Before the report is served and any challenge resolved, the claim is exposed to a dispositive procedural defense that has nothing to do with the merits. After that stage, underwriting can focus on the standard-of-care evidence, the damages record, and the defendants' coverage. Funders generally ask counsel for the report and the status of any motion to dismiss under section 74.351.

How does the fixed $250,000 cap shape a Texas advance?

The cap limits non-economic damages to $250,000 against physicians and up to $500,000 against institutions, so the recoverable value of a Texas med-mal claim depends heavily on documented economic loss. Underwriting builds from medical expenses, lost earnings, and future care rather than pain-and-suffering exposure.

Because the figures are not indexed, the cap has the same dollar value it had in 2003. A case against both a physician and a hospital can reach $750,000 in non-economic damages, while a case against a single physician group is limited to $250,000. Counsel's theory of which defendants are liable therefore matters directly to the fundable amount.

What does the absence of a general discovery rule mean for a Texas plaintiff?

The two-year period under section 74.251 runs from the negligent act or the end of the course of treatment, not from when the patient learned of the injury. Late-discovered injuries face a real limitations risk, and the ten-year repose closes the door entirely for older claims.

The 60-day pre-suit notice tolls limitations for 75 days, which counsel often uses to preserve a claim near the deadline. Underwriting confirms the notice date, the tolling calculation, and the filing date before advancing. Claims that depend on an open-courts argument to survive limitations are treated as materially riskier.