Conning and MPL Association Study Finds MPL Reinsurance Market Stabilizing as Underwriting Scrutiny Intensifies
HARTFORD, CT – August 4, 2026 – The medical professional liability (MPL) reinsurance market has entered a more stable phase following several years of disruption, but reinsurers remain highly selective, applying greater scrutiny to individual risks and program structures, according to a new study released jointly by Conning and the MPL Association.
Medical Professional Liability Reinsurance Market - From Crisis to Stability: Reinsurance Markets in Transition examines how capacity, pricing, competition, and program design are evolving as the market shifts from broad dislocation to a more disciplined underwriting environment. While most programs can be placed, renewal outcomes increasingly depend on portfolio mix, geography, attachment point, claims history, rate adequacy, and the strength of each cedant's underwriting and claims narrative.
"The market has become more discriminating than it was several years ago," said Richard Sbaschnig, a Director in Insurance Research at Conning. "Capacity remains available for well-performing programs, but reinsurers are evaluating each submission on its own merits. Underwriting quality, claims performance, data transparency, and thoughtful program design have become increasingly important differentiators at renewal."
The study identifies meaningful differences across market segments. Physician-focused portfolios generally continue to receive stronger support where underlying rates remain adequate, while hospitals, facilities, senior care, and higher layers of large towers face closer underwriting review. Pricing continues to increase, although at a more moderate pace, with stronger programs often achieving more favorable renewal outcomes.
Beyond current market conditions, the study examines broader competitive dynamics, including market size, profitability, concentration, primary insurer behavior, Lloyd’s market dynamics, and the rising impact of private equity investment in the MPL reinsurance market. It also explores how retention levels, attachment points, co-participation structures, aggregation language, and layered tower design are influencing reinsurance purchasing strategies.
Among the study's key findings:
- MPL reinsurance is becoming increasingly segmented by exposure profile and program quality.
- Credibility around rate adequacy, claims handling, and loss trends is playing a larger role in renewal discussions.
- Program structure has become a key lever for balancing cost, capacity, and volatility.
- The reinsurance market size is significantly larger than is optically apparent from a quick review of statutory filings.
- Reinsurer concentration remains a potential source of risk for future renewals.
The study concludes with recommendations on how cedants and reinsurers can best position themselves for the current environment.
For more information about Medical Professional Liability Reinsurance Market - From Crisis to Stability: Reinsurance Markets in Transition, visit is available for purchase here or contact (888) 707-1711.
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