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Inside Medical Liability: 2025 financial results—Capitalization levels soar despite underwriting losses

6 July 2026

In the May issue of Inside Medical Liability, a publication of the Medical Professional Liability Association, we summarize the 2025 financial results for 74 of the largest specialty writers. Using data obtained from S&P Global Market Intelligence and Milliman Datalytics-Defense, we have compiled financial metrics for the industry.

Key findings:

  • Direct written medical professional liability (MPL) premium rose 1.7% to more than $6.9 billion, its highest level since 2006.
  • Carriers released about $190 million in prior-year reserves in 2025, in line with 2024.
  • Operating ratio for the past two years is modestly better than the results posted from 2021 through 2023.
  • Policyholders’ surplus increased by roughly 5% in 2025, reaching $23.4 billion.
  • Industry surplus continues to rise despite underwriting losses reflected in combined ratios above 100%, as investment income has rebounded from the lows seen between 2020 and 2022.
  • Policyholder dividends for the composite have been relatively consistent over the past five years, averaging about $140 million annually.

Read the full article at Inside Medical Liability.

Read our previous analysis of 2024 MPL financial results.


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