Who writes medical malpractice in California
Ranked by direct premium written in 2025 from the California Department of Insurance market share report (every company, not a top-N list).
35 companies wrote medical malpractice in California in 2025, $450.3M in direct premium. Doctors' Company (The), An Interinsurance Exchange, The Doctor's Management led with 42.4%; the top five hold 81%.
By Sam Alishahi, independent insurance broker · All lines in California
The companies
| # | Company | NAIC | Home state | Status here | Premium | Share |
|---|---|---|---|---|---|---|
| 1 | Doctors' Company (The), An Interinsurance Exchange, The Doctor's Management | 34495 | CA | Admitted (licensed) | $190.9M | 42.40% |
| 2 | NORCAL Insurance Company | 33200 | CA | Admitted (licensed) | $70.2M | 15.60% |
| 3 | American Casualty Company of Reading, Pennsylvania | 20427 | PA | Admitted (licensed) | $42.7M | 9.49% |
| 4 | Medical Insurance Exchange Of California | 32433 | CA | Admitted (licensed) | $31.6M | 7.01% |
| 5 | Dentists Insurance Company (The) | 40975 | CA | Admitted (licensed) | $30.7M | 6.82% |
| 6 | Medical Protective Company (The) | 11843 | IN | Admitted (licensed) | $24.0M | 5.32% |
| 7 | Ace American Insurance Company | 22667 | PA | Admitted (licensed) | $14.8M | 3.29% |
| 8 | MAG Mutual Insurance Company | 42617 | GA | Admitted (licensed) | $7.2M | 1.60% |
| 9 | ProAssurance Insurance Company of America | 14460 | IL | Admitted (licensed) | $6.9M | 1.54% |
| 10 | NCMIC Insurance Company | 15865 | IA | Admitted (licensed) | $6.3M | 1.40% |
| 11 | Liberty Insurance Underwriters, Inc. | 19917 | IL | Admitted (licensed) | $5.4M | 1.20% |
| 12 | Fair American Insurance and Reinsurance Company | 35157 | NY | Admitted (licensed) | $3.2M | 0.70% |
| 13 | ProSelect Insurance Company | 10638 | NE | Admitted (licensed) | $2.8M | 0.61% |
| 14 | TDC Specialty Insurance Company | 34487 | DC | Admitted (licensed) | $2.6M | 0.58% |
| 15 | Pharmacists Mutual Insurance Company | 13714 | IA | Admitted (licensed) | $2.3M | 0.51% |
| 16 | Berkshire Hathaway Specialty Insurance Company | 22276 | NE | Admitted (licensed) | $1.6M | 0.36% |
| 17 | Great Divide Insurance Company | 25224 | ND | Admitted (licensed) | $1.1M | 0.25% |
| 18 | Allied World Assurance Company (U.S.) Inc. | 22730 | NH | Admitted (licensed) | $1.0M | 0.23% |
| 19 | Fortress Assurance Corporation | 10801 | IL | Admitted (licensed) | $1.0M | 0.23% |
| 20 | Aspen American Insurance Company | 43460 | TX | Admitted (licensed) | $837,720 | 0.19% |
| 21 | Professional Solutions Insurance Company | 11127 | IA | Admitted (licensed) | $519,306 | 0.12% |
| 22 | Hudson Insurance Company | 25054 | DE | Admitted (licensed) | $505,699 | 0.11% |
| 23 | State Farm Fire and Casualty Company | 25143 | IL | Admitted (licensed) | $397,375 | 0.09% |
| 24 | Hartford Fire Insurance Company | 19682 | CT | Admitted (licensed) | $229,959 | 0.05% |
| 25 | Beazley Insurance Company, Inc. | 37540 | CT | Admitted (licensed) | $214,484 | 0.05% |
| 26 | Continental Casualty Company | 20443 | IL | Admitted (licensed) | $191,611 | 0.04% |
| 27 | CAMPMED CASUALTY \u0026 INDEMNITY COMPANY, INC. | 12260 | NH | Admitted (licensed) | $158,968 | 0.04% |
| 28 | Preferred Professional Insurance Company | 36234 | NE | Admitted (licensed) | $148,388 | 0.03% |
| 29 | Allied World Specialty Insurance Company | 16624 | DE | Admitted (licensed) | $130,000 | 0.03% |
| 30 | Church Mutual Insurance Company, S. I. | 18767 | WI | Admitted (licensed) | $107,205 | 0.02% |
| 31 | ProAssurance Indemnity Company, Inc. | 33391 | AL | Admitted (licensed) | $106,629 | 0.02% |
| 32 | National Union Fire Insurance Company of Pittsburgh, Pennsylvania | 19445 | PA | Admitted (licensed) | $84,384 | 0.02% |
| 33 | State Farm General Insurance Company | 25151 | IL | Admitted (licensed) | $80,343 | 0.02% |
| 34 | American Home Assurance Company | 19380 | NY | Admitted (licensed) | $74,578 | 0.02% |
| 35 | Continental Heritage Insurance Company | 39551 | FL | Admitted (licensed) | $1,500 | 0.00% |
Method and source
Source: the California Department of Insurance company list, read 2026-10-17 and the surplus lines list. California's company search lists every company on file (all lines, including some no longer active); P&C status comes from the merge. "Premium" is direct premium written in the state for the year shown; "share" is that company's part of the state total for the line. A company can be licensed for a line and write none of it, and a surplus lines insurer can write a line without a state license for it.
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