Texas damage caps: what the law limits in a birth injury case, and what it does not

Families in Texas often hear that “Texas capped malpractice cases in 2003” and assume their child’s case is worth little. That is not what the law says.

The Texas caps limit one category of damages, called non-economic damages. They do not limit the money needed to care for a child for life. This page explains the caps in Chapter 74 of the Civil Practice and Remedies Code, what falls outside them, the separate limit in a wrongful death case, how future care can be paid over time, and a higher standard of proof that can apply to emergencies in labor and delivery.

Where the Texas caps come from

In 2003 the Legislature passed the Texas Medical Liability Act, now Chapter 74 of the Civil Practice and Remedies Code, which governs health care liability claims against doctors, hospitals and other licensed providers. The same year, Texas voters added Article III, Section 66 to the Texas Constitution, which authorizes the Legislature to limit damages “other than economic damages” against a provider of medical or health care.

Texas law defines both categories in Civil Practice and Remedies Code § 41.001. Economic damages compensate “actual economic or pecuniary loss.” Non-economic damages compensate physical pain and suffering, mental or emotional pain or anguish, loss of consortium, disfigurement, physical impairment, loss of companionship and society, inconvenience, loss of enjoyment of life and other non-pecuniary losses. In a birth-injury case, that second category covers a child’s loss of the ability to walk, speak or play, and the daily reality of living with a disability.

The caps in § 74.301

Section 74.301 sets three separate limits on non-economic damages, each measured for each claimant and each covering everyone for whom a defendant is legally responsible. They are listed below.

Put together, a child’s non-economic damages in an injury case can reach at most $750,000, when the doctors and two or more hospitals or other institutions are found liable. Texas wrote these amounts as fixed dollar figures: § 74.301 contains no inflation adjustment, so they are the same today as when the law took effect in 2003.

One definition matters a great deal to families. Under § 74.001(a)(2), “all persons claiming to have sustained damages as the result of the bodily injury or death of a single person are considered a single claimant.” In practice, the child’s claim and the parents’ claims that arise from the child’s injury share one set of caps. A mother’s claim for her own physical injuries is a separate matter. Section 74.302 contains a backup set of caps that takes effect only if § 74.301 is struck down or invalidated other than by the Legislature.

• $250,000 for all physicians and other individual health care providers combined, regardless of how many are sued or how many causes of action are brought.
• $250,000 when judgment is against a single hospital or other health care institution.
• $250,000 per institution, and $500,000 for all institutions combined, when judgment is against more than one.

What is not capped

The caps in § 74.301 apply only to non-economic damages. Economic damages have no cap under that section, and Article III, Section 66 authorizes caps only on damages other than economic damages. In a birth-injury case, economic damages are usually the largest part of the claim, because a child with a permanent disability may need care for sixty or seventy years.

These amounts are calculated by medical and economic experts through a life care plan. One Texas rule shapes how they are measured: under § 41.0105, recovery of medical or health care expenses is limited to the amount actually paid or incurred by or on behalf of the claimant, not a higher amount a hospital may have billed.

• Past and future medical care: hospital stays, surgeries, medications, specialists.
• Therapies: physical, occupational, speech and behavioral therapy, often for life.
• Equipment and technology: wheelchairs, braces, communication devices, feeding supplies.
• Home and vehicle modifications, and the cost of attendant or nursing care at home.
• Special education and vocational support.
• Lost earning capacity: the income the child would have earned as an adult.

Wrongful death: a separate overall limit

If a baby does not survive, § 74.303 applies. In a wrongful death or survival action on a health care liability claim, civil liability for all damages, including exemplary damages, is limited to $500,000 for each claimant, regardless of the number of defendants or causes of action.

That $500,000 figure is not frozen. Under § 74.303(b), it is adjusted by the change in the consumer price index (CPI-W) between August 29, 1977, and the time damages are awarded by final judgment or settlement. Because prices have risen a great deal since 1977, the adjusted limit is much higher than $500,000; the exact figure is calculated when the case is resolved. And under § 74.303(c), the limit does not apply to damages for the expenses of necessary medical, hospital and custodial care received before judgment or required in the future.

Whether a claim exists after a stillbirth or a newborn’s death depends on the facts, and it should be reviewed by an attorney as early as possible.

Periodic payments for future care

Chapter 74 also governs how large awards for future damages are paid. Its periodic-payment rules apply when the present value of future damages, as determined by the court, equals or exceeds $100,000 (§ 74.502). At the request of either side, the court must order that awards for future medical, health care or custodial services be paid in whole or in part in periodic payments rather than a lump sum, and it may do the same for other future damages (§ 74.503).

The judgment must name the recipient, the amount, the interval and the number or period of payments, and a defendant that is not adequately insured must provide evidence of financial responsibility, such as an annuity (§ 74.505). Families should understand one consequence: under § 74.506, periodic payments other than future loss of earnings end when the recipient dies. How future care is structured is part of any settlement discussion.

A higher bar for emergencies in labor and delivery

Texas has a rule that matters in many birth-injury cases. Under § 74.153, when a claim arises from emergency medical care in a hospital emergency department, in an obstetrical unit, or in a surgical suite immediately after evaluation or treatment in the emergency department, the family must prove by a preponderance of the evidence that the doctor or provider departed from the standard of care with “willful and wanton negligence,” not just ordinary negligence.

The rule has limits. It does not apply to care given after the patient is stabilized and receiving treatment as a non-emergency patient, to care unrelated to a medical emergency, or to a provider whose own negligence caused a stable patient to need emergency care (§ 74.153(b)). Chapter 74 defines emergency medical care as bona fide emergency services after the sudden onset of a condition serious enough that, without immediate attention, the patient’s health could be placed in serious jeopardy (§ 74.001(a)(7)).

In 2018 the Texas Supreme Court held that the rule reaches emergency care in a hospital’s obstetrical unit even when the mother was not first seen in the emergency room. The standard does not change the caps, but it can change what must be proven, which is why the minute-by-minute timeline in the records matters so much.

How Beverly Law helps

Beverly Law is a Los Angeles personal injury firm; in Texas we take birth-injury cases through licensed local counsel, in English and Spanish. From the first free consultation, we explain how the Chapter 74 caps apply to your child’s situation and, more importantly, how the uncapped economic damages are proven. We work with medical experts and life care planners to document every future need.

The procedural side is handled with licensed local counsel: the 60-day notice and medical authorization under §§ 74.051 and 74.052, any Tort Claims Act notice for a public hospital, the deadlines in § 74.251 and the expert report under § 74.351. There is no fee unless we win, and the fee agreement is put in writing and signed before any work begins, as Government Code § 82.065 requires. Call 1 (877) 427-2752 to talk with us.

Questions parents ask

Related pages

Cerebral Palsy · Erb’s Palsy / Brachial Plexus Injury · HIE / Oxygen Deprivation at Birth · Statute of Limitations · Texas birth injury lawyers

Important: This page is general information about birth injuries and Texas law, not legal advice, and reading it does not create an attorney-client relationship with Beverly Law. Every case is different — talk to a lawyer about your own situation. Attorney advertising. Prior results do not guarantee a similar outcome. No fee unless we win. Last reviewed: 2026-09-30.