Communication failure is a factor in 40% of malpractice cases, and it is the one you can rehearse
Last updated: August 2026
For risk & patient safety leaders who need results they can measure.
Communication failure is a factor in 40% of malpractice cases, up from 30% a decade ago, and those claims carry 39% greater odds of closing with an indemnity payment (Candello 2025 Benchmarking Report). Average indemnity runs from $386,000 in general medicine to $944,000 in obstetrics before defense costs (CRICO 2015 specialty indemnity averages), and communication claims are more than twice as likely to top $1 million (Humphrey et al., Journal of Patient Safety 2022). OB claim rates dropped roughly 50% under CRICO's simulation-built obstetric safety program (Schaffer et al., Obstetrics and Gynecology 2021), so the behavior behind those claims does respond to structured practice. ClinicalSim extends the simulation program you already fund, adding unlimited voice-based practice on goals-of-care conversations, diagnosis disclosure, family meetings, and de-escalation, with a timestamped, rubric-scored record of every session.
What's at stake
The indemnity math on a single case
Average indemnity on a communication-failure malpractice case runs from $386,000 in general medicine to $944,000 in obstetrics, and that is before defense costs. Communication claims are also more than twice as likely to top $1 million than other claims (Humphrey et al., Journal of Patient Safety 2022).
The share of claims is rising
Communication failure is a factor in 40% of malpractice cases, up from 30% a decade ago, and those claims carry 39% greater odds of closing with an indemnity payment. The one failure mode a risk office can train directly against is the one that keeps growing.
Sentinel events keep coming back to communication
The Joint Commission has repeatedly named communication a leading root cause of sentinel events in Sentinel Event Alert 58. That alert is qualitative and attaches no percentage, which is part of why a risk office struggles to size the exposure and defend a training budget against it.
Credit exists for courses, evidence of practice does not
Carriers award premium credits of 5 to 19% for completing an approved risk-reduction course (CRICO and New York Regulation 124 premium programs). What most risk offices cannot produce is per-clinician evidence that practice actually happened, which conversations were rehearsed, and whether performance moved.
The numbers
average indemnity per communication-failure case, general medicine to obstetrics, before defense costs
CRICO 2015 specialty indemnity averages
of malpractice cases involve a communication failure, up from 30% a decade ago
Candello 2025 Benchmarking Report
greater odds that a communication-failure claim closes with an indemnity payment
Candello 2025 Benchmarking Report
drop in OB claim rates under CRICO's simulation-built obstetric safety program
Schaffer et al., Obstetrics and Gynecology 2021
How ClinicalSim helps
Practice on the Conversations Claims Start In
The library covers goals-of-care conversations, diagnosis disclosure, advance care planning, family meetings, and de-escalation. Clinicians practice by voice, on demand, from any device, and get feedback scored against published frameworks including SPIKES and Calgary-Cambridge.
A Record Per Clinician, Not a Sign-In Sheet
An attendance list tells a carrier who sat in a room. Every ClinicalSim session generates a timestamped, rubric-scored record of which conversation a clinician rehearsed and how it scored, so a risk office can show practice at the individual level.
Extends the Simulation Program You Already Fund
Simulation is what moved OB claim rates roughly 50% in CRICO's obstetric safety program (Schaffer et al., Obstetrics and Gynecology 2021). ClinicalSim adds the repetitions between scheduled standardized patient encounters and drills rather than standing in for them.
Volume Without New Scheduling
A risk office can direct practice at the services carrying the most exposure without adding standardized patient hours or booking sim lab time, because sessions run from any device at any hour.
Faculty Development
The platform isn't only for trainees. Attendings, fellows-as-teachers, and clinician educators practice the conversations they're expected to model — giving difficult feedback, navigating professionalism concerns, and teaching at the bedside — with the same rubric-scored simulation. Because confidence in these conversations is often the absence of feedback, not evidence of skill: in one survey, the attendings furthest out from training reported the highest confidence and the least formal preparation.
Related Insights
Why Communication Training Matters
Communication failures are the leading driver of malpractice claims, yet most clinicians receive minimal structured training. The gap between what's at stake and how we prepare is wider than most realize.
The ROI of Communication Training: By the Numbers
The business case for communication training is clear: reduced malpractice risk, improved HCAHPS scores, and better outcomes.
Questions we get from this seat
What does a communication-failure claim actually cost?
Average indemnity on a communication-failure malpractice case runs from $386,000 in general medicine to $944,000 in obstetrics, before defense costs (CRICO 2015 specialty indemnity averages). Communication failure is a factor in 40% of malpractice cases, up from 30% a decade ago, and those claims carry 39% greater odds of closing with an indemnity payment (Candello 2025 Benchmarking Report). Communication claims are also more than twice as likely to top $1 million (Humphrey et al., Journal of Patient Safety 2022).
Is there evidence that communication training changes claim rates?
The closest published evidence is CRICO's obstetric safety program, built on simulation and team training, where OB claim rates dropped roughly 50% (Schaffer et al., Obstetrics and Gynecology 2021). ClinicalSim itself has not been studied against claim rates and should not be presented as if it had been. What the platform produces today is the practice volume and the per-clinician record a risk-reduction program needs.
Does ClinicalSim qualify for a malpractice premium credit?
Carriers award premium credits of 5 to 19% for completing an approved risk-reduction course (CRICO and New York Regulation 124 premium programs), and approval is the carrier's decision rather than ours. ClinicalSim holds no approved-course designation today. What it provides is the timestamped, per-clinician practice record a carrier review asks for.
Does this replace our standardized patient program?
No. Standardized patient encounters stay the high-stakes assessment, and ClinicalSim adds the repetitions in between, at whatever hour a clinician is free. The simulation-based programs that moved OB claim rates roughly 50% in CRICO's obstetric safety work (Schaffer et al., Obstetrics and Gynecology 2021) are the model this extends, not the thing it substitutes for.
Does any patient data enter the platform?
No. Every patient in every ClinicalSim case is synthetic, authored from the clinical literature rather than from patient records, so no protected health information enters the platform and there is nothing to de-identify. SOC 2 and HIPAA certification are on our funded roadmap and are not yet in place. Full detail is on our trust and compliance page.