Article

A Missouri-based assisted and skilled nursing facility engaged Captives Insure to reimagine its liability insurance program. Intent on retaining greater control over claims and underwriting profit, the organization requested a captive insurance structure able to both fulfill strict regulatory/lender requirements and maximize risk retention.​

Overview

The facility provides comprehensive care and rehabilitation services to over a thousand residents and patients. Leadership prioritized risk management, compliance, and financial resilience, seeking an insurance solution aligned with its operational philosophy: disciplined care, best practices, and long-term sustainability.​

Captive Insurance Solution Provided

• Policy Structure:
  Captives Insure structured and placed a primary General Liability and Professional Liability policy to address resident, visitor, and professional exposures, with policy limits tailored to the insureds risk tolerance and ability to satisfy contractual requirements
• Captive Retention:
  This insured retained 100% of the risk within a single parent captive. No third-party or fronting carrier risk transfer was used;​
• Deductible Structure:
  Facility management established deductibles/SIRs at levels conducive to efficient administration and financial stability, balancing claim activity with surplus protection.​

Key Features and Strategic Benefits

Enhanced Control and Customization

• The captive structure allowed leadership direct involvement in claims management, including counsel selection and negotiations, resulting in tailored risk mitigation and improved outcomes.​
• Flexible coverage terms and risk appetite adjustment were possible as facility size and resident acuity evolved.​

Financial Impact

• Retention of all liability premium directly benefited the captive’s surplus and increased the facility's net operating margin.​
• Surplus from claims improvement and prudent underwriting could be reinvested in safety, staff training, or distributed as dividends.​

Long-Term Strategic Advantages

• Facility management gained a buffer against commercial insurance market swings, ensuring predictable premium and coverage.​
• As surplus grew, strategic options expanded: adding property, auto, or cyber coverage, or distributing dividends to ownership.​

 

Feature	Details
Coverage	General Liability and Professional Liability
Captive Retention	100% of risk (no reinsurance)​
Premium Retention	+$1.1m
Key Benefits	Underwriting profit, claims control, surplus growth, premium stability
Strategic Impact	Lower cost of risk, improved risk management, financial strength

By partnering with Captives Insure, this Missouri facility realized significant value from its captive insurance program: unmatched control, transparency, and retention of all underwriting profit. This structure meets regulatory demands, maximizes operational flexibility, and positions the organization for continued long-term success.