Coverys, a national leader in medical professional liability insurance, published a white paper in August 2025 entitled “Hidden In Plain Sight Exposing The Drivers Of Diagnostic Error,” the second in a three-part series, that investigated diagnostic errors or omissions during office-based care. Coverys evaluated 6,009 events that closed between January 1, 2020 and December 31, 2024, and identified 294 specific events where a diagnostic error in an office-based practice was alleged. Twenty-four percent (24%) of events involved office-based care. Of those 1,442 office-based care events, approximately 38% (552) involved an allegation of a missed, wrong, or delayed diagnosis.
Coverys found that diagnostic error was the second most frequent allegation, accounting for 27% of events, and represented 42% of indemnity paid, which was the highest percentage of payments across all service settings. Office-based settings account for the largest percentage of diagnosis-related events at 34%, and the highest indemnity paid at 38%.
Internal medicine and family medicine are most frequently named as the service responsible for the patient’s care at the time of the alleged diagnostic error, accounting for 41% of events and 45% of indemnity paid. Surgical specialties are the second most common service, accounting for 23% of events and 22% of indemnity paid.
Forty-five percent (45%) of the events alleged a missed cancer diagnosis: prostate, lung, breast, and colorectal cancers were the most common.
In one-third of the events, the patient died, with an additional 22% suffering a high-severity injury, accounting for 72%
of the indemnity paid.
Fifty-three percent (53%) of the events were closed with an indemnity payment (by settlement or trial), with an average indemnity of $661,000, which is more than twice the average indemnity paid on claims that were not diagnostic-related ($323,000).
Prostate Cancer
- 40 events closed 2020-2024
- 10 events resulted in death
- 22 events noted failure to order a diagnostic test (initial, or follow-up testing)
- 29 events (73%) closed with an indemnity payment
- $749,000 average payment
Lung Cancer
- 32 events closed 2020-2024
- 26 events resulted in death
- 16 events noted failure to order a diagnostic test (initial, or follow-up testing)
- 19 events (59%) closed with an indemnity payment
- $555,000 average payment
Breast Cancer
- 27 events closed 2020-2024
- 6 events resulted in death
- 11 events noted failure to order a diagnostic test (initial, or follow-up testing)
- 12 events (44%) closed with an indemnity payment
- $698,000 average payment
Colorectal Cancer
- 19 events closed 2020-2024
- 8 events resulted in death
- 7 events noted failure to order a diagnostic test (initial, or follow-up testing)
- 12 events (63%) closed with an indemnity payment
- $750,000 average payment
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