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World’s Largest Insurers–2021 Edition: M&A, Divestitures Drive Changes in AM Best’s Rankings

Rankings are based on 2019 non-banking assets and net premiums written.
  • David Pilla
  • February 2021
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Acquisitions and divestitures were key factors in changes to AM Best's annual rankings of the world's top 25 insurers, as divestitures led to the biggest ranking change by non-banking assets and acquisitions played a role in the ranking by net premiums written.

One notable NPW change came from CVS Health Corp., which rose three places following completion of its acquisition of Aetna Inc. On the non-banking assets side, Prudential plc fell to No. 20 from No. 8 after it divested its M&G Investments unit in 2019.

“There are a variety of things that drive these rankings, including acquisitions from one year to the next, or dispositions,” said Thomas Rosendale, senior director, AM Best.

Thomas Rosendale AM Best

There are a variety of things that drive these rankings, including acquisitions from one year to the next, or dispositions.

Thomas Rosendale
AM Best

“A fair number of movements on this list are probably driven by acquisition,” he said. “Suddenly you've got an acquisition that brings in more assets or brings in more premium, so the growth or decline year over year can be driven by these acquisitions and dispositions. On the premium side, when you look at U.S. GAAP accounting to the extent that a lot of these may be consolidated, U.S. companies may consolidate on a GAAP basis,” said Rosendale. “Prudential Financial is No. 2 in assets, but they don't even show up on the premium list.”

Rosendale said that with U.S. GAAP, annuity premium is treated as an investment product.

“Pru does a lot of group annuity business through their pension risk transfer business and a lot of retail annuity business through their variable annuity, indexed and fixed annuity sales,” he said. “All those premiums don't count as premium in GAAP accounting.

“Their premium total may look artificially low as a result of just the accounting methodology they use in the U.S.,” he said. “In statutory accounting those are premiums, but in GAAP accounting they're not.”

Most of the top 10 insurers in the ranking by net premiums written kept their positions from the previous year.

UnitedHealth Group Inc. remained on top, while No. 2 Ping An Insurance (Group) Co. of China Ltd. and No. 3 Axa S.A. exchanged places.

Further down the list, People's Insurance Co. (Group) of China rose to eighth place from No. 10, and Centene Corp. rose to 10th place from No. 12.

Three of the top 10 insurers by NPW are Chinese groups. Four are health insurance groups.

CVS, which rose to No. 16 from No. 19, posted a change in NPW of 13.57%, the third-largest gain among the top 25.

CVS acquired Aetna Inc. in 2018, which helped drive positive third-quarter 2019 results for the group, according to CVS President and Chief Executive Officer Larry J. Merlo. Total third-quarter 2019 revenues increased by 36.47% to $64.81 billion.

“It's really hard to believe that at the end of the month, we're going to celebrate our first anniversary as one company,” Merlo said in a third-quarter 2019 earnings call.

“We are increasingly confident in the strength of our broad and differentiated assets as a combined company and our ability to deliver compelling value to our customers and the communities we serve,” he said. “Looking ahead, we remain focused on successful execution of our strategic priorities and integration plans to unleash the full potential of our consumer-centric health care model.”

In September 2019, a federal judge approved CVS Health's $69 billion acquisition of Aetna, ruling the megadeal did not violate U.S. antitrust laws. The two companies finalized the merger last year, but had kept some operations separate during the court review.

Another health insurer, Centene Corp., continued its NPW rise in 2019, reaching No. 10 in the ranking from 2018's No. 12. Centene rose six places in 2018.

In August 2019, Centene said it would expand its participation in the Affordable Care Act exchanges for 2020 in 10 markets. The health insurer expanded its ACA participation with four new markets the previous year. In January 2020, Centene obtained all the regulatory approvals needed to finalize its $17.3 billion acquisition of WellCare Health Plans Inc.

NPW rose 25.13% in 2019 for Centene, outpacing the second-largest percentage increase—14.57%—of another health insurer Humana Inc.

In 2019, Humana President and CEO Bruce D. Broussard quashed speculation Humana may be interested in acquiring rival Centene, while also noting the group is seeing increased opportunity for growth in traditional Medicare states as well as states with dual Medicare and Medicaid programs.

Falling farthest in ranking by NPW was Japan's National Mutual Insurance Federation of Agricultural Cooperatives, which slid to No. 21 from No. 16. National Mutual's NPW fell 17.62% in 2019, the biggest NPW percentage drop among the top 25.

The only newcomer to the top 25 NPW list was Credit Agricole Assurances. Liberty Mutual Holding Co. Inc., which was ranked at No. 24 in 2018, did not make the 2019 list.

Ranked by non-banking assets, the top 25 insurers mostly saw minor shifts in position. U.K. life insurer Prudential plc was an outlier, falling to No. 20 from No. 8.

Prudential plc's non-banking assets fell 29.88%, the largest drop among the top 25. Axa's non-banking assets fell 14.78%, the second-largest fall.

Only three other insurers in the top 25 saw their non-banking assets fall, and all three fell by single digit amounts.

In October 2019, Prudential plc completed the demerger of investment management business M&G plc. Shares of M&G were admitted to trading on the London Stock Exchange's main market for listed securities.

“Prudential is now an Asia-led portfolio of businesses, focused on structural growth markets,” said CEO Michael Wells in a statement. “Our businesses in Asia and the U.S. have leadership positions in their chosen segments, and we now operate in eight markets in Africa.”

“Prudential plc in 2019 split their company into two holding companies,” said Rosendale. “Plc retained the Asian insurance companies as well as Jackson National and some other operations. Largely the investment management operations were split off into a separate holding company, so when you look year over year my guess is that Plc no longer includes some of those operations that were split into a separate company.

“That may have been the driver here for a drop in the rankings—not performance-driven, but a structural change,” Rosendale said.

In late 2019, Axa completed the sale of its remaining stake in Axa Equitable Holdings Inc.

Rosendale said underlying that downward move for Axa may be the divestiture of Axa Equitable. “They're a publicly traded company in the U.S.,” he said. “They no longer consolidate their results as of 2019.”

The closing represents “a key milestone in Axa's transformation journey,” Thomas Buberl, Axa's chief executive officer, said in a statement at the time.

“Our exit from the U.S. life and savings market, along with the integration of XL Group, has accelerated Axa's strategic shift toward its preferred segments and reduced significantly its exposure to financial markets,” he said. “This transaction further strengthens Axa's balance sheet and provides additional financial flexibility for the group to reduce its debt gearing to the lower end of its target range of 25% to 28% by the end of 2020.”

Among the top 10, Allianz S.E. gained the top spot from second place while Prudential Financial Inc. moved to No. 2 from No. 3. Axa fell to No. 3 from its previous top spot.

The United Kingdom's Legal &General Group plc advanced to No. 7 from No. 9, Ping An rose to No. 8 from No. 10 and China Life rose to No. 10 from No. 12.

Japan Post Insurance Co. Ltd. fell to ninth place from No. 7.

There were no newcomers or departures in the top 25 list by non-banking assets.

Click here to view the Listing.


David Pilla is news editor, BestWeek. He can be reached at

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