Focusing on Automation and Technology for Growth
In 2025 our main objective continues to be maintaining strict underwriting standards even if that restricts growth. The lack of growth is not sustainable over the long-term, however, and in 2025 we must stabilize the business and implement technology and automation as the basis for growth in 2026 and beyond as we seek our shorter-term profitability goals.
The medical professional liability industry is at an inflection point. Today’s market is vastly different from the MPL market we’ve known through most of our nearly 50 years of existence. Most estimates for physicians with independent practice ownership are around 25%. Many older physicians who recall our past value propositions are gone or will be soon. Groups of physicians owned by hospitals, private equity, or other entities are the norm. Larger organizations want to do business as efficiently as possible at low costs. Their goals for the purchase of insurance mostly focus on price with some secondary value placed on claims handling and risk management resources. The MPL insurance decision-maker is rarely now a named insured on the policy, creating a buyer-user gap. And today’s low frequency claims environment perversely exaggerates this buyer-user gap. As direct business fades away, brokers have a large and growing share of our distribution.
To address this market reality, we need a new value proposition for the markets we intend to serve, and we must create new competitive advantages. We need compelling new reasons for “Why accounts would want to be insured by ProAssurance?” and “Why distribution partners would want to place clients with us?” and then build our business around those answers.
Part of our vision is to become the Carrier of Choice via underwriting flexibility, product innovation, responsiveness, consistency, and excellent customer experience. Delivering on these characteristics at a lower cost and with better underwriting results requires superior technology, with full self-service channels and automation to drive down costs. Advanced analytics for decision support in underwriting improves risk selection and pricing for better underwriting results. The application of artificial intelligence to routine work can free humans to focus on higher value tasks and customer relationships.
We believe the industry’s best people with deep specialty expertise are already here. We must have systems, processes, and data that allow us to reduce costs, make better decisions, and respond faster than every other carrier. In business, the better-faster-cheaper dilemma states that a company can at most achieve two and cannot achieve all three. In past years, our plans have focused on better and to some extent faster, but we are not growing. In today’s market the surest way to grow is with lower prices, but we must be profitable. Only in the cases of a market disruption or by meeting an urgent need can we win at higher pricing.
The opportunity today is technology. In yesterday’s business model the things that made us better or faster raised costs, which were then passed on to the customer, eliminating cheaper. To reduce costs, a company had to lower quality or take more time, reducing better or cheaper, respectively. The reality of technology today, particularly for automation, data analytics, and artificial intelligence, is that many actions we can take to make us better or faster also reduce costs. We believe that technology breaks the old better-faster-cheaper model, so our goals are to be all three.
To Carrier of Choice we are adding a vision to become a technology-driven insurance operation, or “InsurTech” company, by the end of 2026. As we move into the new year, you will notice us employing many familiar strategies updated for 2025. Woven throughout those strategies is the importance of technology in becoming the type of company to survive today’s market and thrive in tomorrow’s.
I look forward to working with you in 2025 and beyond, with a focus on automation, to meet these challenges.
The Future of MPL Underwriting
As the MPL insurance landscape continues to evolve, underwriting plays a key role in driving profitability, improving efficiency, and responding to market disruptions. At ProAssurance, our underwriting team is focused on achieving goals that will strengthen our financial outcomes while positioning us and our agency partners to thrive in an ever-changing environment. We are clearly committed to the MPL space across a broad spectrum of healthcare sectors. Our primary objective is being a reliable, sustained leader in this space and your Carrier of Choice for many years to come.
This article shares with you the Underwriting department’s perspective regarding its goals and objectives for the new year, some opportunities for us to consider as partners, and potential challenges we are likely to face along the way. We appreciate your partnership and look forward to our mutual success in 2025 and beyond.
Underwriting Results
One of the chief objectives for 2025 and beyond is to continue enhancing our underwriting results in a way that drives growth for ProAssurance and our agency partners. Central to this effort is achieving strategic premium increases across our various regions. Within Underwriting, we are targeting a 9.5% renewal premium increase across the portfolio, with significant variance based upon venue, specialty/class, and account experience.
Underwriting Process Efficiencies
To meet the challenges and opportunities of an increasingly competitive environment, we must continually refine and streamline our underwriting processes. Key initiatives to enhance operational efficiency include:
- Fully automated policy renewals: By Q3 2025, we aim to have fully automated the policy renewal process for most of our small group and solo physician policies, enabling a faster and more accurate approach to managing renewals, reducing human error and increasing throughput.
- Enhanced Underwriting Workbench: Annually, and in cooperation with the IT department, we select functionality improvement items to implement in our core workflow platform, the Underwriting Workbench. Among our upcoming enhancements to the Underwriting Workbench is the integration of operational flags for better tracking and decision-making, helping underwriters identify and address issues earlier in the process.
- AI-driven submission intake process: We are working toward an AI-based submission intake process that will not only improve accuracy but also enhance timeliness and data collection. This advancement will boost our capacity for both production and servicing efforts, and reduce the time needed to quote the business, ensuring we can better meet the needs of our clients and agency partners.
While improving our bottom line is the No. 1 priority, we have both retention and new business goals that are very important. In fact, our new business goal is meaningfully larger than last year.
Maintaining a Competitive Edge
As we look toward the future, we are excited about several emerging opportunities that will enable us to maintain a competitive edge.
- Harnessing Generative AI for Efficiency and Risk Selection: The potential of generative AI in underwriting is immense. We are exploring ways to leverage these capabilities to not only streamline underwriting workflows but also refine our ability to select risk more effectively. By integrating AI into our processes, we anticipate better accuracy and more consistent outcomes, ultimately allowing us to provide competitive, sustainable pricing.
- Advancing Data Analytics: Data analytics remain a cornerstone of our underwriting strategy. By continuing to advance our use of data analytics, we can make more informed decisions regarding risk pricing, claims management, and policyholder selection. Analyzing large volumes of claims data, in combination with a variety of public and private third-party datasets and analytics technologies, allows us to identify trends early, make better underwriting decisions, and mitigate risk in ways that were previously unimaginable.
- Leveraging Market Disruptions: The MPL landscape is evolving, and we must be prepared to capitalize on disruptions, both within the admitted and E&S markets. Market shifts, new regulatory changes, and competitive threats present opportunities for carriers who are agile enough to respond swiftly and strategically. By staying ahead of these disruptions, ProAssurance can not only navigate these challenges but also position itself as an industry leader.
Despite the numerous opportunities ahead, we must remain vigilant in managing the following challenges:
| Submissions Contacts |
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Standard Physicians: Submissions@ProAssurance.com |
| Custom Physicians: CustomPhys@ProAssurance.com |
| Hospitals: Hospitals@ProAssurance.com |
| Miscellaneous Medical: MiscMedSubs@ProAssurance.com |
| Senior Care: SeniorCare@ProAssurance.com |
Competitors Advance with AI and Technology: As AI and other technological innovations continue to reshape the industry, there is a real risk that some competitors will surge ahead in terms of technological advancements. We believe that few carriers, ProAssurance among them, have a critical mass of MPL loss data to enable AI-powered analytics to be effective, so there is a real risk of irresponsible price-based competition from new entrants or smaller carriers whose AI models may be trained improperly. It’s crucial that we stay at the cutting edge of AI-driven underwriting processes to ensure we remain competitive.
Severity Trends and Erosion of Tort Reform: Severity trends, particularly in high-cost claims, continue to rise. Coupled with the ongoing erosion of tort reform in many states, this is a significant concern for MPL carriers. To maintain profitability, we must be vigilant in our risk selection and pricing practices to ensure we are adequately prepared for potential claims severity.
Unrestrained or Irrational Competition: The MPL market remains highly competitive, with some players potentially engaging in irrational pricing or risk acceptance practices. Unrestrained competition can lead to price wars that compromise underwriting discipline and market stability. We must continue to focus on underwriting profitability, even in the face of aggressive competition.
Looking Ahead
As we head into 2025 and beyond, we will continue to evolve to meet new challenges and seize emerging opportunities. By focusing on improving underwriting results, enhancing efficiencies, and leveraging advancements in AI and data analytics, we are positioning ourselves for continued success. Our innovation, focus, and breadth of product will drive our future success in partnership with you.
Claims: Challenges, Goals & Opportunities for 2025
Department Challenges
We anticipate that the challenges impacting the 2024 MPL market will continue through 2025. Challenges confronting the Claims Department include severity, tort reform erosion, and the retirement of experienced defense trial counsel and claims staff.
Goals for 2025
The Claims Department implemented and is refining a new claims document management system within SharePoint and processes to improve efficiency. Roots Automation will be used to efficiently prepare confidential file summaries and cover memos. Specific defense law firms are engaging in a pilot program involving CLARA, an AI-driven claims management platform that summarizes and tabs medical records.
Additional 2025 Goals
- Utilize high-low agreements and engage in Find Liability Early initiatives
- Incorporate Datalytics in managing defense counsel expenses
- Pursue Complex Litigation Team collaboration with PICA on coverage issues
- Finalize and distribute updated Defense Counsel Expectations, focusing on providing industry-leading customer service, expense management, technology opportunities, and reporting expectations on files
- Continued engagement in thought-leadership initiatives
- Provide education on policy forms and coverage
- Continued implementation of preferred vendor pricing to manage expenses
- Explore and implement technology, automation, and AI to improve efficiency and assist with claims predictive modeling endeavors
Department Opportunities
Claims will continue to explore and engage with new technology, automation, and AI to:
- Summarize medical records and depositions
- Support claims predictive modeling
- Improve customer service and the customer experience
- Efficiently prepare correspondence
- Conduct legal research
The team will continue to engage in thought-leadership opportunities as well as contribute to new business initiatives and the continued retention of profitable business.
POLICY VIEW
Risk Management 2025 Roadmap
As Risk Management looks to 2025, mapping out the best way to assist policyholders, agents, and internal customers is a top priority. This is a time to not only plan for opportunities and goals but to also consider influences in the market that could affect the MPL business.
Opportunities
The start of a new year allows us to turn the page and clearly outline opportunities that Risk Management wants to consider in 2025. Developing resources and offerings with strong agency and broker partners through the use of risk education and thought leadership is an opportunity the department will aim for this year. Partnering with these leaders and sharing risk management expertise add value to both current insureds and prospective accounts. Risk Management is also committed to reestablishing in-person meetings and assessments with valued insureds and agency partners.
Another opportunity Risk began in 2024 and will improve on in 2025 is Risk Management specialty-specific overviews. This new resource for agents highlights the variety of offerings for one specialty in each flyer. Connecting risk management educational offerings, industry data, as well as ProAssurance data assists both agency partners and insureds by helping them better understand the risks that come with their individual specialty.
Goals
Goal setting is important, at both an individual and corporate level, to declare a vision for the coming year. In Risk Management the aim for 2025 is to improve utilization of our Risk Management Helpline. This service should be highlighted to distinguish not just its availability but the exceptional customer service and response times associated with it. The Helpline offers the opportunity for an agent or insured to contact Risk via email or phone during regular business hours Monday through Friday, 8:00 a.m. to 5:00 p.m. local time. The goal is to increase agent utilization when an insured is faced with a risk management-related question. In collaboration, Risk can assist the insured and the agent and foster a stronger partnership through meaningful service.
In 2025 Risk will offer the Annual Baseline Self-Assessment (ABSA) as a product with updated questions and recommendations that have evolved after the first year's deployment. This service is a tailored benefit that insureds may take advantage of with ProAssurance. Risk also wants to utilize agency partners to continue the awareness campaign to increase participation and provide additional data to guide development of Risk offerings. The goal is to promote this service and provide value at scale to all ProAssurance customers across the country.
In this unique environment of excess verdicts, large settlements, and other unknowns in litigation, Risk is committed to providing an expansion to the Litigation Stress and Burnout website bundle. This offering features books, videos, and other resources that provide real-life testimonies to assist insureds when facing their own lawsuit.
Changes and Challenges
In the MPL industry there are potential challenges Risk Management wants to prepare for as the new year begins. In 2024 our department experienced significant staffing changes due to retirements. Now fully staffed, we have overcome the initial uncertainty of these changes but continue to prepare for the possibility of new adjustments and their impacts on Risk operations and service to our customers. The changes led to a number of opportunities for project leaders to emerge and helped staff members broaden their skills and areas of expertise.
Another more direct challenge for practices and clinicians from a risk management standpoint is the rise of digital forms of communication, like text messages, and how they can impact the defense of a claim. The 2025 Loss Prevention Seminar and Practice Administration Seminar will both focus on digital communication, particularly the use of text messaging.
Artificial intelligence is another area of emerging risk in the MPL space that could impact future claims, litigation, and professional liability as a whole. Technology that incorporates artificial intelligence is currently utilized for dictation and transcription at hospitals, clinics, and other medical facilities, documenting the details of patient visits and providing diagnostic and treatment summaries for medical records. The potential for error or missed information could impact the defensibility of a future claim. This tool is changing healthcare, especially for documentation, and may be a future challenge in the defense of medical malpractice lawsuits if not understood and appropriately utilized.
The excitement of new opportunities and the process of goal setting must be done with an eye on the threats that could disrupt the desired outcome. Risk is committed to providing timely, innovative, and thoughtful resources to agents and insureds, and we look forward to the start of a new year.
Marketing Outlook in 2025
Happy New Year to our agents and brokers! By the time you are reading this article I’ve emerged from the holidays totally rested, recharged, and ready to get after it in the fresh start that a new year brings us all. Here are a few things to expect from ProAssurance Marketing in 2025.
Staking Our Claim in Claims
We believe the ProAssurance value proposition is significantly different and better in the MPL industry with respect to claims handling. This view was validated in 2024 in an agency partner survey by Deep Customer Connections and in our own internal strengths, weaknesses, opportunities, and threats (SWOT) assessment. We also survey our insureds upon closure of each claim and earn high praise.
Making “Superior Claims Defense” the focus of an MPL marketing campaign, however, is difficult for two reasons. First, every carrier selling MPL insurance says they have a great defense. It’s a “table stake,” i.e., one of those things you simply must state to have a seat at the table (see also “financial strength” and “physician involvement”). The other reason is that comparisons between companies are difficult. Outside of Ohio where the reporting to the Department of Insurance has strict definitions, the statistics claimed by different carriers cannot be directly compared. The definitions and practices underpinning those statistics are different. What one carrier may call an “incident” another carrier may call a “first notice." If a carrier reports incidents that do not develop into claims as part of their “closed with no indemnity” statistic, their statistics would look better than a carrier setting a higher bar. These are just some examples of those differences.
Also, you often just see the percentage but have no knowledge of volume. Would you rather be insured by the company with a 100% trial win rate in your state or one with 90%? Well what if I told you the first tried only one case and the other tried 100 cases? We believe that our value proposition of having the strongest claims defense in the industry can be substantiated by the numbers. We believe when your prospects have more access to those numbers, ProAssurance will become their Carrier of Choice. In the coming year, you’ll see an interactive webpage letting you and your clients see our trial results, and we will ramp up social media and other channels reporting our trial-by-trial results driving traffic to that page.
Revamping the Risk Management Thought Leadership Playbook
Insurance is an odd line of business in that it’s the only product that both the buyer and the user hope does not get used. Only 2% or 3% of our insureds will have a claim and directly experience our value proposition, which is the reason they bought the product.
However, 100% of insureds can be serviced by the Risk Management team, and we hope they are! We believe that when a policyholder or insured interacts with the Risk team, they are both more likely to remain a customer and less likely to have a claim. There is a reason MPL President Rob Francis has the Marketing and Risk Management departments report up the organizational chart to the same executive: It is because we must constantly do a better job of reaching customers through risk management thought leadership.
So far, I would say we’ve done well and get a little better every year. However, in 2025 we are going to take a giant leap through a complete revamp of the communications playbook for Risk Management. All the underlying pieces, including the new website and a top-tier slate of products, are now in place so that we can and will focus on getting attention to those great products.
Happy 49th Anniversary, ProAssurance!
The founding of our ultimate predecessor company, Mutual Assurance of Alabama, was in 1976. This makes 2026 the 50th anniversary of our Company. To prepare for the five-decade milestone year, we’ll spend some time in 2025 preparing. You’ll see an event logo plus online content and related messaging in 2026. But be warned that we’ll be reaching out to some of our long-time partners for stories and memories from our first 50 years together serving the MPL market. If you already have a great story we should include, there’s no need to wait! Contact AskMarketing@ProAssurance.com to get the ball rolling.
Technology Challenges and Opportunities in the Market
While the above highlights a few initiatives on our project list for next year, it is crucial to understand what environment we expect to be marketing in during 2025. Artificial intelligence (AI) is inescapable for better and for worse. My own view is that the correct place for AI in a business like ours is to enable and empower the humans. Humans should delegate to the AI the routine tasks that are holding them back from reaching higher productivity and creativity. I fear, however, AI could flood the zone with low quality products, particularly in the content marketing world. For ProAssurance Marketing we differentiate ourselves on high quality. We will always keep a human in the loop and maintain a high level of transparency about when and how AI was used in a deliverable.
Sticking with technology, there are a significant number of technology initiatives at ProAssurance. Many will affect our distribution partners directly and most, if not all, will affect you at least indirectly. Our Comms team will do an excellent job in 2025 of information discovery and change management communication to you so that you understand what is planned, when, and why. This is to ensure that when the changes occur, you understand it and can take advantage of the benefits.
Finally, there is the opportunity to differentiate with data and advanced analytics. Now with one full year of Risk Management having deployed the ABSA at scale, we have a critical mass of data and meaningful insights. We believe this benchmarking tool can make the difference for medical practices struggling with various aspects of operational risk management. As we collect more data, we’ll keep feeding it back into the system to improve the analytics and our own ability to reduce the risk profiles of your clients. You’ll see us pushing hard to encourage insureds to participate and harder to share the many insights from which all practices can benefit.
Happy January! I look forward to a terrific year in partnership with you and, as always, if there’s any support the ProAssurance Marketing team can provide to help you win or retain more accounts, just let us know.
Inspiring Customer Loyalty: 2025 Retention Campaign Kick-Off
Prioritizing our marketing efforts to acquire and retain customers includes looking for ways to further develop relationships. Each year we offer our insureds a complimentary resource related to their field, usually a book, as part of our annual retention campaign. It’s a way to say thank you for your loyalty.
The initiative involves a series of direct mailings and emails. In the past we’ve seen great success, with reply rates of up to 25%. At the conclusion of each campaign, we measure the retention rate for those who requested the book against non-responders and have seen an up-to-10% bump for those who reply.
This year’s complimentary book is When Good Doctors Get Sued: A Practical Guide for Physicians Involved in Malpractice Lawsuits by Angela M. Dodge, PhD, with Steven F. Fitzer, JD.
According to the American Medical Association, 1 in 3 physicians will report being sued at some point during their career. This does not make them bad doctors. Regardless of the allegations against a physician, facing a lawsuit is a frightening and confusing event. Likely concerned by accusations of wrongdoing and fearful of possible repercussions, many medical professionals feel they have few places to turn for the advice and support they need during the litigation process.
When Good Doctors Get Sued is a practical guide to help physicians understand the complexities of a lawsuit, prepare for a deposition or trial, and avoid common legal pitfalls. Forewarned is forearmed, and an informed and well-prepared witness is a powerful defendant.
If you’d like to read the book yourself, email AskMarketing@ProAssurance.com letting us know your mailing address. We will provide ongoing campaign updates in future issues of ProVisions.
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You Can’t Predict the Future, But You Can Paint a Picture
During my medical sales days, I learned that doctors and other HCPs don’t respond well to abstract risks. Unless they could picture themselves in a situation needing the product I was selling, they tended to commoditize it and believe that whatever they were currently using was sufficient.
You may find it the same when discussing MPL with physicians. For example, when you say, “This coverage protects against unexpected claims,” they’re thinking, “I’ve never been sued. I’m careful.”
Here’s the thing: HCPs live in a world where they literally hold someone’s life in their hands. Abstract risks don’t move them—real scenarios do. They need stories (or case studies, as we call them in healthcare) that connect to their daily clinical realities, or as I call it in my training workshops, “Delivering the Pain” (gently and professionally, of course). Imagine if a statement such as “This coverage protects against unexpected claims ...” is followed up with a narrative like this hypothetical example:
Consider Dr. Tom Smith, a cardiologist in Denver. He’s doing a routine cardiac catheterization on a 52-year-old patient with stable angina. Despite following all the routine protocols, the patient experienced a coronary artery dissection. The symptoms were atypical; the condition was discovered later and required emergency bypass surgery. I mean, this is the type of complication you cover in the informed consent, right? (As an aside, your clients can always contact ProAssurance’s Risk Management department to address questions like these.) The patient recovers and then files a $4.2 million claim alleging delayed recognition of the complication. The case dragged on for 18 months, racking up $200,000 in defense costs. Dr. Smith’s comprehensive PMPL coverage through ProAssurance proved invaluable, covering both the defense costs and the eventual settlement. Here’s what the doctor said, “Without my policy’s full coverage limits and claims-made protection, I could have lost everything—my practice, my retirement savings, even my home. The incident taught me that even the most careful physicians can face unexpected challenges.” And that’s just one story. The state medical board right here in Florida reported that 60% of cardiologists faced at least one claim exceeding $1 million during their careers, and those with inadequate coverage often faced personal financial exposure averaging $750,000 above their policy limits. Ouch!
Doesn’t that feel more compelling than “Have you considered coverage against unexpected claims?”
Here are some tips to structure your story for sales conversations:
- Identify the core benefits of coverage and the potential nightmare scenarios it could prevent.
- Create a compelling narrative, as in the example. Use real cases (with permission) or examples from the public record. Make it relevant to their specialty—neurosurgeons don’t want to hear about a mishap involving a podiatrist.
- Paint the picture with details such as geographic location, procedure type, and patient description—allow them to recognize the similarities to their own situation.
- Present the solution. Show how ProAssurance coverage made a difference. Include specific numbers whenever possible. Don’t forget—doctors love data.
- Help them make an emotional connection (without any drama). “Doctor, can you imagine what it feels like to suddenly find yourself in this situation?”
While you can’t predict the future, you can paint a vivid picture to help prospects and clients see potential risks through the lens of real experience. Relevant stories transform abstract possibilities into tangible scenarios that resonate with their daily practice. The key is to keep your narratives concise and grounded in reality—because while predicting the future would be awesome, being prepared for its uncertainties is the next best thing.
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Written by Mace Horoff of Medical Sales Performance. Mace Horoff is a representative of Sales Pilot. He helps sales teams and individual representatives who sell medical devices, pharmaceuticals, biotechnology, healthcare services, and other healthcare-related products to sell more and earn more by employing a specialized healthcare system. Have a topic you’d like to see covered? Email your suggestions to AskMarketing@ProAssurance.com. |
