Policy Claims and Other Benefits Payable - Schedule of Liability For Policy Claims and Other Benefits Payable (Details) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2019	Mar. 31, 2018
Roll Forward In Liability For Unpaid Claims And Claims Adjustment Expense [Abstract]
Policy claims and other benefits payable, beginning of period		$ 313,862	$ 307,401
Reinsured policy claims and other benefits payable, beginning of period		318,653	322,137
Net balance, beginning of period		(4,791)	(14,736)
Incurred related to current year		47,973	47,787
Incurred related to prior years	[1]	(2,095)	(2,250)
Total incurred		45,878	45,537
Claims paid related to current year, net of reinsured policy claims received		(135,225)	(143,302)
Reinsured policy claims received related to prior years, net of claims paid		13,795	23,287
Total paid		(121,430)	(120,015)
Foreign currency translation		160	(167)
Net balance, end of period		(80,183)	(89,381)
Reinsured policy claims and other benefits payable, end of period		388,605	397,700
Policy claims and other benefits payable, end of period		$ 308,422	$ 308,319

[1] Includes the difference between our estimate of claims incurred but not yet reported as of period-end and the actual incurred claims reported after period-end.