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Accident, Critical Illness & Hospital Indemnity carriers - who writes it, who owns whom, and market share
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Source: NAIC, 2024 Accident and Health Policy Experience Report (published 2025), 'Market Share by Line of Business' tables
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File in your Downloads: publication-ahp-lr-accident-health-report.pdf (313 pages). Data = 2024 calendar year, countrywide, direct premiums earned as filed on the Accident & Health Policy Experience Exhibit (AHPEE).
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WHAT IS IN HERE
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Summary - top carriers per product line, Individual + Group combined (formulas pull from the line sheets).
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Accident / Critical Illness / Hospital Indemnity - every group the NAIC lists for that line, Individual and Group segments, with premiums, loss ratio, policies, lives, market share.
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Other Group Care - the group-business grab-bag line, included only to show where group hospital indemnity hides. Not a clean market.
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Subsidiaries - the legal entities (NAIC company codes) that roll up into each group above, from the report's Group Index, with each group's share in each line.
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HOW I MAPPED YOUR THREE PRODUCTS TO NAIC LINES (my interpretation - check it)
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Accident -> "Accident Only or AD&D". NOT clean: the NAIC lumps supplemental accident (Aflac, Colonial/Unum, Allstate Benefits) with group AD&D sold alongside group life (MetLife, Securian, Hartford, Lincoln, Prudential, NY Life, Voya, Zurich). Group-segment shares are mostly AD&D. Judge each carrier by what you know it sells; the Individual segment is the cleaner read on supplemental accident.
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Critical illness -> "Specified/Named Disease". Clean-ish: this is the CI line, but cancer-only policies are reported here too and cannot be split out.
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Hospital indemnity -> "Other Medical (Non-Comprehensive)" for INDIVIDUAL business only. For GROUP business the NAIC has no such line; group hospital indemnity sits inside "Other group care" with unrelated products. So group hospital indemnity market share is NOT knowable from this report.
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THINGS THAT WILL BITE YOU IF YOU IGNORE THEM
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1. Market share is at GROUP level only for these lines. The report gives entity-level (subsidiary) premiums only for ALL A&H lines combined and only for the top 25 groups overall (UnitedHealth, CVS, etc.). There is no subsidiary-by-line breakdown anywhere in the report, so the Subsidiaries sheet tells you WHICH entities belong to Aflac/Unum/etc., not how much accident premium each entity wrote.
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2. Not the whole market. The NAIC only sees state-DOI filers. Self-insured employer plans and California DMHC-regulated plans are excluded (the report says so). For accident/CI/HI this matters less than for medical, but it is not zero.
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3. Premiums are DIRECT earned (before reinsurance). A carrier that fronts business and cedes it out still shows the full premium.
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4. Loss ratio = (incurred claims + change in contract reserves) / premiums earned. Tiny-premium rows produce absurd loss ratios; ignore those.
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5. "Sum of listed rows" can slightly exceed the reported Grand Total because filers with negative premium are counted in the total but not listed (NAIC technical note). Differences are <0.2% of the line.
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6. Group structures are a snapshot as of the report date (Sept 2025). M&A since then is not reflected.
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7. Blue text = value typed from the report. Black = formula. Green = pulled from another sheet.
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