Founding Companies

ProAssurance: A National Company Built with State-Specific Expertise

In 2001 two regional leaders, ProNational and Medical Assurance, merged to create ProAssurance, a highly strategic, nationally focused company. Both companies were physician-founded and had grown through judicious mergers and acquisitions with strong, like-minded companies. ProAssurance now sought similar companies in key geographic areas to achieve its goal: to become a national leader in professional liability solutions for the entire healthcare industry.  


ProNational, was previously known as Physicians Insurance Company of Michigan (PICOM). In 1980, Detroit physicians stepped up to create PICOM after the State of Michigan decided to return its temporary medical professional liability insurance source, the Brown-McNeely Fund, to the private sector. The physicians worked with an Ohio insurer to convert the state fund into a physician-owned stock insurance company that would ensure a stable source of affordable coverage for Michigan physicians, provide excellent customer service, and defend claims.

PICOM grew, adding companies in Illinois (Associated Physicians Insurance Company, 1995) and Indiana (American Medical Insurance Exchange, 1996). In 1996, PICOM established Professionals Group, a holding company. When PICOM merged with Physicians Protective Trust Fund (Florida) and became ProNational Insurance Company, it also became a subsidiary of Professionals Group. When Professionals Group merged with Medical Assurance to create ProAssurance, ProNational became ProAssurance Casualty Company—one of two equal subsidiaries with a combined total of 30,000 policyholders.

Medical Assurance, Inc.

Medical Assurance, was formerly Mutual Assurance Society of Alabama. Alabama physicians established Mutual Assurance in 1976 when the medical association’s endorsed carrier abandoned the market. From the beginning, Mutual Assurance prioritized operational stability and claims defense; it funded the first $8 million in premium through physician investments and a bank loan. In the mid-1980s Mutual Assurance demutualized and became the first physician/policyholder-founded company to begin insuring hospitals.

Mutual Assurance then began expanding outside of Alabama, acquiring the West Virginia Hospital Insurance Company (WVHIC) in 1994, Physicians Insurance Company of Indiana (PICI) in 1995, and Physicians Insurance Company of Ohio (PICO) in 1995. Mutual Assurance became MAIC Holdings in 1995, began trading on the New York Stock exchange in 1996, and added Missouri Medical Insurance Company (MOMEDICO) later that year. In 1997, the company changed its name to Medical Assurance, Inc. and acquired a second Missouri company, Medical Defense Associates, in 1999. Medical Assurance became ProAssurance Indemnity Company, Inc. when it merged with ProNational in 2001 to form ProAssurance.

NCRIC Group, Inc. (NCRIC)

NCRIC was formed by the Medical Society of the District of Columbia (Society) in 1980 to provide affordable and available coverage for Society members practicing in the District. At the time, the District had the highest cumulative average medical malpractice liability awards of any jurisdiction in the U.S. However, NCRIC attributed its success to physician governance, professional management, and customer retention made possible by the company’s focus on claims defense, risk management, and excellent service. NCRIC’s subsidiary, Commonwealth Medical Insurance Liability Company, extended coverage to Virginia, Maryland, Delaware, and West Virginia. NCRIC Group, Inc. became a 100% publicly held company in 2003 and merged into ProAssurance in 2005.

With the merger, NCRIC's stockholders received value for their investment and insureds benefited from continuity of coverage and the efficiencies, financial strength, and compatible values of ProAssurance. The merger gave ProAssurance access to the mid-Atlantic market, the expertise of NCRIC staff, and 4,600 insureds. Former NCRIC staff continue to contribute to ProAssurance’s success and NCRIC’s Washington, DC office is now a ProAssurance regional office.  

Physicians Insurance Company of Wisconsin (PIC WISCONSIN) 

PIC WISCONSIN was established to provide affordable professional liability coverage for Wisconsin Medical Society physicians in 1986, during the height of the medical professional liability crisis. Physician-founded, governed, and owned, PIC WISCONSIN grew rapidly but carefully, becoming a leading regional professional liability insurer in six Midwestern states with licenses in seven more. PIC WISCONSIN’s guiding principles of affordability, availability, and financial stability and an emphasis on responsible pricing and strong claims defense made it a natural fit with ProAssurance’s values.

ProAssurance gained 9,000 policyholders and entry into the Wisconsin, Minnesota, Nebraska, Nevada, and South Dakota markets and additional business in Illinois, Iowa, and Kansas. The 2006 merger provided liquidity for PIC WISCONSIN shareholders, and PIC WISCONSIN’s former offices and staff now provide a regional office and services for ProAssurance policyholders throughout the upper Midwest and West.

American Physicians Insurance Company (API)

API joined ProAssurance in 2010 when ProAssurance acquired API’s publicly traded parent, American Physicians Service Group, Inc.

An Austin, Texas company, API’s physician-founded roots stretch back to 1975 when it was known as American Physicians Insurance Exchange. API grew to become the second largest medical professional liability insurer in Texas and a significant presence in Arkansas and Oklahoma. ProAssurance achieved entry into the vital Texas market and added to its own business in Arkansas and Oklahoma, gaining 6,800 new policyholders. API considered ProAssurance an ideal buyer due to its financial stability, shared values, and commitment to leverage the skill and dedication of API employees to deliver an unmatched level of service to policyholders. ProAssurance now has an Austin regional office and benefits from the talents of several former API employees. 

Independent Nevada Doctors Insurance Exchange (IND)

IND was founded in 2006 as a response to the medical professional liability crisis. News reports identified Nevada as the hardest hit state with hospitals and clinics closing, no caps on damages, and many physicians facing professional liability insurance premium increases of 400% or unable to find professional liability insurance at any price. Formed as a reciprocal insurer, IND was physician-owned and professionally managed. It quickly became Nevada’s largest professional liability insurer. 

Active in Nevada since 1993 and seeking to expand westward, ProAssurance was impressed with the quality of IND’s operations and their demonstrated commitment to their physician insureds. ProAssurance, too, met IND’s criteria: financially strong, compatible values, and committed to the Nevada market. In 2012 ProAssurance acquired IND and immediately became Nevada’s top medical professional liability insurer with 6,000 new insureds and a strong base of local operations. IND rewarded its subscribers, and IND’s former Las Vegas office is now a ProAssurance regional office, specializing in claims services for our western policyholders.