Background: Emergency medicine, with its limited time for patient encounters, unpredictable flow, and lack of a continuing patient-physician relationship, is a particularly high-risk field with regards to the issue of medical liability. There have been limited studies on the financial and time exposure emergency physicians face when confronted with a liability suit. Objectives: Provide practicing physicians with guidance as to what can be expected if they are confronted with a medical malpractice claim, and contribute to the literature as the issue of tort reform is debated. Methods: Retrospective study of all closed malpractice claims involving emergency physicians insured by the Illinois State Medical Inter-insurance Exchange covering the 10-year period 1995 to 2004. Results: Of 450 claims, there were 200 cases served. The median incident-to-close time was 45.5 months (interquartile range [IQR] 30.6-69.9). The median expense per claim served was $14,091 (IQR $3448- $44,363); 19.5% of cases resulted in an indemnity with a median of $220,000 (IQR $117,500-$700,000). Cases in which an indemnity was eventually made tended to be filed 7.7 months faster (p = 0.065) and took 14.1 months longer to close (p < 0.05). In cases with a payout of >= $1,000,000, 80% were in the <= 1-year age group. Conclusion: In this study, emergency physicians with malpractice suits can expect resolution of the case to take over 45 months after an alleged incident, and their malpractice insurer will incur over $14,000 in expenses regardless of the suit outcome. Cases involving patients aged <= 1 year may incur higher indemnity payments. (C) 2012 Elsevier Inc.