In 2023, the medical professional liability (MPL) line saw a 3.6% increase in direct written premium, which reached $9 billion, according to AM Best. The premium growth was spurred on by favor pricing trends due to a firming market, according to the ratings agency. Further, the sector's net income was up 6.5% in 2023, AM Best reported. The increases were largely driven by significant gains in investment income, which was due to insurers repositioning their portfolios to take advantage of higher interest rates. However, consolidation in the health care industry is hampering demand in the sector as larger hospitals and health care groups favor self-insuring and other alternative risk transfer methods. Additional challenges facing the sector include social inflation and growing claims severity, according to Sharon Marks, director, AM Best. "But these issues are also expected to help focus and maintain the MPL segment's attention on premium adequacy, underwriting discipline and prudent reserving," Marks said in a release. The slideshow above lists the 10 largest medical professional liability carriers based on 2023 market share, according to data from the National Association of Insurance Commissioners. Related:

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