Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Cash flows from operating activities:
Net loss	$ (15,882)	$ (31,342)
Adjustments to reconcile net loss to cash provided by (used in) operating activities:
Provision for doubtful accounts receivable	(411)	112
Share-based compensation expense	1,519	3,191
Depreciation and amortization	8,637	7,884
Amortization of deferred financing costs and debt discount / premium	2,707	495
Amortization of discount / premium on investments	2,834	3,361
(Gain) loss on sale or disposal of assets	(3,752)	887
(Income) loss from equity investees	(7,693)	3,576
Impairment of investments	3,269	2,686
Net realized / unrealized (gains) losses on investments	(368)	3,067
Loss on contingent consideration	231	0
Receipt of dividends from equity investees	917	7,214
Deferred income taxes	(4,443)	(12,311)
Annuity benefits	2,172	2,256
Other operating activities	203	112
Changes in assets and liabilities, net of acquisitions:
Accounts receivable	40,322	15,211
Recoverable from reinsurers	(644)	3,689
Other assets	(5,131)	26,879
Life, accident and health and Annuity reserves	18,219	20,914
Accounts payable and other current liabilities	16,444	(42,324)
Other liabilities	(26,374)	1,268
Cash provided by operating activities:	32,776	16,825
Cash flows from investing activities:
Purchase of property, plant and equipment	(9,413)	(6,512)
Disposal of property, plant and equipment	161	471
Purchase of investments	(56,636)	(73,606)
Sale of investments	23,073	32,765
Maturities and redemptions of investments	24,092	18,052
Purchase of equity method investments	(10,200)	0
Cash paid for business acquisitions, net of cash acquired	0	(6,469)
Other investing activities	154	172
Cash used in investing activities:	(28,769)	(35,127)
Cash flows from financing activities:
Proceeds from long-term obligations	53,655	2,360
Principal payments on long-term obligations	(40,664)	(3,156)
Annuity receipts	873	785
Annuity surrenders	(6,269)	(5,149)
Transactions with noncontrolling interests	331	2,000
Payment of dividends	(1,322)	(1,014)
Other financing activities	(117)	0
Cash provided by financing activities:	6,487	(4,174)
Effects of exchange rate changes on cash and cash equivalents	1,138	1,552
Net change in cash and cash equivalents	11,632	(20,924)
Cash and cash equivalents, beginning of period	115,371	158,624
Cash and cash equivalents, end of period	127,003	137,700
Supplemental cash flow information:
Cash paid for interest	1,456	1,465
Cash paid for taxes	264	639
Non-cash investing and financing activities:
Property, plant and equipment included in accounts payable	740	946
Investments in accounts payable	10,320	7,180
Dividends payable to shareholders	$ 563	$ 988