Best's Rankings
US Medical Professional Liability — 2021 Direct Premiums Written — 2022 Edition
Insurers were ranked by 2021 direct premiums written.
($ Thousands)
2021
Rank |
2020
Rank |
Company/Group |
AMB# |
2021
Direct
Premiums
Written |
%
Change in
Premiums |
Market Share (%) |
Adjusted Loss Ratios |
% of
Company
Premiums |
| 2021 |
2020 |
2019 |
2021 |
2020 |
2019 |
| 1 |
1 |
Berkshire Hathaway Ins |
000811 |
$1,944,101 |
13.4 |
17.3 |
16.8 |
16.9 |
48.7 |
48.0 |
55.3 |
3.8 |
| 2 |
2 |
Doctors Co Ins Group |
018083 |
1,070,669 |
11.2 |
9.6 |
9.4 |
9.4 |
47.1 |
45.9 |
43.0 |
84.2 |
| 3 |
3 |
ProAssurance Group |
018559 |
739,157 |
-7.2 |
6.6 |
7.8 |
8.8 |
56.2 |
58.4 |
78.7 |
70.3 |
| 4 |
4 |
CNA Ins Cos |
018313 |
638,680 |
4.9 |
5.7 |
6.0 |
5.7 |
50.3 |
70.4 |
59.5 |
5.1 |
| 5 |
5 |
Coverys Companies |
018359 |
574,677 |
10.0 |
5.1 |
5.1 |
5.0 |
65.7 |
74.0 |
63.0 |
75.5 |
| 6 |
7 |
MAG Mutual Companies |
018940 |
417,943 |
13.2 |
3.7 |
3.6 |
3.4 |
55.4 |
55.8 |
98.7 |
90.0 |
| 7 |
6 |
MCIC Vermont (A RRRG) |
012014 |
384,988 |
-9.4 |
3.4 |
4.2 |
4.1 |
94.6 |
85.9 |
105.9 |
96.0 |
| 8 |
8 |
Liberty Mutual Ins Cos |
000060 |
307,729 |
17.1 |
2.7 |
2.6 |
2.2 |
71.5 |
72.4 |
36.8 |
0.7 |
| 9 |
13 |
Chubb INA Group |
018498 |
201,437 |
33.2 |
1.8 |
1.5 |
1.4 |
103.8 |
144.9 |
38.9 |
0.7 |
| 10 |
9 |
Constellation Ins Group |
018840 |
187,775 |
8.7 |
1.7 |
1.7 |
1.7 |
36.9 |
56.0 |
63.8 |
94.0 |
| 11 |
14 |
W. R. Berkley Ins Group |
018252 |
184,835 |
26.6 |
1.7 |
1.4 |
1.3 |
47.0 |
47.9 |
46.8 |
2.2 |
| 12 |
11 |
ISMIE Mutual Group |
018644 |
173,748 |
4.5 |
1.6 |
1.6 |
1.6 |
54.3 |
50.9 |
43.5 |
98.8 |
| 13 |
10 |
PRI Group |
018957 |
167,227 |
-1.5 |
1.5 |
1.7 |
1.7 |
48.8 |
15.9 |
-32.7 |
98.5 |
| 14 |
12 |
Controlled Risk Ins Co of VT, Inc |
011814 |
167,011 |
1.6 |
1.5 |
1.6 |
1.7 |
52.8 |
63.4 |
60.6 |
90.3 |
| 15 |
15 |
Curi Hldgs Group |
018072 |
159,592 |
14.4 |
1.4 |
1.4 |
1.5 |
37.9 |
43.6 |
42.8 |
100.0 |
| 16 |
16 |
Alleghany Corp Group |
018640 |
153,834 |
14.6 |
1.4 |
1.3 |
1.3 |
34.8 |
55.9 |
49.2 |
5.8 |
| 17 |
18 |
State Volunteer Mutual Ins Co |
003706 |
121,872 |
7.2 |
1.1 |
1.1 |
1.2 |
27.2 |
24.1 |
35.5 |
99.9 |
| 18 |
17 |
Physicians Ins Mutual Group |
018103 |
118,435 |
-6.2 |
1.1 |
1.2 |
1.1 |
54.8 |
57.7 |
53.3 |
86.0 |
| 19 |
21 |
Fairfax Financial (USA) Group |
003116 |
117,749 |
25.1 |
1.1 |
0.9 |
0.8 |
45.9 |
76.4 |
57.3 |
1.2 |
| 20 |
19 |
COPIC Ins Group |
018866 |
115,876 |
13.0 |
1.0 |
1.0 |
0.9 |
44.6 |
34.6 |
45.8 |
97.6 |
| 21 |
20 |
NCMIC Group |
018579 |
99,545 |
2.7 |
0.9 |
1.0 |
1.0 |
49.1 |
47.2 |
30.7 |
76.1 |
| 22 |
23 |
Markel Corp Group |
018468 |
96,367 |
13.0 |
0.9 |
0.8 |
0.9 |
37.7 |
41.2 |
65.5 |
1.3 |
| 23 |
24 |
Natl Group |
018249 |
95,183 |
14.7 |
0.9 |
0.8 |
1.0 |
32.0 |
33.7 |
21.1 |
100.0 |
| 24 |
26 |
Medical Mutual Group (MD) |
005006 |
93,466 |
22.5 |
0.8 |
0.8 |
1.0 |
63.1 |
59.0 |
23.7 |
99.6 |
| 25 |
22 |
Mutual Ins Co of Arizona Group |
018867 |
89,041 |
4.2 |
0.8 |
0.8 |
0.9 |
50.0 |
51.4 |
30.3 |
100.0 |
|
|
Top 25 Writers |
|
$8,420,937 |
8.4 |
75.1 |
76.2 |
76.7 |
54.0 |
57.1 |
57.4 |
5.1 |
|
|
Total U.S. P/C Industry |
|
$11,214,989 |
10.0 |
100.0 |
100.0 |
100.0 |
55.2 |
57.5 |
58.1 |
1.4 |
Note: Data for some companies in this report has been received from the NAIC.
Reflects Grand Total (includes Canada and U.S. Territories).
Source: 
— State/Line (P/C Lines) - P/C, US; data as of June 9, 2022
