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Burkman RT et al. – The approach to regulation by state government varies substantially. Some states take a market–based approach and allow the competitive environment to set premiums. In general, there is more volatility to premiums during the "underwriting cycle" in such states. Other states require premium increases to be well justified from a business standpoint before allowing them. Thus, as discussed, rate setting is a fairly complicated process. It should be noted, though, that some rates can be reduced by groups of physicians gaining "corporate discounts" or discounts due to a favorable loss experience by the insured. Conversely, in addition to the basic rate, some insured may have higher rates or be assessed a supplement due to an unfavorable loss experience.

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