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Kennesaw, GA – (July 7, 2025) – Tokio Marine HCC – A&H Group, a member of the Tokio Marine HCC group of companies based in Houston, Texas, has released its 2025 Annual Market Report, revealing the challenges facing US businesses in offering competitive and affordable healthcare benefits, in an environment of increasingly frequent and severe stop loss claims.
The report, which looks at TMHCC’s claims and loss ratio data, reveals the threshold that constitutes a “large claim” in medical stop loss has evolved, as what was once considered a catastrophic and rare claim has now become commonplace. This result is shown by the frequency of stop loss claims above $2 million, which are up 1,251% from their levels before the full effect of the Affordable Care Act in January 2014, which removed the cap on health benefit payments.
The percentage point increase in frequency over the years is significant at all TMHCC’s large claim thresholds, each signifying exponential growth in claims per insured. In fact, the report found that the frequency of large claims was up this past year across four key stop loss reimbursement thresholds: $200K (46 points), $500K (75 points), $1M (112 points) as well as $2M (247 points).
Other key takeaways from the report include:
Commenting on the report’s findings, Jay Ritchie, President & CEO of Tokio Marine HCC – A&H Group, said: “As one of the largest carriers in the Stop Loss market, we found 2024 to be a year of significant change. The rising frequency of claims, particularly as hospitals seek to recover financially from the pandemic, have been contributing to a hardening market. Insurers are responding with higher rates and stricter terms all while the industry adapts to new AI capabilities."
“As these trends are expected to continue throughout the remainder of 2025, TMHCC will continue demonstrating a strong underwriting discipline, selecting risks carefully and maintaining relationships across the market to deliver quality service while challenging the status quo and adapting to emerging technologies.”
Contact
David Grider, Chief Marketing Officer, TMHCC – A&H Group
[email protected]
Phone. (800)447-0460
About Tokio Marine HCC
Tokio Marine HCC is a member of the Tokio Marine Group, a premier global company founded in 1879 with a market capitalization of $74 billion as of March 31, 2025. Headquartered in Houston, Texas, Tokio Marine HCC is a leading specialty insurance group with offices in the United States, Mexico, the United Kingdom and Continental Europe. Tokio Marine HCC’s major domestic insurance companies have financial strength ratings of ‘A+’ (Strong) from S&P Global Ratings, ‘A++’ (Superior) from AM Best, and ‘AA-’ (Very Strong) from Fitch Ratings; its major international insurance companies have financial strength ratings of ‘A+’ (Strong) from S&P Global Ratings. Tokio Marine HCC is the marketing name used to describe the affiliated companies under the common ownership of HCC Insurance Holdings, Inc., a Delaware-incorporated insurance holding company. For more information about Tokio Marine HCC, please visit www.tokiomarinehcc.com.
About Tokio Marine HCC – A&H Group
For over 50 years, HCC Life Insurance Company, operating as Tokio Marine HCC – A&H Group, has been at the forefront of medical stop-loss insurance. In addition to traditional stop loss, we offer captive and Taft-Hartley stop loss solutions, level-funded stop loss, Organ & Tissue Transplant insurance and MedPlus insurance. Tokio Marine HCC – A&H Group is rated A++ (Superior) by A.M. Best Company and benefits from the financial stability of its parent company, Tokio Marine HCC.
