exhibit.htm

Forward Looking Statements

This presentation contains Forward Looking Statements and other information designed
to convey our projections and expectations regarding future results. There are a number
of factors which could cause our actual results to vary materially from those projected in
this presentation. The principal risk factors that may cause these differences are
described in various documents we file with the Securities and Exchange Commission,
such as our current reports on Form 8-K, and our regular reports on Forms 10-Q and 10-
K, particularly in “Item 1A, Risk Factors.” Please review this presentation in
conjunction with a thorough reading and understanding of these risk factors.

This presentation contains Non-GAAP measures, and we may reference
Non-GAAP measures in our remarks. A reconciliation of these measures to GAAP
measures is available in our latest quarterly news release, which is available in the
Investor Relations section of our website, www.ProAssurance.com, and in
the related Current Reports on Form 8K disclosing that release.

Non-GAAP Measures

ProAssurance: Quick Facts

Market Cap: $1.7 Billion / Equity: $1.5 Billion

Fifth largest1 writer of medical liability

Writing business in 491 jurisdictions

More than 60,0002 policyholders

45,000 physicians and dentists

7,000 ancillary and other healthcare professionals

8,100 attorneys

Majority in small or solo practice

Highly rated by A. M. Best and Fitch

1 Includes PICA 2 Includes PICA and Georgia Lawyers

Recent Highlights

Completion of three significant transactions

Again recognized as one of the
50 top performing property
casualty insurance companies
by The Ward Group

Our third straight year

ProAssurance: Long-Term Success

Successful performance in a challenging financial
market and a demanding line of insurance

Maintaining profitability

Completion of three M&A transactions in 2009
that will allow us to grow the top line

ProAssurance: Long-Term Success

Our Balance Sheet remains strong

Conservative investments

Little debt

Low leverage

Solid stock performance over time

Growing organically and through M & A

Adding over $100 million in annualized premium
to our top line through M & A

Diversifying our risk profile

ProAssurance: Long-Term Success

Book Value Growth
	Cumulative	CAGR
10 year	222%	12%
5 year	127%	18%
1 year	10%	10%
Measured through Year-End 2008

Opportunities & Strategies

Key Opportunities

New insurance buyers will emerge as
healthcare reform evolves

The outcome of medical liability claims will
become more transparent

Financial issues will highlight the need for
successful, long-term companies with superior
balance sheets strength and outstanding ratings

Strategy: Targeted M & A

Significant growth in our core business

Geographical expansion

Extends our core business
Broadens our medically-related range
Geographical expansion

Adds to our lawyers’ book

Geographical expansion

Affirms our interest in this line

Strategy: Targeted M & A

Podiatry Insurance Company of America (PICA)

Dominant (70%), profitable, national company

~$96 million Direct Premium in 2008

Renewals at expected levels in 2009

$13.7 million added to PRA premium in Q2 2009

Podiatry is growing in importance as a specialty

Involved in treating complications in a population with an
increasing prevalence of diabetes

Increases our understanding of policies that are
higher volume, lower cost

With PICA We Are a National Carrier

Leveraging the benefits of our many M & A transactions
through long-term customer relationships and local
and specialty knowledge

Corporate Headquarters

Claims Offices

Claims / Underwriting Offices

PICA and/or E&S States

PICA Headquarters

(Birmingham)

(Nashville)

Strategy: Targeted M & A

Mid-Continent General Agency

Large writer of ancillary healthcare

Healthcare reform will emphasize care delivery from a
larger array of lower-cost providers

Home health care

Physician-extenders

~$26 million in total premium in 2008

$20 million healthcare related

PRA will write most of this business

$3.6 million added to PRA premium in Q2 2009

Commission derived from business we choose not to write

Strategy: We Dare to Defend

Our balance sheet strength and deep expertise
ensures our insureds have the option of an
uncompromising defense of their claim

We defend our insureds at trial more often
than any other company in our line

Provides a long-term financial and marketing
advantage

A key differentiating factor in the market
as claims data becomes public

Claims Trends Remain Favorable

Frequency trends are
stable after declining
since 2005/2006

The results is fewer
cases to try

Severity trends also stable

Trends are much the same
in states with or without
Tort Reform

ProAssurance Claims Tried

Spreading Risk is Vital

Broad geographic diversification provides an
unmatched spread of risk

Our spread of risk
provides better market
awareness and more
data points to gauge loss
trends

Our internal actuarial
depth allows us to assess
emerging trends and
respond quickly

Claims Offices

Claims / Underwriting Offices

PICA and/or E&S States

PICA Headquarters

(Birmingham)

(Nashville)

The Tort Reform Question

Obama signaled a willingness to consider limited
reforms in his recent speech to the AMA

Unlikely that Washington will provide the full
reforms physicians seek

Major decisions likely left up to each state

We set prices and reserves as if there is no tort
reform, until results reflect otherwise

We are prepared, operationally and financially, if
reforms are struck down in our states

Strategy: Respond to Transparency

Malpractice judgments/settlements now
disclosed in 17 states

Public access to the
National Practitioner
Data Bank is the
next step

Disciplinary actions
now disclosed in
almost every state

Board / Discipline / Med Mal

Med Mal disclosure
legislation proposed

Strategy: Maintain Discipline

Pricing Discipline

Using credits allows us to maintain existing
rate filings

Pricing developed using multiple years

Not unduly influenced by current market
conditions

Rates on renewing physician business down
less than 10% from peak pricing in 2006

Rate Change History

Strategy: Actuarial Conservatism

Consistent and conservative reserving
practices throughout the market cycle

Initial Accident Year Loss Ratios

2008 Industry is
A. M. Best Data
Through Q3 2008

Strategy: Actuarial Conservatism

Reserve History (billions)
2008	$ 2.4
2007	$ 2.6
2006	$ 2.6
2005	$ 2.2
2004	$ 1.8

Pricing in a Low Interest Environment

Assumes a 1:1 premium to surplus ratio for physicians professional
liability claims-made coverages

Loss ratio required
to generate a 13%
after-tax ROE

Strategy: Treated Fairly

Treated Fairly is our brand enhancement initiative

Affirms our existing, enduring commitment to
every stakeholder

Insureds

Agents

Investors

The public

We run our business as owners who are
rewarded for long-term success

Financial Highlights

2009 YTD Income Statement Highlights

in millions, except per share data

Gross Premiums Written $ 266 $ 248 7%

Net Investment Income 74 82 - 10%

Total Revenue 306 313 - 2%

Total Expenses 192 203 -5%

Operating Income $ 86 $ 83 4%

Net Income (Includes Investment Losses) $ 82 $ 79 4%

Operating Income/Diluted Share $ 2.50 $ 2.43 3%

Operating Cash Flow $ 12 $ 101 -88%

June 30, Y-OVER-Y

2009 2008 CHANGE

We have reversed the decline in premiums with new
business from PICA, Mid-Continent and Georgia Lawyers

Strategy: Enduring Financial Strength

Emphasizing an appropriate balance of risk vs. return

Committed to enduring balance sheet strength

Responding to the low interest rate environment

$ amounts
in Billions

Strategy: Use Capital Prudently

Using capital to build through M&A

Preserving capital for future opportunities

Enhancing shareholder value by repurchasing shares
at prices that build Book Value

Source: SNL Financial

Our Strong Capital/Low Leverage Position

(in millions)

Prepared for an
improving market

Prudent capital
management

Premiums to Surplus
for Each year

$ 96 (PICA pro forma)

$471

$567

Excess Capital vs. Excess Capacity

“A” Rating
Threshold

Projected A. M. Best BCAR Scores if

Premiums Increase

Surplus is Reduced

Little Dependence on Debt

Low Debt to Cap Ratio

Little strain on cash flow

$25 million debt added in
the PICA transaction

Includes $7 million in
surplus notes

Redemption expected in Q3

6/30/2009

Strategy: Balance Risk vs. Return

Reduced cash and short-term
balances in Q2

Added to fixed income and equities

Equity investments added in the
PICA transaction

CUSIP-level portfolio disclosure
on our website:
www.proassurance.com/investorrelations/supplemental.aspx

$3.8 Billion
Portfolio

Fixed Income: 89%

Short Term: 6%

Equity and Other Investments: 3%

BOLI: 2%

6/30/09

Fixed Income: $3.4 Billion

Average fixed maturity
duration: 4.2 years

Average tax-equivalent
yield: 5.5%

97.8% investment grade

Weighted average: AA

6/30/09

Summary

ProAssurance

Producing sustainable shareholder value

Growing Book Value per Share

Finding the right M & A opportunities

Significant share ownership at all levels

Focusing on long-term

Preparing for a changing market

Leveraging financial strength

Protecting the balance sheet

Maintain our leading market position

Building strength for the next cycle turn

Appendix: Market Conditions

Current Industry Status

Appendix: Claims

Why Claims Strategy Matters

Favorable
Outcomes:
82%

Five Year Average
2003 - 2007

Favorable
Outcomes:
74%

Why Claims Strategy Matters

Our ability and willingness to defend claims
allows us to achieve better results

Average Statutory Loss Ratio

81.4%

ProAssurance Stand Alone

2005 - 2007

76.0%

64.3%

Appendix: Investments

Portfolio Overview: Equities

$130 million in Equities & Other Investments

6/30/09

Equities & Other Investments

$ in 000’s

Income/Performance Q1, 2005 - Q2, 2009

Strategy: Investment Discipline

The choice: Chase yield or extend duration

We are maintaining duration, looking for opportunities

Loss in value assuming a 100 basis point shift in the yield curve

Yields based on Single A composite corporate debt

Portfolio: Municipals $1.4B

6/30/09

Portfolio: Asset Backed

$790 million Asset Backed Securities

Weighted Average Rating: AAA

Alt-A LTV: 62%

Whole Loan LTV: 57%

Further Details Provided
on Sub-Prime and CMBS
on following pages

Bloomberg Data
6/30/09

Portfolio Overview: Sub-Prime

$6.6 million market value in AFS portfolio

$5.1 million unrealized loss

$3.4 million market value in
high-yield LP rated B

LP’s focus is distressed ABS)

At 6/30/09	Vintage
$4.5 Mln	2004 & Prior
$1.9 Mln	2005
$0.3 Mln	2006

Quality & Vintage information only on direct holdings at 6/30/09

At 6/30/09	Type	Quality
$3.7 Mln	Mortgage-Backed	AA- avg - LTV 72%
$3.9 Mln	Home Equity	AA avg

Portfolio Overview: CMBS

$178 million Fair Value in non-agency CMBS

Book Value: $191 million

5% of fixed income portfolio

At 6/30/09	Quality
$176 Mln	AAA
$ 1.2 Mln	AA
$ 0.6 Mln	A

At 6/30/09	Wtd Avg LTV
48%	<65%
44%	=65%
8%	<72%

At 6/30/09	Credit Support
30%	>30%
48%	20% - 30%
20%	10% - 20%
2%	Less than 10%

At 6/30/09	Deal Cumulative Delinquencies
26%	0% - 0.5%
13%	0.5% - 1.0%
26%	1.0% - 2.0%
18%	2.0% - 3.0%
17%	>3.0%

At 6/30/09	Debt Service Coverage
73%	=>1.5x
23%	1.4x
4%	1.3x

AT
6/30/09

Portfolio Overview: CMBS

Top Property Types

Retail-Anchored: 47% of CMBS portfolio

Exposure: 19% - 42% of individual security value

Office: 32% of CMBS portfolio

Exposure: 23% - 46% of individual security value

Retail-Unanchored: 10% of CMBS portfolio

Mixed Use: 4% of CMBS portfolio

Multi Family: 4% of CMBS portfolio

Other: 3% of CMBS Portfolio

Portfolio: Corporate

6/30/09

Portfolio: Corporate-Financials

Top 20 Largest Banks/Financials: $ 258 million

$75 mm FDIC backing

BOA/ML $30 ($8)	Goldman $8 ($2)
M Stanley $27 ($6)	Eurohypo AG $8
JPM Chase $24 ($13)	NRUC $6
Amex $23 ($12)	HSBC $6 ($1)
GECC $23 ($7)	BONY $5
Wells/Wach $19	Deutsche Bank $5
Citi $18 ($7)	John Dear Cap $5 ($1)
BP Capital Fin $15	Ford Motor Credit $5
Key Bank $13 ($13)	NY Comm’ty Bank $5 ($5)
Credit Suisse $8	Depfa ACS ‘Covered’ $5
FDIC backed amounts listed in parentheses

6/30/2009

$231 million

Portfolio: Treasury/GSE

6/30/09

Portfolio: FRE and FNM

$462 million

Average Rating: AAA

6/30/09

Portfolio Overview: Short Term

$227 Million

S&P: AAA

6/30/09

$64 million

Moody’s: AA3

S&P: AA

A. M. Best: A+

6/30/09

Appendix: Industry History

Will History Repeat Itself—Again?

Source: A. M. Best Aggregates and Averages 1976 - 2001
Medical Malpractice Industry, Net Basis Occurrence and Claims-Made Combined

(Estimated)

(Actual)

Industry Data 1976 Through 2007

Appendix: Our M & A History

We Created a Leader Through Consolidation

2009: Consolidation of:
Mid-Continent General Agency

Georgia Lawyers Insurance Co.

2004: Purchased Selected Renewal Rights from:
OHIC Insurance Company

1994: Consolidation of:
West Virginia Hosp. Ins Co.

1995: Consolidation of;

Physicians Ins Co of Indiana

Assumed business of:
Physicians Ins Co of Ohio

1996: Consolidation of:

Missouri Medical Ins Co

1995: Assumed business of:
Associated Physicians Ins Co. (IL)

1998: Consolidation of:
Physicians Protective Trust Fund (FL)

1996: Assumed business of:
American Medical Ins Exchange (IN)

Founding in the 1970’s

1999: Assumed business of:
Medical Defense Associates (MO)

Mutual Assurance

Physicians Ins. Co. of Michigan

Professionals Group

Creation of:

2005: Consolidation of:
NCRIC Group

2006: Consolidation of:
PIC Wisconsin Group

2007: PRI renewal rights deal

2002: SERTA renewal rights deal

2001: OUM renewal rights deal

2000: DPM Merger

1999: PACO Acquisition

Profitable Growth Through M & A

ProAssurance has been built through M & A

ProAssurance was formed by
the combination of two
successful companies with a
history of M & A

Profitable Growth Through M & A

ProAssurance has been built through M & A

Each company brought
multiple transactions into
ProAssurance at our founding
in 2001

Profitable Growth Through M & A

ProAssurance has been built through M & A

We have continued to grow
through M & A

NCRIC in the mid-Atlantic

PIC-Wisconsin in the upper
Midwest

PICA Nationwide

Denovo Growth Also Plays a Role

We have added states as opportunities arose

We carefully evaluate the
medical and legal climate of
each state before entering

We are the market leaders in
AL, DE, DC, OH, & WI