Directory · Illinois · Medical malpractice
Who writes medical malpractice in Illinois
Ranked by direct premium written in 2025 from the Illinois market share report (every company, not a top-N list).
127 companies wrote medical malpractice in Illinois in 2025, $612.8M in direct premium. ISMIE Mutual Insurance Company led with 29.4%; the top five hold 48%. 184 companies are licensed for the line.
By Sam Alishahi, independent insurance broker · All lines in Illinois
Medical malpractice · Illinois
The companies
| # | Company | NAIC | Home state | Status here | Premium | Share |
|---|---|---|---|---|---|---|
| 1 | ISMIE Mutual Insurance Company | 32921 | IL | Admitted (licensed) | $179.9M | 29.36% |
| 2 | Medical Protective Company (The) | 11843 | IN | Admitted (licensed) | $44.0M | 7.18% |
| 3 | Columbia Casualty Company | 31127 | IL | Admitted (licensed) | $26.6M | 4.34% |
| 4 | NATIONAL FIRE \u0026 MARINE INSURANCE COMPANY\ | 20079 | NE | Admitted (licensed) | $23.0M | 3.75% |
| 5 | Ironshore Specialty Insurance Company | 25445 | AZ | Admitted (licensed) | $22.0M | 3.59% |
| 6 | Doctors' Company (The), An Interinsurance Exchange, The Doctor's Management | 34495 | CA | Admitted (licensed) | $18.2M | 2.97% |
| 7 | Professional Security Insurance Company | 11811 | AZ | Admitted (licensed) | $17.3M | 2.82% |
| 8 | Medical Alliance Ins Co | 11861 | IL | Admitted (licensed) | $14.1M | 2.30% |
| 9 | Professional Solutions Insurance Company | 11127 | IA | Admitted (licensed) | $11.9M | 1.94% |
| 10 | Arch Specialty Insurance Company | 21199 | MO | Admitted (licensed) | $11.2M | 1.83% |
| 11 | American Casualty Company of Reading, Pennsylvania | 20427 | PA | Admitted (licensed) | $10.6M | 1.73% |
| 12 | The Mutual Risk Retention Group, Inc. | 26257 | HI | Admitted (licensed) | $10.3M | 1.69% |
| 13 | Sunland Risk Retention Group, Inc. | 14026 | TN | Admitted (licensed) | $9.8M | 1.60% |
| 14 | Caring Communities, a Reciprocal Risk Retention Group | 12373 | DC | Admitted (licensed) | $9.4M | 1.53% |
| 15 | |Hudson Excess Insurance Company | 14484 | DE | Admitted (licensed) | $9.2M | 1.50% |
| 16 | Admiral Insurance Company | 24856 | DE | Admitted (licensed) | $8.6M | 1.40% |
| 17 | Evanston Insurance Company | 35378 | IL | Admitted (licensed) | $8.1M | 1.33% |
| 18 | ProAssurance Indemnity Company, Inc. | 33391 | AL | Admitted (licensed) | $8.1M | 1.32% |
| 19 | MAG Mutual Insurance Company | 42617 | GA | Admitted (licensed) | $7.9M | 1.30% |
| 20 | ProAssurance Specialty Insurance Company | 17400 | VT | Admitted (licensed) | $6.0M | 0.98% |
| 21 | PracticeProtection Casualty Company | 12843 | FL | Admitted (licensed) | $5.9M | 0.96% |
| 22 | Ophthalmic Mutual Insurance Company (A Risk Retention Group) | 44105 | VT | Admitted (licensed) | $5.6M | 0.92% |
| 23 | Coverys Specialty Insurance Company | 15686 | NJ | Admitted (licensed) | $5.6M | 0.92% |
| 24 | Health Care Industry Liability Reciprocal Insurance Company, A Risk Retention Group | 11832 | DC | Admitted (licensed) | $5.6M | 0.91% |
| 25 | Physicians Insurance Risk Retention Group, Inc. | 15738 | VT | Admitted (licensed) | $5.3M | 0.86% |
| 26 | General Star Indemnity Company | 37362 | DE | Admitted (licensed) | $5.0M | 0.82% |
| 27 | ProAssurance Insurance Company of America | 14460 | IL | Admitted (licensed) | $5.0M | 0.81% |
| 28 | StarStone Specialty Insurance Company | 44776 | DE | Admitted (licensed) | $4.9M | 0.80% |
| 29 | |Landmark American Insurance Company | 33138 | NH | Admitted (licensed) | $4.5M | 0.74% |
| 30 | Trinity Risk Solutions Recip Ins Co | 11958 | DC | Admitted (licensed) | $4.4M | 0.72% |
| 31 | MSIG Specialty Insurance USA Inc. | 34886 | NY | Admitted (licensed) | $4.3M | 0.71% |
| 32 | NORCAL Insurance Company | 33200 | CA | Admitted (licensed) | $4.2M | 0.68% |
| 33 | TDC Specialty Insurance Company | 34487 | DC | Admitted (licensed) | $4.1M | 0.68% |
| 34 | Vantage Risk Specialty Insurance Company | 16275 | DE | Admitted (licensed) | $4.1M | 0.67% |
| 35 | Bridgeway Insurance Company ( Formerly American Modern Surplus Lines Insurance Company | 12489 | DE | Admitted (licensed) | $3.7M | 0.61% |
| 36 | NCMIC Insurance Company | 15865 | IA | Admitted (licensed) | $3.7M | 0.60% |
| 37 | Beazley Excess and Surplus Insurance, Inc. (C) | 17520 | CT | Admitted (licensed) | $3.6M | 0.59% |
| 38 | MMIC Insurance, Inc. | 16942 | MN | Admitted (licensed) | $3.6M | 0.59% |
| 39 | Doctors Company Risk Retention Group, A Reciprocal Exchange, The | 14347 | DC | Admitted (licensed) | $3.5M | 0.57% |
| 40 | Ace American Insurance Company | 22667 | PA | Admitted (licensed) | $3.4M | 0.55% |
| 41 | Healthcare Professional Long Term Care Risk Retention Group, Inc. | 16957 | AL | Admitted (licensed) | $3.2M | 0.52% |
| 42 | Endurance American Specialty Insurance Company | 41718 | DE | Admitted (licensed) | $3.0M | 0.48% |
| 43 | Medical Liab Alliance | 10686 | MO | Admitted (licensed) | $2.9M | 0.48% |
| 44 | ISMIE Indemnity Company | 11084 | IL | Admitted (licensed) | $2.7M | 0.44% |
| 45 | Illinois Union Insurance Company | 27960 | IL | Admitted (licensed) | $2.6M | 0.42% |
| 46 | |Texas Insurance Company | 16543 | TX | Admitted (licensed) | $2.6M | 0.42% |
| 47 | Allied World Assurance Company (U.S.) Inc. | 22730 | NH | Admitted (licensed) | $2.4M | 0.39% |
| 48 | ProSelect Insurance Company | 10638 | NE | Admitted (licensed) | $2.2M | 0.36% |
| 49 | Kinsale Insurance Company | 38920 | AR | Admitted (licensed) | $2.2M | 0.36% |
| 50 | Lexington Insurance Company | 19437 | DE | Admitted (licensed) | $2.2M | 0.35% |
| 51 | Allied World Surplus Lines Insurance Company | 24319 | AR | Admitted (licensed) | $2.0M | 0.33% |
| 52 | Liberty Insurance Underwriters, Inc. | 19917 | IL | Admitted (licensed) | $1.9M | 0.32% |
| 53 | Homesite Insurance Company | 17221 | MA | Admitted (licensed) | $1.9M | 0.32% |
| 54 | QBE Specialty Insurance Company | 11515 | ND | Admitted (licensed) | $1.8M | 0.30% |
| 55 | OMS National Insurance Company | 44121 | IL | Admitted (licensed) | $1.8M | 0.29% |
| 56 | Indigo Risk Retention Group Inc. | 17484 | SC | Admitted (licensed) | $1.7M | 0.27% |
| 57 | Cincinnati Insurance Company (The) | 10677 | OH | Admitted (licensed) | $1.4M | 0.24% |
| 58 | Richmond National Insurance Company | 17103 | NH | Admitted (licensed) | $1.4M | 0.23% |
| 59 | Fair American Insurance and Reinsurance Company | 35157 | NY | Admitted (licensed) | $1.3M | 0.22% |
| 60 | Dentists Insurance Company (The) | 40975 | CA | Admitted (licensed) | $1.3M | 0.22% |
| 61 | Aspen Specialty Insurance Company | 10717 | ND | Admitted (licensed) | $1.2M | 0.20% |
| 62 | National Guardian Risk Retention Group, Inc. | 36072 | HI | Admitted (licensed) | $1.2M | 0.19% |
| 63 | Houston Specialty Insurance Company | 12936 | TX | Admitted (licensed) | $1.1M | 0.18% |
| 64 | Fortress Assurance Corporation | 10801 | IL | Admitted (licensed) | $1.0M | 0.17% |
| 65 | Lone Star Alliance, Inc., a Risk Retention Group | 15211 | DC | Admitted (licensed) | $1.0M | 0.16% |
| 66 | Continuing Care Risk Retention Group, Inc. | 11798 | VT | Admitted (licensed) | $942,590 | 0.15% |
| 67 | Risk Underwriters Group, LLC, a Risk Retention Group | 17635 | VT | Admitted (licensed) | $871,833 | 0.14% |
| 68 | Pharmacists Mutual Insurance Company | 13714 | IA | Admitted (licensed) | $861,924 | 0.14% |
| 69 | Dellwood Specialty Insurance Company | 17332 | AZ | Admitted (licensed) | $781,436 | 0.13% |
| 70 | Berkshire Hathaway Specialty Insurance Company | 22276 | NE | Admitted (licensed) | $747,732 | 0.12% |
| 71 | Great Divide Insurance Company | 25224 | ND | Admitted (licensed) | $731,440 | 0.12% |
| 72 | Medical Security Insurance Company | 33090 | NC | Admitted (licensed) | $726,824 | 0.12% |
| 73 | Aspen American Insurance Company | 43460 | TX | Admitted (licensed) | $593,985 | 0.10% |
| 74 | MS Transverse Specialty Insurance Company | 41807 | TX | Admitted (licensed) | $590,530 | 0.10% |
| 75 | Emergency Capital Management, a Risk Retention Group, LLC | 14163 | VT | Admitted (licensed) | $579,033 | 0.09% |
| 76 | Liberty Surplus Insurance Corporation | 10725 | NH | Admitted (licensed) | $535,542 | 0.09% |
| 77 | Hamilton Select Insurance, Inc. | 17178 | DE | Admitted (licensed) | $535,157 | 0.09% |
| 78 | Future Care Risk Retention Group, Inc. | 16661 | AL | Admitted (licensed) | $517,897 | 0.08% |
| 79 | Healthcare Professional Risk Retention Group, Inc. | 16383 | NC | Admitted (licensed) | $474,571 | 0.08% |
| 80 | National Union Fire Insurance Company of Pittsburgh, Pennsylvania | 19445 | PA | Admitted (licensed) | $459,029 | 0.07% |
| 81 | |Trisura Specialty Insurance Company | 16188 | OK | Admitted (licensed) | $454,719 | 0.07% |
| 82 | Allied Professionals Insurance Company, A Risk Retention Group, Inc. | 11710 | AZ | Admitted (licensed) | $417,783 | 0.07% |
| 83 | California Healthcare Insurance Company, a Risk Retention Group | 44504 | HI | Admitted (licensed) | $402,648 | 0.07% |
| 84 | Chubb Custom Insurance Company | 38989 | NJ | Admitted (licensed) | $393,798 | 0.06% |
| 85 | American Home Assurance Company | 19380 | NY | Admitted (licensed) | $369,119 | 0.06% |
| 86 | MMIC Risk Retention Group, Inc. | 14062 | DC | Admitted (licensed) | $365,610 | 0.06% |
| 87 | COPIC, a Risk Retention Group | 14906 | DC | Admitted (licensed) | $344,481 | 0.06% |
| 88 | Navigators Specialty Insurance Company | 36056 | NY | Admitted (licensed) | $339,751 | 0.06% |
| 89 | Capitol Specialty Insurance Corporation | 10328 | WI | Admitted (licensed) | $336,230 | 0.05% |
| 90 | Continental Casualty Company | 20443 | IL | Admitted (licensed) | $328,241 | 0.05% |
| 91 | Ascot Specialty Insurance Company | 45055 | RI | Admitted (licensed) | $326,906 | 0.05% |
| 92 | Preferred Professional Insurance Company | 36234 | NE | Admitted (licensed) | $309,621 | 0.05% |
| 93 | Preferred Physicians Medical Risk Retention Group, a Mutual Insurance Company | 44083 | MO | Admitted (licensed) | $306,933 | 0.05% |
| 94 | NCMIC Risk Retention Group, Inc. | 14130 | VT | Admitted (licensed) | $295,605 | 0.05% |
| 95 | Ironshore Indemnity, Inc. | 23647 | IL | Admitted (licensed) | $269,239 | 0.04% |
| 96 | Cincinnati Indemnity Company (The) | 23280 | OH | Admitted (licensed) | $266,219 | 0.04% |
| 97 | American Association of Orthodontists Insurance Company (a RRG) | 10232 | AZ | Admitted (licensed) | $257,269 | 0.04% |
| 98 | Green Hills Insurance Company, A Risk Retention Group | 11941 | VT | Admitted (licensed) | $256,629 | 0.04% |
| 99 | American Alternative Insurance Corporation | 19720 | DE | Admitted (licensed) | $246,038 | 0.04% |
| 100 | Community Blood Centers' Exchange, Risk Retention Group | 13893 | IN | Admitted (licensed) | $163,391 | 0.03% |
| 101 | ProAssurance American Mutual, A Risk Retention Group | 15647 | DC | Admitted (licensed) | $161,635 | 0.03% |
| 102 | State Farm Fire and Casualty Company | 25143 | IL | Admitted (licensed) | $160,373 | 0.03% |
| 103 | Tecumseh Hlth Recip RRG | 11692 | VT | Admitted (licensed) | $153,053 | 0.02% |
| 104 | Bold Risk Retention Group, Inc. | 17677 | AL | Admitted (licensed) | $150,970 | 0.02% |
| 105 | Hartford Fire Insurance Company | 19682 | CT | Admitted (licensed) | $118,889 | 0.02% |
| 106 | Peace Church Risk Retention Group, Inc. | 11846 | VT | Admitted (licensed) | $113,207 | 0.02% |
| 107 | Affiliates Insurance Reciprocal, a Risk Retention Group | 13677 | VT | Admitted (licensed) | $104,156 | 0.02% |
| 108 | Allied World Specialty Insurance Company | 16624 | DE | Admitted (licensed) | $89,500 | 0.01% |
| 109 | American Excess Insurance Exchange, Risk Retention Group | 10903 | VT | Admitted (licensed) | $88,189 | 0.01% |
| 110 | Beazley Insurance Company, Inc. | 37540 | CT | Admitted (licensed) | $87,172 | 0.01% |
| 111 | Cincinnati Casualty Company (The) | 28665 | OH | Admitted (licensed) | $80,220 | 0.01% |
| 112 | United Specialty Insurance Company | 12537 | TX | Admitted (licensed) | $79,576 | 0.01% |
| 113 | Berkley Assurance Company | 39462 | IA | Admitted (licensed) | $76,088 | 0.01% |
| 114 | Nautilus Insurance Company | 17370 | AZ | Admitted (licensed) | $69,129 | 0.01% |
| 115 | HealthStar Risk Retention Group, LLC | 17756 | AL | Admitted (licensed) | $68,355 | 0.01% |
| 116 | Great American Fidelity Insurance Company | 41858 | OH | Admitted (licensed) | $65,432 | 0.01% |
| 117 | Cincinnati Specialty Underwriters Insurance Company (The) | 13037 | DE | Admitted (licensed) | $60,083 | 0.01% |
| 118 | Practiceprotection Insurance Company (A Rrg) | 16189 | AL | Admitted (licensed) | $49,960 | 0.01% |
| 119 | AXIS Surplus Insurance Company | 26620 | IL | Admitted (licensed) | $46,214 | 0.01% |
| 120 | Western World Insurance Company, Inc. | 13196 | NH | Admitted (licensed) | $39,793 | 0.01% |
| 121 | Spirit Mountain Insurance Company Risk Retention Group, Inc. | 10754 | AL | Admitted (licensed) | $38,467 | 0.01% |
| 122 | Academic Medical Professionals Insurance RRG, LLC | 12934 | VT | Admitted (licensed) | $36,965 | 0.01% |
| 123 | Church Mutual Insurance Company, S. I. | 18767 | WI | Admitted (licensed) | $28,770 | 0.00% |
| 124 | NORCAL Specialty Insurance Company | 35114 | TX | Admitted (licensed) | $27,490 | 0.00% |
| 125 | Continental Insurance Company, (The) | 35289 | PA | Admitted (licensed) | $7,686 | 0.00% |
| 126 | Franklin Casualty Insurance Company, A Risk Retention Group | 10842 | VT | Admitted (licensed) | $7,000 | 0.00% |
| 127 | Ace Property and Casualty Insurance Company | 20699 | PA | Admitted (licensed) | $1,377 | 0.00% |
Method and source
Source: the Illinois insurance regulator company list, read 2026-10-18. IDOI 2025 Market Share Report: Property and Casualty (published March 2026, 2025 annual-statement data). Lists every company with Illinois business written on the P&C statement: licensed companies, surplus lines insurers and risk retention groups together, with no status/type flag, so type is '' for all rows and the list is NOT a certificate-of-authority roster (a licensed company with zero IL premium and zero losses is omitted; non-admitted writers are included). 'lines' = P&C statement lines of business the company reported IL premium or losses under (48 of 54 lines have entries), a proxy for lines of authority. No 'since' date in the source. No Illinois surplus lines eligibility list exists (IL has no white list). 26 companies had a name or domicile cell missing in at least one PDF row; filled from the same NAIC code's other rows. "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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