Could it be the return on investments that drives med mal premiums?

“Insurance premiums and claims for doctors both have dropped significantly in recent years, while the medical malpractice insurance industry is enjoying "remarkable profits" in light of the global economic collapse, a study released by Americans for Insurance Reform finds. The report concludes that further limiting the liability of negligent doctors and unsafe hospitals is not only unjustified, but also would have almost no impact lowering this country’s overall health care expenditures.”