A single, simple fee standard despite a complex damages cap
Compare Texas to a state like New York, which applies a hard statutory sliding scale to medical malpractice attorney fees specifically. Texas has no equivalent figure anywhere in its rules for any type of personal injury claim, including malpractice — the fee simply can't be unconscionable under Rule 1.04(a), assessed case by case, however complicated the underlying damages cap in that case might be.
Two very different levels of complexity
It's worth being clear how differently these two questions are structured. Texas's medical malpractice damages cap genuinely is layered — $250,000 against all physicians combined, $250,000 or $500,000 against institutions depending on how many are sued, up to $750,000 combined. The attorney's own fee rule carries none of that complexity; it's one standard, applied the same way regardless of how the damages cap plays out in a given case.
Two separate things that sound related but aren't
The layered damages cap limits what a plaintiff can recover from the defendants. The attorney's own percentage fee remains governed entirely by Rule 1.04's unconscionable-fee standard, untouched by whichever layer of the damages cap ends up applying in a specific case.
A distinctive combination among the states
Many states that leave personal injury fees uncapped still allow some form of damages cap, at least for medical malpractice. Texas's combination — one of the country's most elaborately layered malpractice damages caps, paired with a simple, uncapped fee standard — fits that broader national pattern while standing out for just how complex its damages side has become.