News Release


Challenges Continue for MPL Insurance Sector Despite Improvement in 2023

(Rockville, MD, May 22, 2024)—A new report issued by the MPL Association shows the medical professional liability insurance sector’s combined ratio for the industry improved from 102.4% in 2022 to 101.3% in 2023. This marks the second consecutive year of improvement in the industry’s underwriting results. While the results of 2023 represent the best performance since 2017 when the industry reported a combined ratio of 101.7%, the industry still has not generated an underwriting profit since 2013.

According to MPL Association Vice President of Research & Analytics Bill Burns, lead author of the report, “While the combined ratio for the industry improved by a little more than 1 percentage point, the improvement was due to slight changes in several areas. Specifically, there was improvement in the accident-year 2023 loss ratio, and minimal increase in the contribution of prior years’ reserve development. However, the expense ratio increased by 1 percentage point, somewhat negating the improvement in the loss experience.”

The MPL Association's publication, MPL Insurance Sector Report: 2023 Financial Results Analysis and 2024 Financial Outlook, highlights key financial metrics, including financial performance (combined ratios), premium growth, accident-year loss ratios, loss reserve changes in prior accident years, expenses, and policyholder dividends. The report also examines external factors affecting the MPL industry, specifically, social inflation, the roles of nurse practitioners and physician assistants, and the concept of "medical deserts." Additionally, the report includes comprehensive lists of the top 5 insurers by state and sector and the annual changes in direct premiums written by state and sector.

The MPL Association is hosting a webinar on May 22 at 2:00 p.m. ET, “MPL Insurance Sector Report: 2023 Financial Results Analysis and 2024 Financial Outlook.” The presentation will dive deeper into the report and provide analysis and commentary on the 2023 results and what challenges the sector may face in the year ahead. Webinar registration, as well as on-demand viewing, and the full report are available at


The MPL Association is the leading international association representing medical professional liability insurance companies, risk retention groups, captives, trusts, and other entities with a commitment to the quality delivery of healthcare. MPL Association members insure nearly 2.5 million healthcare professionals around the world—doctors, dentists, oral surgeons, nurses and nurse practitioners, podiatrists, and other healthcare providers. MPL Association members also insure more than 3,000 hospitals and 50,000 medical facilities and group practices globally.

Cassie Knapp

Vice President of Marketing & Communications


Bill Burns

Bill Burns, Vice President, Research & Analytics, MPL Association