AM Best has revised the outlooks to positive from stable and affirmed the Financial Strength Rating of B++ (Good) and the Long-Term Issuer Credit Ratings of “bbb+” (Good) of Kansas Medical Mutual Insurance Company and its subsidiary, KAMMCO Casualty Company, Inc. These companies are collectively referred to as Kansas Medical Mutual Group or the group.

The Credit Ratings (ratings) reflect Kansas Medical Mutual Group’s balance sheet strength, which AM Best assesses as very strong, as well as its marginal operating performance, limited business profile and appropriate enterprise risk management.

The revision of the outlooks to positive from stable reflects continued favorable trends in the group’s overall operating performance measures following corrective actions taken by management that have led to improved pre-tax operating earnings and overall net income in recent years. The improvement in operating earnings is driven by favorable trends in underwriting and operating metrics, which continue to improve compared with peers that are assessed as adequate from an operating performance standpoint.

Prospectively, AM Best expects the group’s favorable underwriting and operating trends to continue in the near-term, supported by favorable frequency and modest severity levels across the book of business. KAMMCO’s return to operating profitability is largely attributable to refocused efforts in its core insurance operations, expense management initiatives and significant rate increases over the last five years. Operating performance metrics continue to improve and are expected to trend in line with the group’s medical professional liability (MPL) peers assessed at the adequate level. The group’s investment income continued to improve through the first half of 2025, following an increase in investment yields and less interest expense on borrowed funds.

The group’s balance sheet strength assessment remains at the very strong level, supported by its strongest level of risk-adjusted capitalization, as measured by Best’s Capital Adequacy Ratio (BCAR), a conservative investment portfolio and prudent reserving philosophy. Kansas Medical Mutual Group has reported favorable surplus growth, historically driven by realized capital gains, and in more recent periods, profitable operating earnings. Loss reserve development has been favorable in nine of the past 10 calendar years and across most accident years.

The limited business profile reflects Kansas Medical Mutual Group’s market position as a primarily single state writer of MPL insurance. A 2019 judicial ruling resulted in the removal of noneconomic damage caps on personal injury cases in Kansas; however, uncertainty remains as to whether this applies to medical malpractice actions until further clarification from the Kansas Supreme Court. The group’s portfolio is subject to the Health Care Stabilization Fund (the Fund), which expanded basic coverage limits from $200,000 to $500,000 per occurrence, and $600,000 to $1.5 million in aggregate beginning in 2022. While the Fund tenders loss and loss adjustment expenses above $500,000 to $1 million, uncertainty remains as claims experience on expanded coverage limits is minimal.

This press release relates to Credit Ratings that have been published on AM Best’s website. For all rating information relating to the release and pertinent disclosures, including details of the office responsible for issuing each of the individual ratings referenced in this release, please see AM Best’s Recent Rating Activity web page. For additional information regarding the use and limitations of Credit Rating opinions, please view Guide to Best's Credit Ratings. For information on the proper use of Best’s Credit Ratings, Best’s Performance Assessments, Best’s Preliminary Credit Assessments and AM Best press releases, please view Guide to Proper Use of Best’s Ratings & Assessments.

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