By Dr. David Carlson, DO
President and CEO
With a steadfast commitment to our Members nationwide, PI has built a legacy grounded in financial strength, excellent service and trusted relationships. In our 45th year, we celebrate our journey—and the future we are shaping together.
Healthcare has never been without challenges. In fact, PI was born out of challenge—created by physicians facing a difficult liability environment decades ago.
From the beginning, we understood that challenge brings clarity of purpose. Ours has been constant: to protect, defend, and our support our Members through liability issues, shifts in care delivery, evolving litigation trends, and regulatory changes. Our purpose anchors how we show up for our Members, year after year, consistently and reliably—with unwavering protection.
2025 in Review
In 2025, Physicians Insurance continued to harness tremendous resources to ensure the best possible claims and litigation outcomes for Members facing malpractice accusations. Our approach—always strategic and disciplined—has driven an impressive 92.3% public-trial win rate over the past decade. This track record underscores not only our deep expertise, but our stalwart dedication to defending good medicine.
Demand for our risk management services reached new highs in 2025. Utilization of our deep-dive risk assessments, for example, increased 63% over the year prior. We also expanded our assortment of assessment tools, added several Risk Factor webinars, and introduced robust new content on timely topics such as GLP-1 medications and workplace violence, as well as dozens of new risk management courses.
Through our Physicians Insurance Risk Retention Group (PI RRG), we continued expanding and diversifying our offerings beyond the Pacific Northwest, and now proudly serve physicians and hospitals in 38 states.
Our state and federal legislative and regulatory advocacy remained more important than ever. Once again in 2025, we worked rigorously alongside industry partners to fight tort erosion and counter legal tactics that are harmful and divisive for our Members.
Financial Results
Financial stewardship is foundational to our business and our long-term commitment to our Members, and I’m pleased to report that we achieved another year of strong financial performance in 2025. Gross written premium increased to $205 million, up from $191 million last year. We ended the year with total assets of $657 million, up from $618 million in 2024, and a policyholder surplus of $279 million. Our year-end premium-to-surplus ratio was 62%. AM Best rates our financial strength at A- (Excellent).
Our financial results also reflect our Members-first commitment. Diligent internal cost management is baked into our culture, reflected in an expense ratio of 32%—significantly below the average of our industry peers.
Looking Ahead
PI moves into the future committed to keeping our Members out ahead of the shifting challenges in healthcare—investing in services, expertise, and partnerships that benefit our Members—while maintaining our financial strength.
We will continue our journey as a Members-first, independent medical professional liability carrier, firmly grounded in the purpose that has enabled us to provide unwavering protection to Members for 45 years.
In closing, I want to thank you for the confidence you place in Physicians Insurance. Our 90.3% Member retention rate underscores the trust we have earned, and we never take it for granted.
It is a privilege to serve as your partner and to stand beside you—every day, and in the moments that matter most.