Berkshire Hathaway Insurance remained the top writer of medical professional liability (MPL) insurance in 2023, with $1.30 billion in direct premiums written (DPW), despite a slight 0.2% decrease from the previous year, according to a new Best’s Rankings report.

The report measures DPW, market share, and adjusted loss ratios for the top writers of medical professional liability insurance, based on claims made.

Doctors Co Insurance Group held its second-place position, experiencing a 4.4% increase to $822.4 million in DPW. ProAssurance Group, ranked third, saw a 1.9% decline to $635.1 million in DPW.

The fourth and fifth positions saw a swap, with MCIC Vermont dropping to fifth after a 0.2% decrease to $458.8 million in DPW, while MAG Mutual Cos moved up to fourth with an 18.9% increase to $503.8 million in DPW.

Coverys Cos, ranked seventh, recorded the largest decrease among the top 10 insurers, with a 5.4% decline to $341.0 million in DPW, though it maintained its ranking from the previous year.

Overall, the medical professional liability insurance industry saw a 0.9% increase in DPW, reaching $9.40 billion in 2023.

The report also highlighted the performance of medical professional liability underwriters based on occurrence policies, which cover any event that occurred while the policy was in effect, regardless of when it was reported. The adjusted loss ratio for these underwriters averaged 48.6%, with total direct premiums increasing 5.3% to $2.78 billion in 2023.

Top insurers in terms of DPW

The top five insurers by DPW remained consistent year-over-year, led by Berkshire Hathaway Insurance, which saw a 5.0% increase to $876.4 million. Its adjusted loss ratio increased slightly to 44.3% from 43.1% the previous year.

MAG Mutual Cos recorded the largest DPW increase among the top 10 insurers, with a 37.0% rise to $77.4 million, moving it from 10th to seventh in the rankings. Its adjusted loss ratio improved significantly to 31.9% from 67.1%.

ProAssurance Group, on the other hand, experienced the largest DPW decrease among the top 10, with an 18.3% drop to $56.8 million. Despite this, its adjusted loss ratio fell below 100%, to 94.6%, though it remained the highest among the top 10.

The report provides detailed insights into the DPW, changes in premiums, market share, adjusted loss ratios, and the percentage of total company premiums attributed to medical professional liability insurance for each company in the study.

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