Here are a couple of good reasons why malpractice premiums have risen sharply recently:

Throughout the 1990s, that lowered premium earnings until they were less than what insurers expected to pay in malpractice awards. But for most of the decade, insurers could make up the difference from their investments on bonds and stocks.

In addition, insurers could lower their risk and sell off excess capacity to overseas "reinsurance" companies, much the way banks sell home mortgages to other institutions.

But the international reinsurance market tightened in 2000, meaning there was no market for the excess policies.

And that's when First Professionals Insurance Corp. of Jacksonville filed for a 9.7 percent premium hike based almost entirely on the increased cost of reinsurance.

After that, the malpractice insurance business only got worse. The terrorism attacks of Sept. 11 hit reinsurance companies hard and investment rates dropped, wiping out the margins that had kept insurers afloat - and premiums low.

"Almost everything that could have go wrong, has ... short of a hurricane," said Tom Gallagher, the state's former insurance commissioner and now its Chief Executive Officer, in charge of the Department of Financial Services.

First Professionals' parent company, The FPIC Group, took back-to-back charges on its books in 2000 and 2001. They amounted to a $29.8 million admission that profits had been undermined by inadequate reserves.

It's hard for the average Joe Citizen to understand the byzantine maneuverings of insurance companies. That's why it's so easy to make a scapegoat out of trial lawyers and their clients. There's plenty of data to indicate that malpractice claims affect insurance rates minimally, if at all.