Berkshire Hathaway Insurance remained the No. 1 medical professional liability (MPL) insurer in 2023, with $1.30 billion in direct premiums written (DPW), despite a slight 0.2% decline from the previous year, according to the new Best Rankings report.

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

Insurance group Doctors Co. took second place, seeing a 4.4% increase to $822.4 million in DPW. ProAssurance Group, which ranked third, saw a 1.9% decline to $635.1 million in DPW.

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

Coverys Cos., ranked seventh, had the largest decline among the top 10 insurers, with a 5.4% decline to $341.0 million in DPW, although 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.

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

Top insurance companies in terms of DPW

The top five insurance companies, according to DPW, remained stable year-on-year, led by Berkshire Hathaway Insurance, which saw a 5.0% increase to $876.4 million. The adjusted loss ratio rose slightly to 44.3% from 43.1% a year earlier.

MAG Mutual Cos. posted the largest increase in DPW among the top 10 insurers, with a 37.0% rise to $77.4 million, moving from 10th to 7th in the rankings. The adjusted loss ratio improved significantly to 31.9% from 67.1%.

On the other hand, ProAssurance Group saw the largest decline in DPW among the top 10 companies, with an 18.3% decline to $56.8 million. Despite this, the adjusted loss ratio fell below 100%, to 94.6%, although it remained the highest among the top 10 companies.

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

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