We Analyzed 759,000 Settlement Records: Here's What We Found

Using publicly available data from the National Practitioner Data Bank (NPDB), U.S. Treasury Judgment Fund, NYC Comptroller, and five other government sources, we compiled and analyzed every available settlement and judgment record — 759,178 in total, representing $204.9B in payouts.

Here are the most significant findings:

• Average medical malpractice payments have risen 114% since 2000 — from $213,801 in 2000 to $457,362 in 2025, even as case volume dropped 40%. Fewer cases are filed, but the ones that settle are worth dramatically more.
• New York City alone has paid out $5.3 billion in municipal claims, more than the next three largest cities combined. The NYPD accounts for $1.9 billion of that total — more than the entire city budgets of most U.S. municipalities spend on settlements.
• The federal government paid $14.2 billion in a single year (2020) — nearly 10x the prior year. A single category, breach of contract, drove 89% of the spike. This unprecedented payout has never been publicly reported before our analysis.
• Where you live determines what your case is worth. The average medical malpractice payment in Illinois ($403,557) is nearly 3x higher than in California ($140,946). Damage cap laws account for most of this gap — states without caps pay 34% more on average.
• Police misconduct settlements total $3.2 billion across the cities in our dataset. In Philadelphia, wrongful conviction payouts are the single largest settlement category, with individual payments reaching $9.8 million.
• The median settlement is far lower than most people expect. While the average medical malpractice payment is $257,531, the median is just $97,500. For federal claims, the gap is even more extreme: $525,149 average vs. $5,000 median — a 105:1 ratio.

This analysis combines data from 8 publicly available government databases. All data was downloaded directly from official government sources, imported into a normalized SQLite database, and analyzed programmatically. No records were filtered, excluded, or modified.

Data sources

Methodology notes

• NPDB payment amounts are range-coded in the public data file (e.g., $25,001–$50,000). We use the midpoint of each range for all calculations.
• The data includes payments only — cases dismissed without payment are not reported, so the dataset does not represent all claims filed.
• A payment or settlement does not necessarily indicate negligence or wrongdoing. Many cases are settled without any admission of fault.
• Municipal data varies in coverage period and reporting standards. Direct city-to-city comparisons should account for population size, time period, and what types of claims each city reports.
• All dollar amounts are nominal (not inflation-adjusted).

How to cite this study

Settlement Insight. "We Analyzed 759,000 Settlement Records: Here's What We Found." settlementinsight.com, March 26, 2026.