In our latest issue of Medical Liability Monitor, we summarize results from the first quarter of 2026 for a composite of medical professional liability (MPL) specialty writers. The data used in our analysis covers 20 years and consists of aggregate statutory financial information compiled from S&P Global Market Intelligence. The current composite includes 194 MPL specialty companies with total direct written premium of more than $8.7 billion in 2025.
Key Q1 metrics discussed include the following.
- Direct written premium: Increased 2% over Q1 2025, to $2.92 billion, reflecting a cumulative rise of nearly 40% since 2017.
- Reserves: Increased $18 million during the quarter, continuing the recent pattern of modest adverse one-year reserve development associated with prior accident years.
- Combined ratios: Held steady, at 112%, nearly unchanged from the first quarters in prior years.
- Investment income: Eased slightly, to $315 million, but still ranks as the fourth-highest Q1 level over the last 20 years.
- Surplus: Maintained strength, reaching $24.4 billion, representing a nearly 6% increase over the same period in 2025 and more than 2.5 times the $9.3 billion reported in Q1 2007, the earliest quarter included in our analysis.
This article originally appeared in Medical Liability Monitor, July 2026 Vol. 51 No. 7.
Download the full report (PDF).
The previous edition of this series can be read here.