State Insurance Commissioner George Dale told the joint study committee on tort reform that insurance rates are driven by the underwriting standards of the company, the company's investment performance, the cost of its own insurance and the legal climate.

But whether tort reform alone would stabilize high insurance rates, he could not say.

"Will doing something to the legal climate by itself completely change or turn around the problems we're in today? No, not in my opinion. Will it help some? How much will it help? I don't know," Dale said.

Dale's testimony began the next phase of the on-going examination of the civil justice system.

Thirty-one patients, doctors and workers from the Delta Obstetrics and Gynecology Clinic in Cleveland were also in Jackson for the meeting.

They did not testify, but some pregnant patients said they wanted to talk to legislators during breaks. Drs. Mark Blackwood and Bradley Baugh closed their office Saturday after their insurance carrier would not renew them, leaving the Delta city of 14,000 with no one to provide obstetrical or gynecological services.

"I was looking forward to being comfortable with my doctor and my hospital. Now, we'll have to go to a totally different doctor and different hospital," said Jodie Pinter, 26, of Cleveland, whose baby girl is due Sept. 4.

Robin Mitchell, 37, of Greenwood, had been driving to Cleveland for obstetrical services. She said she relies on a combination of private insurance and Medicaid and doesn't know where she'll find medical care.

"It hasn't been a pleasant thing," said Mitchell, whose baby boy is due Sept. 19.

Doctors have complained that skyrocketing medical malpractice insurance premiums are driving them out of practice, but many have questioned whether the legal climate has anything to do with rising rates.

"Some suggest that I should deny rate increases for medical malpractice coverage or that caps would be placed on medical malpractice rates," Dale said. "When the actuaries say that a rate increase is justified due to losses being experienced with respect to a particular line of business, such as medical malpractice, I have no real grounds to turn that rate increase down. "

On Thursday, Michael Houpt, the CEO of Medical Assurance Co. of Mississippi, called for a $250,000 cap on non-economic damages in jury awards, a provision supported by doctors but rejected by trial lawyers.

Houpt said the measure, which would mimic a portion of the tort reform undertaken in California more than 25 years ago, would aid in lowering the medical malpractice rates in Mississippi.

Over the past several months, Houpt said, the company, which only insures the "cream of the crop" of Mississippi doctors, has had to increase its rates an average of 15 percent due to the unpredictable nature of the state's tort system.

MACM, the nonprofit insurance arm of the Mississippi State Medical Association, was set up in 1977 to cope with the declining number of insurance companies willing to write medical malpractice insurance. It's exempt from state laws regulating other insurance companies and files annual reports with the state insurance commissioner.

Houpt told committee members that for the past 10 years, MACM's profits have been the result of the company's investments. The nonprofit insurance group, he said, has never seen a profit from its premiums.

Sen. Terry Burton, D-Newton, asked Houpt where the company would be without its investment income.

"We'd be in a lot of trouble," Houpt said.

At the end of 2002, Houpt said, MACM insured about 2,200 physicians, or about 70 percent of the doctors in the state.

"Since Jan. 1 of this year, we have received 523 applications, of which 278 have been approved for coverage and 107 declined," Houpt said.

The remaining 138 applications are still begin evaluated, he said.

"Because of the current tort system, we have had to tighten our underwriting guidelines and have become much more restrictive in writing new business, but, obviously, we are still insuring those physicians who meet our standards. "