What Is a Mutual Insurance Company, and Why Should You Choose One?

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The idea of a mutually-owned insurance company is an old one. In 1752, Benjamin Franklin established America’s first mutual insurance company to cover home fires in Philadelphia. 

But what does it mean to be a “mutual"?

When medical professional liability, or malpractice, insurers describe themselves as “mutual,” they mean their policyholders mutually own the company. When you purchase a policy from a mutual medical professional liability insurance company, you receive an ownership stake in that company, similar to the way investors hold shares in a mutual fund or buy stock.

Physicians who purchase their own malpractice insurance will typically choose between policyholder-owned mutual companies or stock insurance companies, which are owned by their shareholders. Mutual insurers focus on long-term ways to serve their policyholders, who can influence the company’s direction and product offerings. Stock companies, by contrast, tend to focus on short-term financial performance for their investors. While both types of companies earn income from policy premiums and investments, stock companies can also raise capital through the sale of stocks.

Since mutual insurance companies cannot sell stocks to generate income, they maintain stricter underwriting discipline or adopt a more conservative approach to investments in order to protect the shared assets of the policyholders. This degree of fiscal responsibility creates an efficient environment, and the amount of time a claim stays open tends to shorten.  

The Purpose of Mutual Insurance Companies

Most mutual insurance companies are established to fill a gap or address a specific need in the insurance marketplace. In medical professional liability insurance, the need typically arises when increases in malpractice claims severity and/or frequency causes poorly managed insurers to exit the market. At the same time, larger carriers may stop offering medical malpractice coverage because of reduced profit potential — a cycle commonly referred to as a "hard market."

The first significant hard market for the medical malpractice industry started in the mid-1970s. During this period, many primary insurers, most of which were shareholder-owned stock companies, ceased offering coverage altogether. In response, physician groups and professional associations formed their own policyholder-owned mutual insurance companies to secure affordable and reliable malpractice insurance. Like any mutual insurers, these organizations focused on healthcare, and typically operated within a single state or geographic region.

The creation of these mutual medical professional liability insurers changed the insurance market. Some of the nation's largest medical malpractice carriers today are mutual insurers.

The Benefits of Mutual Insurance Companies

While there may be specific reasons to choose one medical professional liability insurance carrier over another that have nothing to do with the company’s structure, mutual insurers offer their policyholders some notable advantages.

• Financial Rewards: As a mutual owner of the company, you will share its success. If the company meets or exceeds its financial goals, it will often return a portion of its profits back to its policyholders in the form of dividends, similar to how a stock company pays dividends to its shareholders. You might receive your dividend as a credit against your premium payment, reducing the amount you pay, or as cashback in the form of a check. Policyholders can also benefit from free access to risk mitigation resources, like our specialty-specific risk reports that have been associated with a significant reduction in medical malpractice losses overall.
• Input: As an owner of the company, you have a voice in how it is run. Mutual insurance companies are governed by a board of directors,  elected by and sometimes even comprised of its policyholders. The board members represent the policyholders and work to ensure the company is operating in their best interests. In contrast, the board of a stock insurance company is chosen by and committed to meeting the financial goals of outside investors, whose interests may or may not align with those of the policyholders.
• Outcomes: Having an ownership stake in the company can incentivize better performance among the policyholders. Guided by their policyholder-led board of directors, mutual companies may have stronger risk management programs and stricter underwriting requirements to help reduce the likelihood of  malpractice claims. The fewer claims the company has to pay out, the higher the potential profits and the greater the potential dividend. Instead of the success of your insurer being an abstract concept, it can have a concrete impact on your bottom line.
• Focus: Mutual companies are typically established by an association or group of people with a common interest. As a result, the company will have a more focused approach to its product offerings. In the case of medical professional liability insurance, that means the carrier specifically serves the healthcare market. By limiting their area of concentration, mutuals can offer more in-depth experience, highly targeted resources and skilled support than stock companies, which often have a larger customer base and broader coverage offerings.

The Difference Between “Physician-Owned” and “Policyholder-Owned”

You might have heard some insurance companies refer to themselves as being “physician-owned,” or “doctor-owned” — but is that the same thing as being a mutual? 

Truthfully, it depends on the situation. If a company is physician-owned, it could mean any number of things: maybe the board members are physicians, or perhaps the company is owned by a group of physicians. This does not necessarily equate to a policyholder-owned mutual company, and won’t have the same products and benefits as one. 

At the end of the day, it comes down to a simple question: as a policyholder, are you an owner of the company? If not, the company isn’t a true mutual.