Amwins has released its State of the Market – A Focus on the Healthcare Industry report on November 24, 2025, as part of the State of the Market 2025 series. The report explains that the healthcare insurance market continues to move through change as capacity, pricing, and coverage terms evolve across multiple sectors heading into 2026. It also shows that new entrants and surplus lines carriers are creating more options in certain areas. However, claims severity, social inflation, and regulatory pressures continue to challenge both insurers and insureds. As a result, markets remain selective for classes tied to vulnerable populations or high-severity claims, while competition stays stronger in more stable sectors.
Capacity, Pricing, and Coverage Limitations
The report describes a mixed environment across healthcare lines. Overall, the market shows both easing and selective hardening. Competitive segments such as home healthcare and some allied health classes maintain broad capacity and modest rate movement. In contrast, high-severity classes like human services face constrained capacity and significant rate increases. New surplus lines entrants are helping to expand options, yet carriers continue to apply caution in high-risk jurisdictions and for accounts serving vulnerable populations.
Allied Health Shows Softening With Targeted Constraints
According to the report, allied healthcare has softened over the past year. Rates are generally flat to single digits for standard business because new carriers entered the market and competed aggressively for new accounts. At the same time, certain exposures continue to challenge underwriters. These include correctional healthcare, hospital staffing, and inpatient facilities such as drug and alcohol treatment centers.
Carriers are limiting capacity more frequently in these areas. They are reducing excess limits from historical layers of $5 million to $10 million down to $2 million to $3 million. In some cases, carriers are not renewing excess layers at all. High-severity jurisdictions such as New York City, Philadelphia, Washington, D.C., California, New Mexico, and Florida remain under close review. The report links this scrutiny to higher litigation risk and rising professional liability claim severity. It also notes that carriers are closely underwriting sexual abuse coverage for accounts serving vulnerable populations. In addition, they are increasing attention on hired and non-owned auto exposures.
Home Healthcare Remains Highly Competitive
The report states that home healthcare and hospice continue to benefit from strong market competition. More than 60 admitted and surplus lines carriers offer primary professional liability, commercial general liability, and abuse and molestation coverage. Coverage forms tend to be broader than many competitors, especially regarding abuse and molestation limits.
Even though claims severity has increased, deep market competition keeps rate movement modest. Pricing remains the main challenge in this segment, according to the report.
Life Sciences Exposures Drive Detailed Underwriting
The report explains that life sciences remain an area of focused underwriting. Carriers are watching the risk landscape expand as emerging technologies and new business models grow. Exposures tied to AI-driven diagnostics, direct-to-consumer health technologies, and data privacy present distinct underwriting challenges. As a result, insurers are reviewing clinical trials, product development, and regulatory compliance carefully.
Capacity remains generally available, yet carriers are scrutinizing operational protocols, quality control, and risk management frameworks more closely. Coverage limitations are also becoming more specialized. For example, cyber liability and technology-driven risks may require endorsements or separate policy structures. The report adds that pricing stays competitive in lower-risk life sciences sectors but hardens where emerging liability or regulatory uncertainty appears. Carriers are monitoring potential exposure from diagnostics errors, medical device failures, and AI-driven decision-making because these issues can increase claim severity. The continued expansion of direct-to-consumer products and telehealth services also introduces operational and reputational risks that require tailored policy language.
Human and Social Services Remain the Hardest Market
The report identifies human and social services as one of the most difficult areas in healthcare liability coverage. These organizations serve vulnerable groups, including children, seniors, disabled individuals, and people in residential or foster care programs. The report explains that the hard market reflects claims brought many years after incidents occurred. These delayed claims can trigger underpriced occurrence-form policies. In addition, Abuse and Molestation liability losses, especially in youth services, are increasing volatility.
Pricing for this sector shows large swings. The report cites increases ranging from 100 percent to 800 percent or more when accounts move from admitted carriers to excess and surplus lines markets. Capacity is limited. Traditional package carriers are reducing umbrella limits or withdrawing, and excess liability often requires layered programs with lower limit deployment strategies. Coverage exclusions are also increasing. These include enforcement exclusions tied to background checks, limitations involving self-inflicted injury or elopement, and SAM sublimits.
The report links high claim severity to reviver statutes, sympathetic juries, vulnerable populations, and third-party litigation funding. It also notes that expanding service models, including youth residential programs, correctional healthcare, and telehealth exposures, add complexity. Specialized surplus lines carriers and experienced brokers support this space through layered placements. Strong submissions that describe operations, staffing, and risk management remain critical when seeking favorable terms.
Senior Care Faces Rising Loss Costs and Limited Excess Capacity
In long-term care and senior living, the report notes rising loss costs tied to social inflation, litigation funding, and operational stress. New entrants may offer aggressive pricing to gain market share. However, carriers with longer experience aim to moderate reductions because claims trends continue to worsen. Excess capacity remains limited, and some carriers are reducing limits while excluding SAM coverage on excess layers.
Coverage forms have changed in response to credit risk. The report notes greater use of lower deductibles and first-dollar structures. At the same time, insureds face pressure from declining Medicare and Medicaid reimbursements plus staffing shortages. These dynamics contribute to heightened underwriting scrutiny.
Underwriter Perspective on Current Pressures
Amwins underwriters emphasize closer evaluation across segments. In allied healthcare, they focus on inpatient and correctional staffing exposures because these remain higher risk. In human services and senior care, they require deeper analysis of abuse and molestation risk, looking at both historical losses and current operational controls.
Across all sectors, rising social inflation, nuclear verdicts, and higher claim severity are driving more review of risk management protocols, staffing practices, and loss mitigation. Underwriters are also assessing deductibles, coverage forms, and policy limits against real operational exposure. They are becoming increasingly selective about excess capacity and attachment levels.
The report notes that new market entrants may offer reduced pricing or limits, yet underwriters caution that these terms may not last because loss and litigation pressures continue. In contrast, carriers with long-term healthcare experience provide more stable pricing and stronger claims handling over time. Underwriters also stress the value of complete and detailed submissions. Loss runs, staffing data, operational narratives, and corrective action documentation help carriers understand risk and price accordingly. Structured solutions, such as layered excess and stand-alone excess placements, support challenging exposures.
Regulatory and Litigation Trends Shape Coverage
The report explains that healthcare insurance faces complex regulatory and litigation pressures, especially in California, New York, Pennsylvania, and Florida. Reviver statutes and expanded lookback periods for abuse claims increase liabilities tied to older incidents. Third-party litigation funding also affects claim severity and settlement values, which leads to higher pricing and more restrictive terms. Tort reform efforts, including recent legislation in Georgia, may offer some relief, although the report states that outcomes remain too early to measure.
Technology and AI Expand Exposure Profiles
Technology-driven services continue to expand exposure. The report highlights telehealth and remote counseling as growing areas that bring supervision gaps, cyber risks, and questions about standards of care. Life sciences tied to AI diagnostics, data privacy, and direct-to-consumer technology also require tailored underwriting and careful evaluation.
AI use is increasing across diagnostics, drug development, and clinical trial analysis. The report notes that AI tools can improve efficiency, yet they also create risk if they misinterpret data during trials. Insurers are paying close attention to how companies validate and monitor AI systems to ensure proper oversight and compliance.
Strategic Renewal Approaches for Retailers and Insureds
The report advises retailers and insureds to take proactive renewal steps. These include early engagement with brokers, strong and complete submissions, and proactive negotiation around coverage details such as abuse and molestation limits, employee definitions, incident-sensitive triggers, and defense outside limits. The report also recommends considering layered excess structures to maximize capacity while managing retention trade-offs. It emphasizes documenting risk management programs, including staff training, abuse-prevention protocols, and incident reporting.
London Market Conditions Mirror Domestic Pressures
London markets are facing similar conditions to U.S. domestic markets. The report states that rising claims and social inflation are influencing pricing, attachment points, and coverage terms. Sexual abuse and molestation claims have reached new highs, and London carriers are managing SAM limits more actively, including through standalone solutions.
Even so, London remains supportive of allied healthcare, long-term care, and hospital programs, especially for large or hard-to-place risks. Correctional healthcare and social services remain difficult. Full submissions with detailed claims histories and risk management protocols are essential to secure favorable terms.
Key Watch Points Heading Into 2026
The report highlights several areas for continued attention:
• Reduced capacity for excess and SAM coverage in human services and senior care
• Continued pricing pressure for vulnerable populations and high-severity classes
• Greater scrutiny in jurisdictions with strong litigation trends or expanded statutes of limitation
• Increased importance of proactive risk management and mitigation documentation
• Ongoing need to evaluate emerging technology and telehealth exposures for liability and cyber risk
Amwins’ State of the Market healthcare report presents a market that continues to shift as the industry moves toward 2026. Competitive capacity remains in place for segments such as home healthcare and standard allied health risks. Meanwhile, high-severity sectors like human and social services and senior care face tighter capacity, rising pricing, and more restrictive coverage terms. Across the market, regulatory change, litigation trends, and technology-driven exposures are shaping underwriting behavior. As carriers apply selectivity and new entrants compete in targeted areas, detailed submissions and proactive renewal strategies remain central themes for securing sustainable coverage.
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