Best's Rankings
World’s Largest Insurers — 2022 Edition: China Insurers, US Health Writers Show Gains in AM Best’s Ranking

• David Pilla
• February 2022
• 

Two major Chinese insurers saw big gains in AM Best's top 25 list of world's largest insurers, ranked by nonbanking assets, as U.S. health insurers dominated AM Best's top list when ranked by 2020 net premiums.

Based on net premiums written, U.S.-based health insurer Centene Corp. rose to fourth place from 10th as NPW rose 49.7%. “Centene completed its acquisition of WellCare Health Plans in January 2020, which resulted in a significant increase in premiums and members year over year,” said Sally Rosen, senior director, AM Best. “This combined with membership growth were the drivers of the year-over-year growth.”

U.S.-based UnitedHealth Group Inc. retained the top spot, with $201.49 billion in NPW, a 6.2% increase. China-based Ping An stayed at No. 2, with $118.75 billion, up just 0.1%.

Other insurers with double-digit NPW increases—all U.S. health insurers—were Humana Inc., up 17.9% as it moved to No. 11 from No. 12 in the ranking; Health Care Service Corp. Group, moving to No. 19 from No. 25 as NPW rose 12.1%; and Anthem Inc. with NPW up 11.6% as it rose to No. 5 from No. 6.

In addition to rate increases, premium growth has largely been driven by membership gains in government programs such as Medicaid managed care and Medicare Advantage, said Rosen. “Medicare Advantage is driven by the growing number of individuals eligible for Medicare and selecting Medicare Advantage,” said Rosen. She said Medicaid managed care growth was driven by increases in the number of individuals eligible for Medicaid due to the economic impacts of COVID-19 combined with states not terminating Medicaid members.

“The Families First Coronavirus [Response] Act [passed in March 2020] provided additional federal funding for states for Medicaid, a joint federal/state funded program, during the period of the public health emergency,” said Rosen. “In order to receive the extra funding, states are required to retain members and not allowed to perform re-determinations of eligibility. As a result, states have added new members but did not dis-enroll existing members.”

France-based Axa S.A. decreased furthest among the top 10, falling 8.7% to seventh from third place in terms of NPW for the Paris-based international multiple-line group.

NPW declines were seen in two Japanese life insurers in 2020.

Nippon Life Insurance Co. fell to No. 18 from No. 15 and Dai-ichi Life Holdings Inc. fell to No. 22 from No. 19.

“The domestic new business sales of major Japanese life insurers, which typically involve considerable face-to-face interactions, have been under pressure mainly due to the country's state of emergency over the COVID-19 pandemic,” said Christie Lee, senior director, analytics, AM Best. “However, AM Best expects new business sales to recover gradually as insurers adopt digital initiatives and online tools to mitigate the impact of reduced face-to-face sales activity.”

Companies in this year's top 25 for NPW that were not on the list a year ago include Germany-based HDI V.a.G. at No. 21, U.S.-based Liberty Mutual Holding Co. Inc. at No. 24 and U.S.-based Progressive Corp. at No. 25.

Net Nonbanking Assets

Ranked by assets, the top 25 saw big gains from two China-based insurers. Ping An Insurance (Group) Company of China Ltd. rose to fourth place from eighth as its nonbanking assets grew 16.5%. China Life Insurance (Group) Co. Ltd. advanced to No. 8 from No. 10 as nonbanking assets rose 12.2%.

Allianz SE stayed at No. 1 in assets, with $1.26 trillion, while Axa SA rose from No. 3 to No. 2.

Among companies that saw a decline in ranking position, Nippon Life Insurance Co. fell to seventh from fifth place even as nonbanking assets rose 6.9%. Japan's National Mutual Insurance Federation of Agricultural Cooperatives fell to No. 19 from No. 15 as assets rose 1.5% and Japan Post Insurance Co. Ltd. fell to No. 13 from No. 9.

“Chinese companies' big asset gains were partially driven by the appreciation of the renminbi in 2020,” said Lee. “Over the year, the renminbi appreciated by approximately 6% against the U.S. dollar.”

One company on the list that was not there last year is Canada-based Great-West Lifeco Inc. at No. 22, with a 33.1% rise in assets.

Best’s Rankings
World’s Largest Insurance Companies—2022 Edition

Ranked by 2020 net nonbanking assets.

* Percent change is based upon local currency.

Source: Best’s Financial Suite - Global; data as of Dec. 13, 2021.

Best’s Rankings
World’s Largest Insurance Companies—2022 Edition

Ranked by 2020 net premiums written.

* Percent change is based upon local currency.

¹ Premiums shown are earned premiums.

² AM Best consolidation; U.S. companies only.

Source: Best’s Financial Suite - Global; data as of Dec. 13, 2021.

David Pilla is news editor. He can be reached at david.pilla@ambest.com.