London calling: captives, claims, and reinsurance unlocked
The London insurance market remains a cornerstone for healthcare captives and reinsurance programmes, offering unparalleled expertise, innovative solutions, and a global perspective. This was the focus of the recent panel discussion, London Calling, moderated by John Sutton, chairman of the Healthcare group at Acrisure London Wholesale, alongside Chris Brooking, chief underwriting officer at Coverys London, and Alex Taylor, class underwriter at Dale Underwriting Partners.
The conversation, held at Cayman Captive Forum 2025, centred on how organisations can navigate the Lloyd’s and London markets to optimise captive structures, harness subscription reinsurance, and tackle evolving regulatory and claims challenges in 2025.
Sutton opened the discussion by emphasising the enduring strength of London as a hub for complex risk placement. Drawing on both history and modern relevance, he highlighted how the Lloyd’s market, dating back to 1688, has evolved into a global powerhouse. Today, 80 syndicates collectively write around $90 billion in premiums annually, while London-based companies like Coverys supplement this capacity, providing significant support for captives and other alternative risk structures. Sutton framed the panel’s purpose as helping clients and brokers understand how to leverage this breadth of expertise for optimal reinsurance solutions in a challenging market environment.
Chris Brooking reflected on London’s historic role in supporting captive programmes. He recalled the early 2000s when US clients faced high retentions and claims complexity, prompting the creation of captives and layered reinsurance solutions. London’s subscription market model—where multiple underwriters share risk—enabled these clients to access high limits without concentrating exposure on a single carrier. Brooking emphasised that this collaborative approach remains central to London’s value proposition, providing both financial stability and strategic flexibility for captives navigating a global healthcare landscape.
Taylor built on this by highlighting how London’s market responds to withdrawal of domestic and offshore capacity. Over the past decade, large carriers and reinsurers have retreated from certain lines, particularly in North America and Bermuda. London’s subscription model allows clients to mitigate these gaps by diversifying risk across multiple markets, maintaining coverage continuity, and optimising premium spend. For captives, this syndication model is particularly advantageous, enabling creative risk transfer solutions and tailored programme structures that may not be available in a traditional insurance market.
A defining theme of the panel was the importance of claims strategies and regulatory insight. Sutton and Brooking described the critical role of underwriting representatives—independent legal defence firms appointed in clients’ jurisdictions—to audit claims, share trends, and provide local insight. This cooperative model ensures that London underwriters support clients effectively while respecting jurisdictional expertise. Taylor emphasised that maintaining open dialogue on claims and emerging risks—ranging from cyber exposure to sexual molestation liability—is key to both risk management and captive success. By proactively understanding risk frequency and severity, underwriters and captives can design policies that are responsive yet sustainable.
Emerging risks in healthcare were also a major focus. Panelists discussed innovations such as GLP-1 therapies, AI-assisted healthcare, and international telemedicine. London underwriters leverage global insights to evaluate these risks, providing captives with guidance on regulatory compliance, cross-border licensing, and operational best practice. Taylor noted that by aggregating intelligence from diverse healthcare systems, London can help captives deploy new initiatives safely while maintaining insurance protection, demonstrating the market’s adaptability to evolving trends.
Brooking underscored the efficiency of London’s concentrated market. With hundreds of underwriters operating within the Square Mile, clients can access multiple markets, lines of business, and expert insights in a few days. This physical and operational density enhances the placement process, allowing captives to structure multi-layered reinsurance programmes, optimise capacity, and engage in strategic negotiations with ease. Sutton added that the breadth of expertise spans not just primary healthcare coverage but extends to cyber, D&O, and global liability, providing captives with comprehensive solutions under one market umbrella.
The panel repeatedly emphasised collaboration as the foundation of success in London. Taylor described how long-term relationships between underwriters, brokers, and clients allow for more nuanced conversations about risk tolerance, coverage needs, and innovative structures. Brooking highlighted that this approach reduces surprises, enabling captives to plan confidently for high-severity events and integrate emerging risks into their programmes strategically.
In conclusion, London Calling reinforced that London’s insurance market offers captives and reinsurance programmes a unique combination of capacity, expertise, and global perspective. By leveraging syndication, regulatory insight, and collaborative claims strategies, organisations can optimise reinsurance solutions, manage emerging risks, and drive captive success in 2025 and beyond. For those navigating increasingly complex healthcare markets, London remains not only a place to secure coverage but a strategic partner in risk innovation.
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