Posted on 24 Sep 2015 by Neilson
Fitch Ratings has published a special report titled 'U.S. Medical Professional Liability Insurance' which is available on www.fitchratings.com.
Medical professional liability insurance (MPLI) net written premium volume for the U.S. property/casualty (P/C) industry fell for the eighth consecutive year with a 2.5% decline in 2014, reflecting changing market fundamentals and declining premium rates.
The evolution of the broader healthcare market and ample underwriting capacity in the MPLI market point toward further weakening of MPLI market fundamentals and a gradual decline in premium rates. The MPLI market continues to generate significant profits on a calendar year basis. The industry generated a calendar-year basis combined ratio of 94% in 2014, which represents a slight deterioration in performance over the past five years.
Calendar-year results in MPLI continue to benefit from substantial favorable loss reserve development that averaged 22% of annual earned premiums for the last eight years. This level is anticipated to diminish as favorable development from recent accident years, which account for the largest proportion of all MPLI reserves, has been materially lower relative to past years.
Healthcare providers are moving from independent and smaller group practices towards employment with hospitals and large medical groups. This shift is changing purchase and coverage preferences for MPLI. Large groups are more likely to self-insure and use captive or alternative risk programs, reducing demand for primary MPLI coverage.
Market share in MPLI is widely dispersed, as a large proportion of premiums are written by monoline MPLI specialists, many of which have concentrated geographic scope. Most MPLI specialists have strong capital positions and low operating leverage, but limited opportunities for business expansion due to a lack of underwriting expertise in other markets.
Acquisitions of MPLI specialists were relatively few in the last three years. Merger activity in the broader P/C market has quickened in the first half of 2015. Heightened expense pressure from a declining revenue base coupled with profit erosion from weaker underwriting results and depleted reserve redundancies could spur an expansion in MPLI transactions going forward. However, the mutual/reciprocal organization structure of many MPLI specialists reduces incentives for management to find a merger partner.