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Just over £20m was paid out during 2020-21 but that increased to more than £40m in the 2021-22 financial year.
Last year, £30.7m was paid out in damages, while £5.9m went on plaintiff costs and £3.7m in defence costs.
The increase in cost is being attributed to the coronavirus pandemic.
A spokesperson for the Department of Health said: "There was a general decrease in the processing and settling of cases during the main Covid-19 pandemic period, with a subsequent increase in 2021-22."
The annual amount spent on clinical negligence cases prior to the pandemic was about £30m each year.
However, in 2020-21 it was much lower than normal, decreasing to £21.9m but increasing again to £40.2m in 2021-22.
Figures show that between April 2021 and March 2022, 351 clinical negligence cases were settled, compared with 251 in 2020-21 and 226 in 2019-20.
'Duty of care'
Clinical negligence is defined by the Department of Health as a member of the health and social care service breaching their duty of care.
Settlements can relate to legal cases that have been initiated over the course of previous years and not just the year the case was taken.
The latest statistics were collected from health and social care trusts and published by the Department of Health.
Last year, 3,987 clinical negligence cases were open.
Almost half (1,813) of all cases open in 2021-22 related to four specialties:
Obstetrics - 564
Accident and emergency - 456
Neurology - 407
General surgery - 386
There has been a stark increase in the number of cases relating to neurology in the past five years from 23 in 2017-18 to 407 in 2021-22.
The health service in Northern Ireland has been under increased scrutiny in recent years with a number of high-profile reviews making headlines.
The Independent Neurology Inquiry was at the centre of Northern Ireland's biggest ever recall of patients.
It examined concerns over clinical decision-making, prescribing and diagnostics.
Last year Northern Ireland's emergency departments were described as being "under extreme pressure".
Delays in social care provision have been slowing hospital discharges and having a knock-on effect on the ability of emergency departments to transfer patients to wards.
In 2021-22 the highest number of cases related to "treatment" in the Belfast, South Eastern and Western health trusts.
The highest number of cases in the Northern and Southern trusts related to "diagnosis and tests".
Over a quarter (£10.6m) of all clinical negligence payments in 2021-22 came from the Western Health Trust.