Healthcare is a diverse industry, ranging from individual practitioners and home health nurses, to ambulatory care centers and integrated systems with revenues in the billions of dollars. The risks along that spectrum also vary widely, but the insurance marketplace for healthcare organizations has been almost uniformly tight. Several insurance companies that underwrote healthcare business for decades have withdrawn from some classes, citing high loss ratios. In their place, new sources of capacity have emerged. Historically, the presence of new entrants has signaled competition and a loosening of terms, conditions and rates. Unfortunately for insureds, that is not happening in the current marketplace. It's a challenging environment that requires retailers to approach the renewal process differently.

While the COVID-19 pandemic offered new challenges, the healthcare market was already primed to be tough in 2021. After more than 10 years of a soft market and deteriorating results, it started to turn in the latter half of 2019. Launching into the new year, significant rate and retention increases, lower limits, and more policy movement toward claims made, was expected. However, the coronavirus amplified all of these issues, and while market adjustments were sorely needed, it remains unclear how long it will take to bring the business back to profitability.

The excess casualty market faces a rough road ahead. After a difficult 2020, the market is likely to remain hard at least through 2021 and possibly into the following year. Carriers continue to reduce limits and increase premiums as they grapple with the aftereffects of underpricing in the soft market. Much of the hardening is being driven by losses in auto, and also where social inflation is leading to more so-called ‘nuclear’ verdicts. Along with auto fleets, construction, real estate, habitational and hotels stand among the more difficult markets.

As a coverage line, directors and officers liability was already hardening before the coronavirus pandemic emerged in 2020. COVID-19 has accelerated tightening in the D&O marketplace, which has become much more challenging for both public companies as well as private organizations.

At the beginning of the COVID-19 pandemic, employers moved quickly to develop and implement remote work-from-home protocols to protect employees. Almost a year since it all began, employers are starting to develop return to work plans.