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2026 Best's Rankings: US Medical Professional Liability (Occurrence) Loss Ratios Rise in 2025

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OLDWICK, N.J. //BestWire// - The adjusted loss ratio for U.S. medical professional liability underwriters rose slightly in 2025 to 47.4% based on occurrence for policies covering any event that occurred while the policy was in effect regardless of when it was reported, according to a new Best's Ranking.



The number stood at 45.8% in the prior year, according to the report.

Total industry premiums of $2.96 billion in 2025 were up 3.4% from the prior year.

Berkshire Hathaway Insurance retained the top spot on the list of 25 carriers with direct premiums written of $890.9 million in 2025, which was up by 1.4%, according to the report. The Doctors Co. Insurance Group took second place with DPW of $446.8 million, an increase of 9.2%.

Finishing out the top five were: No. 3, CNA insurance Cos., $318.9 million, up 7%; No. 4 Coverys Companies, $141.9 million, down 2.9%; and No. 5 Liberty Mutual Insurance Cos., $132.2 million, up 9.4%.

All of the top five insurers remained the same year-over-year, according to the report.

The report measures 2025 DPW, percentage change in premiums, market share, adjusted loss ratios and percentage of company premiums.

Subscribers can access the report and data here.

Learn more about Best’s News and Research Service.

AM Best data sourced from Best’s Financial Suite, US.

(By Terrence Dopp, senior associate editor, Best’s Review: Terry.Dopp@ambest.com)


Premiums Insurance Underwriting Best's Rankings Medical Professional Liability


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