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iPMI Market Interviews

Interviews

iPMI Global Speaks with Chris Carter, CEO, ExpatInsure

The International Private Medical Insurance (IPMI) sector has long been defined by legacy giants, complex policy jargon and traditional corporate packages. As the modern expat demographic shifts towards digital nomads, independent professionals and micro-multinationals, the industry is being forced to rethink.  In this exclusive iPMI Global Interview, we sit down with Chris Carter, CEO of ExpatInsure, to discuss the company's growth, how it is using technology to strip the complexity out of buying cover, and why the model of the bloated...

18-06-2026 iPMI Global

Interviews

iPMI Global Speaks with Gitte Bach, CEO, New Frontier Group

iPMI Global, the leading business intelligence platform for the international private medical insurance (IPMI) and global assistance sectors, has officially released its latest executive round table report, titled "The Algorithmic Gatekeeper: AI and the Future of IPMI." Featuring crucial insights from New Frontier Group CEO Gitte Bach, “The Algorithmic Gatekeeper” maps the transition from manual administration to intelligent clinical navigation. A primary focal point of the round table is the critical necessity for "explainability" and human accountability as artificial intelligence begins to...

22-05-2026 iPMI Global

iPMI Market Providers

Revenues Earned Globally by MGAs, MGUs and Coverholders Grew by Around 19%

According to an updated ranking and analysis completed by Insuramore, the value of revenues earned worldwide by MGA, MGU and cover-holder groups (a.k.a. delegated underwriting authority / underwriting agency groups) was around USD 17.3 billion in 2022, signifying annual growth in this sector of around 19% before adjusting for inflation.

This is substantially ahead of the growth rate of world’s insurance broking sector which, as reported by Insuramore in a related press release on 6th June 2023, is believed to have advanced in value by almost 10.5% in 2022.

As a group, Brown & Brown was ranked first globally in this arena in 2022 having become the first group to generate more than USD 1 billion in annual revenues from this activity. It has since built on that position during 2023 through the announcement of its intended acquisition of Kentro Capital, parent company of Nexus Underwriting. In descending order, Brown & Brown is likely to have been followed from second to fifth by Truist Insurance Holdings, Amwins, Ryan Specialty Group and Gallagher, with these top five groups holding a combined market share of just under 20% of global MGA revenues.

By ownership, 54 of the top 300 groups in this space in 2022 are classifiable as broker-owned, 28 as insurerowned and the remaining 218 as independent (albeit many of these are backed by private equity firms). Among insurer-owned groups, Insuramore judges that Munich Re generated the highest revenues from proprietary MGA business in 2022 while NSM Insurance Group was the largest independent group. Furthermore, by location of headquarters, with 170 in total and benefiting from the strength of the US dollar against most other global currencies, the US played host to the most MGA groups in the top 300 in 2022 with the UK (49), the Netherlands (13), Canada (12) and Germany (10) coming next on this count.

As would be expected given the very high industry-wide growth rate, almost all MGA groups experienced an increase in their revenues in 2022 and 11 of the top 300 are believed likely by Insuramore to have more than doubled their income relative to 2021. The most rapid year-on-year growth is likely to have been achieved by Acrisure following its acquisition of both Appalachian Underwriters and Volante Global during 2022. Cyber insurance specialists such as Coalition, Envelop and Resilience also feature among the groups that more than doubled their revenues in 2022.

Worldwide, there are over 2,500 individual enterprises involved in MGA activity among which around a half are likely to have written premiums of more than USD 10 million in 2022 (www.insuramore.com/globalvista), and regular new launches appear to be sustaining this volume. Nevertheless, other significant acquisitions in this space that were in the process of being completed during the first half of 2023 included those of Envest by Ardonagh Group, BridgeForce by HUB, both Taga and Tay River Holdings by Gallagher, Acquis Insurance Management by NSM Insurance Group, Animal Friends by Pinnacle Pet Group, and Griffin Underwriting Services by Ryan Specialty Group. In addition, Amynta Group has concluded its acquisition of Ambridge from Fairfax Financial.

Definition of MGA / MGU / cover-holder revenues

MGA (managing general agency), MGU (managing general underwriter) and cover-holder revenues are defined as fees and commissions earned from underwriting / program administration (and related activities) by entities with the authority to underwrite or bind insurance (or reinsurance) risk in any class and that do this exclusively or mainly on behalf of unaffiliated carrier partners. Such entities that are insurer-owned and that are believed to place risks exclusively or mainly with parent or sister underwriters (i.e. affiliated entities) are excluded from the analysis. Revenues from wholesale or other broking / agency activities that do not meet this definition of MGA, MGU or cover-holder business are also not in scope. However, MGA, MGU and cover-holder groups that have set up their own underwriters remain in scope unless they can be said to place risks exclusively or mainly with those underwriters.

iPMI Global Network Directory

iPMI Global Launches July 2026 Global Provider Network Directory to Streamline B2B Sourcing and Glob…

14-07-2026 Network Directory iPMI Global

iPMI Global, the preeminent business intelligence resource for the international medical insurance sector, today announced the official release of the July 2026 edition of its Global Provider Network Directory. This directory serves as a mission-critical infrastructure tool for senior executives navigating the increasingly complex landscape of global B2B healthcare sourcing. Engineered to function as the definitive online B2B buyer’s guide, the directory eliminates the friction inherent in international partnership identification, providing a standardized, high-impact framework for insurers, hospitals, assistance companies, and third-party administrators (TPAs).

iPMI Global Unveils June 2026 Provider Network Directory: The Authoritative B2B Guide for Internatio…

19-06-2026 Network Directory iPMI Global

iPMI Global, the leading provider of business intelligence for the International Private Medical Insurance (iPMI) sector, today announced the launch of the June 2026 edition of its Global Provider Network Directory. Serving as the definitive online B2B buyer’s guide, this resource is engineered to streamline the identification of global partnerships for insurers, hospitals, assistance companies, and third-party administrators. In an industry where "right place, right time" care delivery is critical, iPMI Global provides a high-impact solution for industry payers looking to expand their service capabilities. The directory centralizes comprehensive company intelligence, offering a single, authoritative platform for executives to navigate the complex international healthcare ecosystem and secure seamless global reach. Discover the June 2026 iPMI Global Provider Network Directory—the definitive B2B buyer's guide for international healthcare sourcing, partnership identification, and market intelligence.

Welcome To iPMI Global

iPMI Global is the leading business intelligence provider for international private medical and expatriate healthcare insurance markets worldwide. Due to the nomadic nature of the international private medical insurance (iPMI) market, iPMI Global is an internet based business intelligence  service for worldwide insurance and medical assistance professionals, who need to understand the impacts of insurance and healthcare policy, regulatory, and legislative developments.

For the past 15 years senior level business executives, in over 120 countries, rely on iPMI Global to stay 1 step ahead of the risk and on the inside track of international private medical insurance.

Covering business travellers, high net worth individuals, expatriate and leisure travel markets, iPMI Global is the only international news source covering the most exciting sector of international health insurance: international private medical insurance.

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