The reserve for losses is established based on estimates of individual claims and actuarially determined estimates of future losses based on ProAssurance’s past loss experience, available industry data and projections as to future claims frequency, severity, inflationary trends and settlement patterns. Estimating the reserve, particularly the reserve appropriate for liability exposures, is a complex process. For a high proportion of the risks insured or reinsured by ProAssurance, claims may be resolved over an extended period of time, often five years or more, and may be subject to litigation. Estimating losses requires ProAssurance to make and revise judgments and assessments regarding multiple uncertainties over an extended period of time. As a result, the reserve estimate may vary considerably from the eventual outcome. The assumptions used in establishing ProAssurance’s reserve are regularly reviewed and updated by management as new data becomes available. Changes to estimates of previously established reserves are included in earnings in the period in which the estimate is changed.

ProAssurance believes that the methods it uses to establish reserves are reasonable and appropriate. Each year, ProAssurance uses internal actuaries to review the reserve for losses of each insurance subsidiary. ProAssurance also engages consulting actuaries to review ProAssurance claims data and provide observations regarding cost trends, rate adequacy and ultimate loss costs. The statutory filings of each insurance company with the insurance regulators must be accompanied by a consulting actuary's certification as to their respective reserves. ProAssurance considers the views of the actuaries as well as other factors, such as premium rates, historical paid and incurred loss development trends and an evaluation of the current loss environment including frequency, severity, expected effect of inflation, general economic and social trends, and the legal and political environment in establishing the amount of its reserve for losses. The Company expects there will be impacts to these factors as well as to the timing of loss emergence and ultimate loss ratios for certain coverages it underwrites as a result of COVID-19 and the related economic shutdown; however, the extent to which COVID-19 impacts these factors is highly uncertain and cannot be predicted (see "Item 1A, Risk Factors" included in this report for additional information). As a result of COVID-19, the industry is experiencing new conditions, including the postponement of court cases, changes in settlement trends and a significant reduction in economic activity and insured exposure in some classes. ProAssurance's booked reserves as of December 31, 2021 include consideration of these factors, but the duration and degree to which these issues persist, along with potential legislative, regulatory or judicial actions, could result in significant changes to the Company's reserve estimates in future periods.

ProAssurance partitions its reserve by accident year, which is the year in which the claim becomes its liability. For claims-made policies, the insured event generally becomes a liability when the event is first reported to the Company. For occurrence policies, the insured event becomes a liability when the event takes place. For retroactive coverages, the insured event becomes a liability at inception of the underlying contract. As claims are incurred (reported) and claim payments are made, they are aggregated by accident year for analysis purposes. ProAssurance also partitions its reserve by reserve type: case reserves and IBNR reserves. Case reserves are established by the claims department based upon the particular circumstances of each reported claim and represent ProAssurance’s estimate of the future loss costs (often referred to as expected losses) that will be

paid on reported claims. Case reserves are decremented as claim payments are made and are periodically adjusted upward or downward as estimates regarding the amount of future losses are revised; a reported loss for an individual claim equates to the case reserve at any point in time plus the claim payments that have been made to date. IBNR reserves represent an estimate, in the aggregate, of future development on losses that have been reported to ProAssurance plus an estimate of losses that have been incurred but not reported.

The acquisition of NORCAL increased ProAssurance's net reserves by $1.1 billion which represented the fair value of NORCAL's reserve, net of the fair value of related reinsurance recoverables, at the time of acquisition including a fair value adjustment on the reserve as well as negative VOBA recorded on NORCAL's unearned premium and DDR reserve. The reserve fair value adjustment will be amortized utilizing loss payment patterns and the negative VOBAs will be amortized over a period in proportion to the earn-out of the premium or in-line with the approximate consumption of losses. Such amortization is recorded as a reduction to net losses and loss adjustment expenses. See Note 2 for more information.

In addition to setting the initial reserve for the current accident year, each period ProAssurance reassesses the amount of reserve required for prior accident years. The foundation of ProAssurance’s reserve re-estimation process is an actuarial analysis that is performed by both the internal and consulting actuaries. This detailed analysis projects ultimate losses based on partitions which include line of business, geography, coverage layer and accident year. The procedure uses the most representative data for each partition, capturing its unique patterns of development and trends. ProAssurance believes that the use of consulting actuaries provides an independent view of the loss data as well as a broader perspective on industry loss trends.

For the HCPL, Medical Technology Liability and Workers’ Compensation lines of business, the analysis performed by the consulting actuaries analyzes each partition of the business in a variety of ways and uses multiple actuarial methodologies in performing these analyses, including: Bornhuetter-Ferguson (Paid and Reported) Method, Paid Development Method, Reported (Incurred) Development Method, Average Paid Value Method and Average Reported Value Method. Generally, methods such as the Bornhuetter-Ferguson Method are used on more recent accident years where there is less data available on which to base the analysis. As time progresses and an increased amount of data is available for a given accident year, management gives more confidence to the development and average methods, as these methods typically rely more heavily on ProAssurance's own historical data. These methods emphasize different aspects of loss reserve estimation and provide a variety of perspectives for ProAssurance's decisions.

For the Workers’ Compensation line of business in both the Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance segments, ProAssurance utilizes the Reported (Incurred) Development Method, Paid Loss Development Method and Bornhuetter-Ferguson Method, to develop the reserve for each accident year. The actuarial review includes the stratification of claims data (lost time claims and medical only claims) using different variations that allow for identification of trends that may not be readily identifiable if the data was evaluated only in the aggregate. Reported and paid loss development factors are key assumptions in the reserve estimation process and are based on ProAssurance’s historical reported and paid loss development patterns. As accident years mature, the various actuarial methodologies produce more consistent loss estimates.

For the Lloyd’s Syndicates segment business, losses are initially estimated using the loss assumptions by risk category incorporated into the business plan submitted to Lloyd’s with consideration given to loss experience incurred to date. These assumptions were influenced by loss results reflected in Lloyd’s historical data for similar risks. As losses are reported and resolved and loss experience becomes more credible from a statistical perspective, actual loss experience is incorporated into the estimates.

Certain of the methodologies utilized to estimate the ultimate losses for each partition of the reserve consider the actual amounts paid. Paid data is particularly influential when a large portion of known claims have been closed, as is the case for older accident years. In selecting a point estimate for each partition, management considers the extent to which trends are emerging consistently for all partitions and known industry trends. Thus, actual, rather than estimated severity trends are given more consideration. If actual severity trends are lower than those estimated at the time that reserves were previously established, the recognition of favorable development is indicated. This is particularly true for older accident years where actuarial methodologies give more weight to actual loss costs (severity).


(In thousands)	2021		2020		2019
Balance, beginning of year	$	2,417,179	$	2,346,526	$	2,119,847
Less reinsurance recoverables on unpaid losses and loss adjustment expenses	385,087		390,708		343,820
Net balance, beginning of year	2,032,092		1,955,818		1,776,027
Net reserves acquired from acquisitions	1,089,103		—		—
Net losses:
Current year(1)(2)(3)	797,732		711,846		765,698
Favorable development of reserves established in prior years, net	(45,483)		(50,399)		(11,783)
Total	752,249		661,447		753,915
Paid related to:
Current year(4)	(109,925)		(83,204)		(115,133)
Prior years(4)	(635,320)		(501,969)		(458,991)
Total paid	(745,245)		(585,173)		(574,124)
Net balance, end of year	3,128,199		2,032,092		1,955,818
Plus reinsurance recoverables on unpaid losses and loss adjustment expenses	451,741		385,087		390,708
Balance, end of year	$	3,579,940	$	2,417,179	$	2,346,526

(1) Current year net losses for the year ended December 31, 2019 included incurred losses of $2.1 million related to a loss portfolio transfer entered into during 2019 in the Specialty P&C segment. In addition, current year net losses in 2019 included a PDR of $9.2 million associated with the unearned premium of a large national healthcare account's claims-made policy in the Specialty P&C segment. Current year net losses for the year ended December 31, 2020 included the amortization of the aforementioned $9.2 million PDR which offsets the impact of the losses incurred associated with the premium earned related to the large national healthcare account's claims-made policy.

As discussed in Note 1, estimating liability reserves is complex and requires the use of many assumptions. As time passes and ultimate losses for prior years are either known or become subject to a more precise estimation, ProAssurance increases or decreases the reserve estimates established in prior periods. The net favorable loss development recognized for the year ended December 31, 2021 primarily reflected a lower than anticipated loss emergence in the Specialty P&C segment, primarily related to the 2015 through 2020 accident years. The net favorable development recognized in the Specialty P&C segment also included $7.9 million related to the amortization of the purchase accounting fair value adjustment on NORCAL's assumed net reserve and amortization of the negative VOBA associated with NORCAL's DDR reserve which is recorded as a reduction to prior accident year net losses and loss adjustment expenses (see Note 2). ProAssurance did not recognize any development related to NORCAL's prior accident year reserves since the date of acquisition. Net favorable prior accident year reserve development recognized in the Specialty P&C segment also included a $1.0 million reduction in our IBNR reserve for COVID-19 during the third quarter of 2021. The net favorable development also reflected overall favorable trends in claim closing patterns in the Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance segments. The net favorable loss development recognized in the Workers' Compensation Insurance segment is primarily related to the 2012

The net favorable loss development recognized for the year ended December 31, 2020 primarily reflected a lower than anticipated claims severity trend (i.e., the average size of a claim) in the Specialty P&C segment, primarily related to the 2014 through 2017 accident years. The net favorable development also reflected overall favorable trends in claim closing patterns in the Segregated Portfolio Cell Reinsurance and Workers' Compensation Insurance segments. The net favorable loss development recognized in the Segregated Portfolio Cell Reinsurance segment primarily related to the 2014 through 2019 accident years and the net favorable loss development recognized in the Workers' Compensation Insurance segment primarily related to the 2014 through 2017 accident years.

The net favorable loss development recognized for the year ended December 31, 2019 primarily reflected overall favorable trends in claim closing patterns in the Workers' Compensation Insurance and Segregated Portfolio Cell Reinsurance segments, largely offset by net unfavorable loss development recognized in the Specialty P&C segment. The net favorable loss development recognized in the Workers' Compensation Insurance segment primarily related to the 2015 and 2016 accident years and the net favorable loss development recognized in the Segregated Portfolio Cell Reinsurance segment primarily related to the 2015 through 2018 accident years. The net unfavorable loss development recognized in the Specialty P&C segment primarily related to accident years 2016 through 2018. The favorable loss development recognized in 2018 primarily reflected a lower than anticipated claims severity trend for accident years 2011 through 2015.

ProAssurance establishes its reserve and manages claims activity by coverage, product or line of business and various categories of reserves have similar characteristics. Therefore, ProAssurance has aggregated these reserve categories into several reserve groups in the following disclosures and tables that provide a more meaningful view of the amount, timing and uncertainty of cash flows arising from the liability. At the same time, these reserve groups present a disaggregated view of the major elements of the overall loss reserve liability. The reserve groups include HCPL claims-made reserve, HCPL occurrence reserve, Medical Technology Liability claims-made reserve, Workers’ Compensation Insurance reserve and Segregated Portfolio Cell Reinsurance - workers' compensation reserve. All other loss reserve categories are deemed to be less homogeneous or relatively small on a standalone basis and are included in other short-duration lines in the claims development reconciliation.

HCPL claims are disaggregated into those claims covered by claims-made policies and those claims covered by occurrence policies. For claims-made policies, the insured event generally becomes a liability when the event is first reported to the insurer. For occurrence policies, the insured event becomes a liability when the event takes place, even if unknown at that time. Claims-made coverage has a short reporting pattern, with virtually all claims known shortly after the end of the policy period. Occurrence coverage claims can have an extended reporting pattern, with the time from the loss event until the filing of the claim often measured in years, at which point the claims resolution process begins. Although the resolution process and time frame is similar once a claim is reported, combining claims from claims-made and occurrence coverage types would result in distortion due to the difference in reporting lag. Medical Technology Liability reserves are grouped separately due to the nature of the risk, including the potential for mass torts and multiple claims arising out of the same product or service. The small amount of Medical Technology Liability occurrence reserves are included in other short-duration lines.

HCPL loss costs are impacted by many factors, including but not limited to the nature of the claim, including whether or not the claim is an individual or a mass tort claim, the personal situation of the claimant or the claimant's family, the outcome of jury trials, the legislative and judicial climate where any potential litigation may occur, general economic and social conditions and, for claims involving bodily injury, the trend of healthcare costs. ProAssurance sets an initial reserve based upon the evaluation of the current loss environment including frequency, severity, the expected effect of inflation, general economic and social trends, and the legal and political environment. The initial loss ratio for HCPL business has ranged from 87% to 106% in recent years and has recently trended towards the higher end of this range due to increased reserve estimates for a large national healthcare account as well as increases in loss severity in the broader HCPL industry, including our Specialty line of business.

Healthcare Professional Liability Claims-Made




Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance																					December 31, 2021
($ in thousands)	Year Ended December 31,																				IBNR*		Cumulative Number of Reported Claims
	2012		2013		2014		2015		2016		2017		2018		2019		2020		2021
Accident Year	Unaudited
2012	$	555,440	$	528,799	$	510,085	$	490,981	$	474,631	$	468,956	$	458,826	$	453,625	$	451,152	$	448,782	$	402	7,103
2013	—		$	527,520	$	513,937	$	501,580	$	489,378	$	480,036	$	466,798	$	451,182	$	455,346	457,038		$	(1,284)	7,697
2014	—		—		$	509,774	$	494,024	$	491,403	$	488,185	$	474,317	$	468,153	$	470,189	466,554		$	(373)	7,523
2015	—		—		—		$	503,412	$	486,760	$	492,824	$	491,180	$	500,336	$	500,550	503,600		$	(4,798)	7,402
2016	—		—		—		—		$	484,153	$	488,349	$	507,586	$	555,416	$	554,395	560,840		$	(11,854)	7,993
2017	—		—		—		—		—		$	508,072	$	506,207	$	577,401	$	569,737	573,570		$	(16,923)	8,054
2018	—		—		—		—		—		—		$	544,617	$	643,864	$	630,169	636,023		$	(53,325)	8,575
2019	—		—		—		—		—		—		—		$	670,958	$	664,934	642,370		$	4,919	8,443
2020	—		—		—		—		—		—		—		—		$	593,994	574,274		$	127,489	6,563
2021	—		—		—		—		—		—		—		—		—		525,363		$	345,154	4,799
Total																			$	5,388,414
* Includes expected development on reported claims


Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
(In thousands)	Year Ended December 31,
	2012		2013		2014		2015		2016		2017		2018		2019		2020		2021
Accident Year	Unaudited
2012	$	25,864	$	136,883	$	257,697	$	331,521	$	374,537	$	401,604	$	424,987	$	434,141	$	440,872	$	441,417
2013	—		$	30,214	$	142,759	$	255,605	$	328,982	$	376,930	$	398,549	$	415,012	$	430,916	435,158
2014	—		—		$	30,483	$	125,078	$	246,510	$	325,782	$	389,983	$	416,150	$	434,540	439,575
2015	—		—		—		$	26,664	$	125,234	$	256,791	$	351,703	$	410,506	$	446,069	463,224
2016	—		—		—		—		$	27,442	$	137,338	$	276,548	$	378,828	$	440,163	472,441
2017	—		—		—		—		—		$	32,342	$	147,515	$	288,695	$	351,548	419,180
2018	—		—		—		—		—		—		$	34,238	$	159,657	$	279,204	367,522
2019	—		—		—		—		—		—		—		$	37,755	$	144,225	259,889
2020	—		—		—		—		—		—		—		—		$	32,270	117,153
2021	—		—		—		—		—		—		—		—		—		23,494
Total																			3,439,053

All outstanding liabilities before 2012, net of reinsurance																			22,023
Liabilities for losses and loss adjustment expenses, net of reinsurance																			$	1,971,384




Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance																					December 31, 2021
($ in thousands)	Year Ended December 31,																				IBNR*		Cumulative Number of Reported Claims
	2012		2013		2014		2015		2016		2017		2018		2019		2020		2021
Accident Year	Unaudited
2012	$	62,214	$	61,719	$	58,234	$	51,382	$	45,602	$	44,575	$	40,676	$	36,946	$	37,300	$	37,553	$	660	597
2013	—		$	51,996	$	54,143	$	49,970	$	53,905	$	56,640	$	50,632	$	49,270	$	47,550	48,116		$	1,640	636
2014	—		—		$	45,975	$	43,606	$	44,075	$	40,699	$	37,653	$	34,428	$	33,353	35,139		$	1,290	540
2015	—		—		—		$	52,531	$	54,890	$	56,621	$	57,606	$	52,455	$	51,276	56,468		$	(2,578)	614
2016	—		—		—		—		$	56,089	$	49,795	$	53,358	$	56,345	$	66,886	64,122		$	(240)	684
2017	—		—		—		—		—		$	45,463	$	42,338	$	40,983	$	44,449	46,865		$	4,381	731
2018	—		—		—		—		—		—		$	59,351	$	61,880	$	63,576	73,599		$	7,977	692
2019	—		—		—		—		—		—		—		$	63,548	$	58,555	70,926		$	21,587	752
2020	—		—		—		—		—		—		—		—		$	165,955	178,804		$	140,975	992
2021	—		—		—		—		—		—		—		—		—		82,590		$	76,228	166
Total																			$	694,182
* Includes expected development on reported claims


Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
(In thousands)	Year Ended December 31,
	2012		2013		2014		2015		2016		2017		2018		2019		2020		2021
Accident Year	Unaudited
2012	$	480	$	3,635	$	11,445	$	17,797	$	26,830	$	30,469	$	32,384	$	33,144	$	34,373	$	34,398
2013	—		$	539	$	4,620	$	12,130	$	25,131	$	30,474	$	37,778	$	40,775	$	42,455	43,254
2014	—		—		$	512	$	4,674	$	11,192	$	17,349	$	22,649	$	25,671	$	27,753	30,407
2015	—		—		—		$	(180)	$	2,617	$	9,953	$	20,627	$	28,482	$	36,413	41,800
2016	—		—		—		—		$	44	$	2,750	$	15,433	$	28,362	$	40,766	48,691
2017	—		—		—		—		—		$	(6,631)	$	(3,385)	$	3,592	$	11,051	19,696
2018	—		—		—		—		—		—		$	444	$	6,193	$	15,229	26,932
2019	—		—		—		—		—		—		—		$	628	$	4,575	10,399
2020	—		—		—		—		—		—		—		—		$	397	6,194
2021	—		—		—		—		—		—		—		—		—		762
Total																			262,533

All outstanding liabilities before 2012, net of reinsurance																			5,202
Liabilities for losses and loss adjustment expenses, net of reinsurance																			$	436,851

The risks insured in the Medical Technology Liability line of business are more varied, and policies are individually priced based on the risk characteristics of the policy and the account. These policies often have substantial deductibles or self-insured retentions, and the insured risks range from startup operations to large multinational entities. Premiums are established using the most recently developed actuarial estimates of losses expected to be incurred based on factors which include: results from prior analysis of similar business, industry indications, observed trends and judgment. Claims in this line of business primarily involve bodily injury to individuals and are affected by factors similar to those of the HCPL line of business. For the Medical Technology Liability line of business, ProAssurance also establishes an initial reserve using a loss ratio approach, including a provision in consideration of historical loss volatility that this line of business has exhibited.




Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance																					December 31, 2021
($ in thousands)	Year Ended December 31,																				IBNR*		Cumulative Number of Reported Claims
	2012		2013		2014		2015		2016		2017		2018		2019		2020		2021
Accident Year	Unaudited
2012	$	11,162	$	9,989	$	8,906	$	7,441	$	5,824	$	4,797	$	5,051	$	3,889	$	3,868	$	3,864	$	48	223
2013	—		$	9,807	$	9,955	$	9,536	$	7,226	$	4,697	$	3,566	$	3,504	$	3,305	3,199		$	96	218
2014	—		—		$	9,989	$	10,306	$	9,012	$	8,984	$	7,679	$	6,194	$	5,888	5,636		$	406	272
2015	—		—		—		$	9,376	$	8,757	$	7,193	$	5,929	$	5,081	$	4,664	4,192		$	771	156
2016	—		—		—		—		$	9,200	$	8,467	$	7,413	$	6,422	$	6,241	4,491		$	35	182
2017	—		—		—		—		—		$	11,049	$	10,143	$	8,306	$	4,919	3,381		$	505	100
2018	—		—		—		—		—		—		$	10,141	$	8,108	$	7,506	4,961		$	1,847	218
2019	—		—		—		—		—		—		—		$	10,072	$	8,324	9,588		$	4,660	359
2020	—		—		—		—		—		—		—		—		$	11,082	10,671		$	9,279	177
2021	—		—		—		—		—		—		—		—		—		13,914		$	13,787	141
Total																			$	63,897
* Includes expected development on reported claims


Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
(In thousands)	Year Ended December 31,
	2012		2013		2014		2015		2016		2017		2018		2019		2020		2021
Accident Year	Unaudited
2012	$	568	$	1,520	$	2,805	$	3,247	$	3,366	$	3,676	$	3,800	$	3,817	$	3,817	$	3,816
2013	—		$	102	$	1,029	$	1,967	$	2,599	$	3,092	$	3,102	$	3,102	$	3,102	3,101
2014	—		—		$	388	$	1,527	$	2,564	$	3,046	$	3,724	$	3,776	$	4,074	4,076
2015	—		—		—		$	25	$	440	$	1,625	$	2,097	$	2,567	$	2,911	2,987
2016	—		—		—		—		$	53	$	1,690	$	2,365	$	2,959	$	4,295	4,342
2017	—		—		—		—		—		$	56	$	1,681	$	2,017	$	2,360	2,867
2018	—		—		—		—		—		—		$	6	$	191	$	1,850	2,651
2019	—		—		—		—		—		—		—		$	584	$	2,552	3,902
2020	—		—		—		—		—		—		—		—		$	40	526
2021	—		—		—		—		—		—		—		—		—		4
Total																			28,272

All outstanding liabilities before 2012, net of reinsurance																			99
Liabilities for losses and loss adjustment expenses, net of reinsurance																			$	35,724

Many factors affect the ultimate losses incurred for the workers' compensation coverages in the Workers' Compensation Insurance segment including, but not limited to, the type and severity of the injury, the age and occupation of the injured worker, the estimated length of disability, medical treatment and related costs, and the jurisdiction and workers' compensation laws of the injury occurrence. ProAssurance uses various actuarial methodologies in developing the workers’ compensation reserve combined with a review of the exposure base generally based upon payroll of the insured. For the current accident year, given the lack of seasoned information, the different actuarial methodologies produce results with considerable variability; therefore, more emphasis is placed on supplementing results from the actuarial methodologies with trends in exposure base, medical expense inflation, general inflation, severity, and claim counts, among other things, to select an expected loss ratio.




Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance																					December 31, 2021
($ in thousands)	Year Ended December 31,																				IBNR*		Cumulative Number of Reported Claims
	2012		2013		2014		2015		2016		2017		2018		2019		2020		2021
Accident Year	Unaudited
2012	$	80,285	$	76,551	$	75,848	$	76,357	$	75,836	$	75,576	$	75,076	$	75,076	$	75,076	$	74,776	$	236	16,205
2013	—		$	86,973	$	85,935	$	86,928	$	88,010	$	87,260	$	87,260	$	89,760	$	89,560	89,010		$	409	16,429
2014	—		—		$	93,019	$	93,529	$	93,029	$	93,029	$	93,029	$	93,029	$	91,329	90,579		$	782	16,210
2015	—		—		—		$	100,101	$	100,454	$	98,454	$	97,654	$	96,354	$	93,054	92,072		$	1,140	16,550
2016	—		—		—		—		$	101,348	$	97,348	$	92,148	$	84,799	$	82,799	81,599		$	1,182	15,978
2017	—		—		—		—		—		$	99,874	$	99,874	$	99,874	$	97,874	95,674		$	2,897	16,084
2018	—		—		—		—		—		—		$	118,095	$	118,095	$	120,095	120,095		$	327	18,013
2019	—		—		—		—		—		—		—		$	119,752	$	119,752	115,352		$	4,251	17,528
2020	—		—		—		—		—		—		—		—		$	106,145	102,475		$	5,438	14,512
2021	—		—		—		—		—		—		—		—		—		105,722		$	30,379	14,982
Total																			$	967,354
* Includes expected development on reported claims


Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
(In thousands)	Year Ended December 31,
	2012		2013		2014		2015		2016		2017		2018		2019		2020		2021
Accident Year	Unaudited
2012	$	27,448	$	56,122	$	65,908	$	70,558	$	72,766	$	73,662	$	73,676	$	73,768	$	73,851	$	73,976
2013	—		$	30,554	$	63,825	$	76,813	$	82,369	$	85,689	$	86,783	$	87,466	$	87,772	88,033
2014	—		—		$	30,368	$	65,922	$	77,631	$	85,022	$	87,314	$	87,998	$	88,487	88,977
2015	—		—		—		$	32,078	$	65,070	$	78,947	$	83,483	$	86,528	$	87,884	88,476
2016	—		—		—		—		$	28,377	$	58,192	$	69,237	$	74,886	$	76,954	77,546
2017	—		—		—		—		—		$	31,586	$	70,333	$	82,289	$	87,129	88,504
2018	—		—		—		—		—		—		$	41,619	$	86,063	$	104,216	110,928
2019	—		—		—		—		—		—		—		$	40,994	$	88,008	100,373
2020	—		—		—		—		—		—		—		—		$	33,431	74,532
2021	—		—		—		—		—		—		—		—		—		39,634
Total																			830,979

All outstanding liabilities before 2012, net of reinsurance																			12,631
Liabilities for losses and loss adjustment expenses, net of reinsurance																			$	149,006




Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance																					December 31, 2021
($ in thousands)	Year Ended December 31,																				IBNR*		Cumulative Number of Reported Claims
	2012		2013		2014		2015		2016		2017		2018		2019		2020		2021
Accident Year	Unaudited
2012	$	22,940	$	21,513	$	21,048	$	20,028	$	19,972	$	19,864	$	19,799	$	19,727	$	19,602	$	19,519	$	68	3,454
2013	—		$	23,809	$	25,310	$	26,758	$	26,619	$	26,260	$	26,033	$	25,938	$	25,546	25,450		$	9	3,723
2014	—		—		$	28,248	$	28,423	$	29,000	$	28,373	$	28,281	$	27,919	$	27,482	27,360		$	78	4,433
2015	—		—		—		$	36,423	$	32,519	$	28,746	$	27,548	$	26,720	$	26,121	25,566		$	144	4,949
2016	—		—		—		—		$	37,601	$	34,055	$	30,998	$	29,424	$	28,437	28,411		$	208	5,328
2017	—		—		—		—		—		$	42,725	$	38,594	$	34,246	$	32,879	32,763		$	389	5,707
2018	—		—		—		—		—		—		$	43,654	$	41,283	$	40,017	38,569		$	1,402	6,341
2019	—		—		—		—		—		—		—		$	48,505	$	42,345	38,815		$	2,670	6,153
2020	—		—		—		—		—		—		—		—		$	40,094	38,602		$	5,642	5,789
2021	—		—		—		—		—		—		—		—		—		39,510		$	15,591	5,062
Total																			$	314,565
* Includes expected development on reported claims


Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
(In thousands)	Year Ended December 31,
	2012		2013		2014		2015		2016		2017		2018		2019		2020		2021
Accident Year	Unaudited
2012	$	7,808	$	14,740	$	17,728	$	18,474	$	19,208	$	19,402	$	19,328	$	19,311	$	19,340	$	19,391
2013	—		$	8,131	$	19,054	$	24,268	$	25,209	$	25,366	$	25,489	$	25,440	$	25,442	25,442
2014	—		—		$	9,933	$	21,880	$	26,173	$	26,810	$	26,959	$	27,083	$	27,110	27,119
2015	—		—		—		$	11,257	$	21,706	$	23,977	$	24,781	$	25,033	$	25,125	25,144
2016	—		—		—		—		$	10,980	$	23,003	$	26,285	$	27,162	$	27,211	27,585
2017	—		—		—		—		—		$	12,404	$	24,791	$	28,853	$	31,140	31,631
2018	—		—		—		—		—		—		$	12,517	$	27,501	$	33,236	35,575
2019	—		—		—		—		—		—		—		$	15,100	$	29,604	33,314
2020	—		—		—		—		—		—		—		—		$	11,238	26,626
2021	—		—		—		—		—		—		—		—		—		12,465
Total																			264,292

All outstanding liabilities before 2012, net of reinsurance																			377
Liabilities for losses and loss adjustment expenses, net of reinsurance																			$	50,650



(In thousands)	December 31, 2021
Net outstanding liabilities
Healthcare Professional Liability claims-made	$	1,971,384
Healthcare Professional Liability occurrence	436,851
Medical Technology Liability claims-made	35,724
Workers' Compensation Insurance	149,006
Segregated Portfolio Cell Reinsurance - workers' compensation	50,650



Other short-duration lines	163,375
Liabilities for losses and loss adjustment expenses, net of reinsurance	2,806,990

Reinsurance recoverable on unpaid losses
Healthcare Professional Liability claims-made	258,528
Healthcare Professional Liability occurrence	35,324
Medical Technology Liability claims-made	31,036
Workers' Compensation Insurance	47,963
Segregated Portfolio Cell Reinsurance - Workers' Compensation	22,455



Other short-duration lines	56,435
Total reinsurance recoverable on unpaid losses and loss adjustment expenses	451,741

Reserve for the future utilization of the DDR benefit	113,246
Unallocated loss adjustment expenses	152,209
Loss portfolio transfer (1)	16,610
Purchase accounting adjustments (2)	39,186
Other	(42)
	321,209
Gross liability for losses and loss adjustment expenses	$	3,579,940
(1) Represents the reserve for retroactive coverages, net of any applicable deferred gains, related to the loss portfolio transfer entered into during 2019.
(2) Represents the remaining unamortized fair value adjustment on the net reserve for losses and loss adjustment expenses, the negative net VOBA recorded on the assumed unearned premium and negative VOBA recorded on the DDR reserve associated with our acquisition of NORCAL (see Note 2 for additional information).