As in many states, in Illinois the debate over the cost of medical malpractice often puts insurance companies and trial lawyers at bitter odds.

In an unusual bid to challenge the status quo, former president of the Illinois Trial Lawyers Association Kim Presbrey has started an insurance company promising doctors more choice and better deals on expensive malpractice coverage.

He’s pumping a lot of work into challenging the state’s major medical insurance company, a doctor-owned business that has more than 65 percent of the malpractice market. “We expect to make money,” Presbrey said. “To the extent that we are able to decrease their premiums at some level, I think we’ll save everybody money.”

That was the goal last year when state officials approved changes in the law meant to encourage more competition for malpractice insurance. Some doctors were fleeing the state or retiring because of steeply rising insurance premiums – some of which had more than tripled. Doctors and insurers blamed the rate increases on out-of-control lawsuit awards, while trial lawyers and victim advocates condemned insurance mismanagement.

In response, legislators approved some limits on lawsuit awards but also strengthened state oversight of doctors and insurers. The major insurer, ISMIE Mutual Insurance Co., was forced to promote competition by opening its ratemaking formulas to other companies.

Presbrey, an Aurora-based attorney, says the notion of getting into the insurance business came to him while researching claims that Illinois faced a malpractice “crisis.” Further research and ISMIE’s data made it clear the market was lucrative market, he said.

Presbrey hopes to collect between $10 million and $20 million in premiums the first year. By comparison, ISMIE collects more than $400 million in premiums each year.