A $60m campaign by insurance companies in the USA has successfully persuaded Californians to vote against Proposition 46, a bill that would have raised the cap on the amount awarded to the victims of medical malpractice.

While the yes campaign relied upon lawyers groups and the talismanic support of consumer advocate Erin Brockovich, made famous by the Julia Roberts film depicting her investigation into groundwater contamination, the no campaign relied upon financial might. Nearly three-quarters of the $60m spent came from just six insurance companies, determined to quash a measure that would have resulted in them paying out more in compensation.

Tom Jones, head of policy at Thompsons Solicitors, said: “This is a salient reminder of the power of the insurance lobby, how it will fight tooth and nail to protect its market and its profits and of what happens when lawyers only get paid from injured people’s compensation. Here in the UK we have seen the insurance industry strike a deal with the current government which aimed to make the victims of mesothelioma, a cancer caused by exposure to asbestos, pay legal costs and limit their compensation and, at the behest of their big insurance donors, the government has compliantly started the UK down the road of victims paying lawyers out of their compensation rather than payment being by the guilty party.

“It’s an indictment of the funding regime in the US, where lawyers only get paid if they win and take their payment entirely from the claimant’s compensation, that lawyers in California facing a cap on damages are shying away from taking on cases from children, disabled people, stay-at-home parents and the elderly, in fact anyone not in work. What that means in reality is that some of the most vulnerable people in society – those who can’t afford medical malpractice insurance - are effectively shut out from holding bad doctors to account and claiming their rightful compensation.

“The insurance line in all this was the usual mix of scare tactics about increased premiums and money running out when in fact it’s all about protecting their profits and a lucrative market in medical malpractice insurance.

“For those who have followed the actions of insurance giants in the UK on mesothelioma and in the car insurance market, insurers being happy to take in the premiums but doing anything to avoid picking up the bill is a familiar story. In mesothelioma the tactic here is behind closed door deals and in car insurance, despite the fact that the industry makes millions in profit every year, the unrelenting focus is on spurious statistics suggesting a crisis and scare stories about ever higher premiums.

“Whether it’s the UK or the US, the insurance industry may sugar coat its intentions but the bottom line is that it fights tooth and nail to protect their bottom line.”