Positive Physicians Holdings, Inc. · OTC:PPHI
Positive Physicians — Investor Presentation (September 2025)
111 slides from Positive Physicians's investor presentation, Sep 10, 2025
Slide 1: Positive Insights
Positive Insights President & CEO: Michael G. Roque September 10th 2025 850 Cassatt Road positivephysicians.com 100 Berwyn Park, Suite 220 Berwyn, PA 19312
Slide 2: Behind the Scenes at Positive Physicians
Behind the Scenes at Positive Physicians • What we built in 2024, why it matters now • The 2025 to 2026 game plan, disciplined and targeted • Continued written premium growth, improved combined ratio • 82 percent policy retention after re-underwriting actions • New statewide class plan filings, stan
Slide 3: Claims That Actually Protect Doctors
Claims That Actually Protect Doctors • 74 percent of claims close with no payment • 90 percent defense verdicts over five years • 65 percent of claims close within three years • 34 percent lower average loss payments nationwide than NPDB average
Slide 4: Where We Compete, How We Scale
Where We Compete, How We Scale Admitted Admitted States (2022) States (2025) • Dedicated physician carrier, focused by design PA PA NJ NJ • Controlled expansion only with the right partners MI MI • 16 admitted states, increase from 10 admitted states in 2022 SC SC DE DE MD MD FL FL GA GA TX TX OH OH
Slide 5: Reinsurance That Backs the Promise
Reinsurance That Backs the Promise • Retentions structured to protect capital and provide price consistency • Excess awards, clash, ECO, XPL addressed • A rated reinsurance panel, with Hannover Re as lead reinsurer (A+ A.M. Best rating)
Slide 6: Ownership Structure
Ownership Structure Positive Physicians Holdings, Inc., the holding company, has 3 investment “groups” 1. Insurance Capital Group (ICG), 63% • Matthew T. Popoli, Partner and Global Head of Bain Capital Insurance 2. Enstar Holdings (US) LLC (Enstar), 27% 3. Other shareholders, 10% ICG Enstar Other (6
Slide 7: Financial Highlights – 2024
Financial Highlights – 2024 • Improved combined ratio, profitability and stabilized surplus • Continued Direct Written Premium growth - 6% in 2024 • Significant wins in PA and NJ • 32% growth since 2021 under new management team
Slide 8: Financial Highlights – 2024, continued
Financial Highlights – 2024, continued • Balance sheet strength with approximately $100 million in cash and investment grade invested assets
Slide 9: The Discipline Edge
The Discipline Edge • Expense ratio target, goal to be under 30 percent by 2027 • Playbook: standardize, automate, eliminate • Profit before presence: markets we enter must be profitable
Slide 10: Product, Data, and Tools Your Agencies Can Use
Product, Data, and Tools Your Agencies Can Use • Data collection, risk analysis, already in production • Simple, field-ready deliverables for producers and insureds • Mobile experience and 2026 enhancements
Slide 11: What We Are Watching, And Why
What We Are Watching, And Why • The MPL landscape is diverse by segment, one size does not fit all • Expense pressure persists across the market, rates inch up unevenly • Our answer: stay in our lane, price to trend, and protect severity layers • Physician consolidation and employment shifts • Frequ
Slide 12: Our 2025 to 2026 Plan, Simple and Relentless
Our 2025 to 2026 Plan, Simple and Relentless • Underwrite to margin, not to a number • Expand only with partners who share discipline • Invest in claims excellence, data, and producer-ready tools • Hold the expense line, progress towards under 30 percent target
Slide 13: What Partners Get From Positive
What Partners Get From Positive • Consistent appetite and improved pricing logic • Clear processes, faster answers, fewer surprises • Access to leadership that actually decides • You matter. We care. We’ll be there when you need us.
Slide 14: Thank You!
Thank You! POSITIVE PHYSICIANS INSURANCE COMPANY™
Slide 15: Claims and Risk Management
Claims and Risk Management Presented by Cobie Buchman and Pauline Budd September 10, 2025 850 Cassatt Road positivephysicians.com 100 Berwyn Park, Suite 220 Berwyn, PA 19312
Slide 16: Who We Are
Who We Are • Average tenure in medical malpractice 25 years • Experience in 47 states, PR and Canada • Large company expertise with small company service • True claims handling, team approach • Only work with heavy-hitting trial attorneys • Ease of doing business
Slide 17: Claims Trends
Claims Trends • Trial backlog continues to clear in PA • Frequency may be leveling off; severity continues to rise • Private equity and impact on patient care • Physician strain and communication issues • Under-resourced and overused surgery centers • Increased interest in arbitration
Slide 18: Somerlot Case
Somerlot Case PA’s Supreme Court enabled venue shopping in 2023 Rule implemented in late 1990s was successful – filings, rates and payouts decreased. Plaintiff attorneys were not happy. The reversal has been predictably problematic. Appellate decision will allow providers to fight back Healthcare pr
Slide 19: Risk Management
Risk Management • Our claims team is ready to assist with our insureds’ risk management questions and concerns • Decades of claims and risk management experience • Medical Interactive – Online CMEs • Providers can reach out to us over the phone or at riskmanagement@positivephysicians.com
Slide 20: Integrated risk and claims management services
• Offers integrated risk management and claims management services tailored for self-insured healthcare providers, large physician groups, hospitals, and nursing homes • Full-service claims and risk management team able to serve clients nationwide • Customizable and personalized services within clai
Slide 21: Reinsurance and AM Best - State of the Market
Reinsurance and AM Best- State of the Market September 10, 2025
Slide 22: Agenda
Agenda 1. Global Reinsurance Market Update 2. MPL Reinsurance Market Update 3. AM Best Insights LOCKTON RE 22
Slide 23: Global Reinsurance Market Update
1 Global Reinsurance Market Update LOCKTON RE 23
Slide 24: Top Global P&C Reinsurers
Top 25 Global P&C Reinsurers • Based on 2024 gross reinsurance premiums; All figures in USD (billions) 2024 Reinsurance Ranking Company Name Country Premiums 1 Swiss Re * Switzerland 36.2 2 Munich Re * Germany 32.6 2024 Reinsurance Premiums by Region 3 Hannover Re * Germany 27.5 4 Berkshire Hathaway
Slide 25: Traditional Reinsurance Capital and Combined Ratio
Traditional Reinsurance Capital 600 110% 105% 500 100% 95% 400 Capital (USD bn) Combined Ratio 90% 300 85% 535 500 80% 475 468 429 434 200 394 345 345 341 75% 320 340 332 292 70% 100 65% 0 60% • Traditional 2012 reinsurance 2013 2014 is projected capital 2015 to grow 20167% in 2025, 2017 reaching 20
Slide 26: Steady Underwriting Results, Increasing Investment Income
Steady Underwriting Results, Increasing Investment Income Based on Moody’s Reinsurance Composite LOCKTON RE 26 Source: Moody’s Note: Data based on a selection of Moody's rated reinsurers; Combined ratios reflect undiscounted ratios for IFRS 17 reporters. First half 2025 annualized for underwriting I
Slide 27: Significant Insured Losses 2015 – Q2 2025
Significant Insured Losses 2015 – Q2 2025 Includes estimated global losses for events of at least $100 million $200 Hurricane Ian $180 171.9 Hurricane Laura, Hurricane Ida, Hurricanes Hurricanes Harvey, Western U.S. Winter Storm Helene & Milton, $160 Turkey/Syria U.S. SCS, Irma, and Maria Wildfires,
Slide 28: Global Reinsurers' ROE Exceed Cost of Capital Since 2023
Global Reinsurers’ ROE Exceed Cost of Capital Since 2023 18% Median ROE Median WACC 16% 14% 12% 10% 8% 6% 4% 2% LOCKTON RE 0% 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 H1 2025 28 Source: S&P, AM Best, Lockton Re, Bloomberg Note: ROE for H1 2025 uses weighted average for reinsurers with
Slide 29: Rating Agency Views – Global Reinsurance Market Outlooks
Rating Agency Views – Global Reinsurance Market Outlooks Positive Outlook Stable Outlook Stable Outlook Deteriorating Outlook • Risk-adjusted capitalization remains robust, reflecting both retained earnings and disciplined capital management • Elevated interest rates and strong capital markets perfo
Slide 30: Convergence of Reinsurance P/B Valuations
Convergence of Reinsurance P/B Valuations Historically higher valuations for casualty reinsurance Reinsurers' Stock Price to Book Value Movements 2.0 Greater than 33% Casualty Less than 33% Casualty 1.8 1.6 (x) 1.4 1.2 1.0 LOCKTON RE 0.8 30 Source: AM Best
Slide 31: What Lies Ahead in 2025 and 2026
What Lies Ahead in 2025 and 2026 ▪ Reinsurers are maintaining 2025 profit targets despite LA wildfires in Q1 and signs of rate softening ▪ Expected ROEs in the low-mid teens in 2025 and 2026 ▪ Many reinsurers are seeking increased levels of diversification outside property Cat and more stable earnin
Slide 32: MPL Reinsurance Market Update
2 MPL Reinsurance Market Update LOCKTON RE 32
Slide 33: MPL Reinsurance Utilization
MPL Reinsurance Utilization % of GPW Ceded to Non-Affiliates 25% 20% % Ceded to Non-Affiliates 15% 10% 5% 0% 1996 1997 1998 1999 2010 2012 2013 2014 2015 2016 2017 2018 2019 2011 2001 2007 2021 2000 2002 2003 2004 2005 2006 2008 2009 2020 2022 2023 2024 Lockton Re MPL Specialists Composite All Lines
Slide 34: Strong Support from Reinsurers Remains for MPL
Strong Support from Reinsurers Remains for MPL 2024 Top 10 Unaffiliated Reinsurers % of Total Ceded to 2024 Ceded Premiums to Supporting MPL Specialists Unaffiliates Unaffiliate Reinsurers Hannover Re 16% Lloyd's 15% TransRe 7% Other AXA 4% Bermuda Aspen 3% USA Axis 3% United PeakRe 2% Kingdom Conve
Slide 35: Change in Assumed Premiums, 2023 to 2024
2024 Assumed Premiums from MPL Specialists 220 80% Premiums Assumed from MPL Specialists (bars, $mn) Change in Assumed Premiums, 2023 to 2024 (dots) 200 60% 180 40% 160 20% 140 120 0% 100 -20% 80 -40% 60 -60% 40 20 -80% 0 -100% LOCKTON RE 2024 Assumed Premiums ($mn) Change in assumed premiums, 2023
Slide 36: MPL Reinsurance Key Themes
MPL Reinsurance Key Themes ▪ Reinsurance pricing expected to stabilize to keep the product marketable o Recent re-underwriting and rate action achieved by cedents to be evident in results o Cedents will continue to retain more to minimize spend, but taken too far will make the reinsurance product ob
Slide 37: MPL Reinsurance Pricing Themes
MPL Reinsurance Pricing Themes ▪ Many reinsurers are in loss positions for the late 'teens treaty years ▪ Most markets are reducing weight to the Covid impacted years or removing them altogether in projecting loss costs ▪ Court backlogs from covid shutdowns have had a lengthening effect on developme
Slide 38: AM Best Insights
3 AM Best Insights LOCKTON RE 38
Slide 39: Comparison of the Rating Agencies
Comparison of the Rating Agencies AM Best S&P Moody’s Fitch KBRA Demotech $14.2B $7.1B Annual Revenue $240M Ratings = $1.7B $300M $15M (Ratings = $4.4B) (Ratings = $3.8B) # of Employees 900 42,500 16,000 5,000 700 25 Large National and Large National and Large National and Niche Markets – Company Pr
Slide 40: AM Best's Rating Process – Obtaining a Rating
AM Best’s Rating Process – Obtaining a Rating AM Best review ▪ Historical performance ▪ Financial projections Phase 1 Phase 2 Phase 3 Phase 4 ▪ Product offerings and pricing Enter agreement with Analyst is assigned Meeting/presentation standards AM Best committee marketing Ongoing dialogue with AM B
Slide 41: AM Best's Rating Process – Maintaining a Rating
AM Best’s Rating Process – Maintaining a Rating ▪ Rating analyst and senior analyst typically assigned to each account ▪ Annual meeting in person or on a conference call with analyst and senior analyst ▪ Analysts review meeting materials and make rating recommendation to the committee ▪ Rating commi
Slide 42: AM Best's MPL Sector Outlook Remains Stable
AM Best’s MPL Sector Outlook Remains Stable March 28, 2025 + Robust balance sheets and sizable invested asset bases, supported by strongest levels of risk-adjusted capital + Increasing premium while tightening underwriting guidelines + Persistently redundant loss reserves + Higher reinvestment rates
Slide 43: AM Best Key Themes in MPL
AM Best Key Themes in MPL ▪ ~40 MPL writers rated by AM Best ▪ Majority are rated A ▪ Reserves in focus ▪ Softened tone on combined ratio ▪ Many insurers hold capital in excess of AM Best requirement ▪ Capital deployment remains a challenge ▪ Receptive to diversified revenue streams LOCKTON RE 43
Slide 44: Thank you
Thank you REINSURANCE
Slide 45: State of the MPL Market: A View From Rockville, MD
State of the MPL Market A View From Rockville, MD Bill Burns, VP, Research and Analytics September 10, 2025
Slide 46: Agenda
Agenda 1. MPL in the news 2. Financial results/Market conditions 3. A look at the MPL sectors 4. Loss and pricing trends 5. Wrap up 46
Slide 47: MPL in the News
MPL IN THE NEWS 47
Slide 48: MPL/Healthcare Related Headlines
MPL/Healthcare Related Headlines A partial list… ▪ “Judge awards family nearly $1 billion for botched delivery of baby at Utah hospital he blasted as ‘most dangerous place on the planet’” (New York Post) ▪ “Hulk Hogan’s Cause of Death May Be Medical Malpractice” (TMZ) ▪ “Governor signs bills limitin
Slide 49: MPL Financial Results
MPL FINANCIAL RESULTS 49
Slide 50: Before we continue…
Before we continue… ▪ There is no single MPL “market” ▪ Companies have different missions, business strategies, target markets, etc. ➢ Impacts losses, expenses, and investment returns, which makes comparisons of companies and generalizations difficult ▪ A large part of the “market” can’t be seen fro
Slide 51: Yellow Book MPL Market by NAIC Segment
Yellow Book MPL Market by NAIC Segment Distribution of 2024 Direct Premiums Written Other health care facilities 18% Physicians Other health care 46% professionals 14% Hospitals 22% Prepared by MPL Association. Source: S&P Global Market Intelligence 51
Slide 52: Who Are the Top Ten MPL Writers?
Who Are the Top Ten MPL Writers? Various company structures in the market ($ in millions) Rank Company Type 2024 DPW Market Share Target Market(s) 1 Berkshire Hathaway S $2,214 16.9% All 2 TDC M 1,268 9.7% Phys/Surg, Hospitals 3 CNA S 757 5.8% Other Prof, Facilities 4 ProAssurance S 680 5.2% Phys/Su
Slide 53: Underwriting (Un)Profitability
Underwriting (Un)Profitability …but operating results are better than almost every other line of business Combined Ratio Operating Ratio 160% 140% 120% 100% 80% 60% 40% 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2
Slide 54: Loss Reserve Redundancies – Running on Fumes
Loss Reserve Redundancies – Running on Fumes …largely driven by Berkshire Hathaway and TDC Reserve Change Points on CR $1,500 15% $1,000 10% $500 5% $0 0% -$500 -5% -$1,000 -10% -$1,500 -15% -$2,000 -20% -$2,500 -25% 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 200
Slide 55: Expense Ratio Is Stuck at Around 25%
Expense Ratio Is Stuck at Around 25% Top 20 companies range from 12% to 39% 35% 30% 25% 20% 15% 10% 5% 0% 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Prepared by MPL Association. Sourc
Slide 56: What About the Investment Side of the House?
What About the Investment Side of the House? Higher book yields mean improved investment ratios 40% 35% 30% 25% 20% 15% 10% 5% 0% 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Prepared b
Slide 57: Leaving Us with Low Leverage and Unused Barrels of Surplus
Leaving Us with Low Leverage and Unused Barrels of Surplus MPL Surplus, Premium and Reserve Leverage Ratios ($ in billions) Surplus Premium/PHS Reserves/PHS $46 3.0 $41 $36 2.0 $31 $26 $21 1.0 $16 $11 $6 0.0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20
Slide 58: Physicians & Surgeons Market
PHYSICIANS & SURGEONS MARKET 58
Slide 59: Physician-Owned Companies Continue to Dominate the Market
Physician-Owned Companies Continue to Dominate the Market Direct Premiums Written ($ in millions) Rank Company 2024 DPW Market Share 1 Berkshire Hathaway $1,030 17.8% 2 TDC 922 15.9% 3 ProAssurance 518 8.9% 4 Mag Mutual 472 8.1% 5 Curi 348 6.0% 6 Coverys 236 4.1% 7 ISMIE 210 3.6% 8 SVMIC 144 2.5% 9
Slide 60: Physicians' Premiums Inching Up Due to Pricing
Physicians’ Premiums Inching Up Due to Pricing Direct Premiums Written ($ in millions) $8,000 $7,000 $6,000 $5,000 $4,000 $3,000 $2,000 $1,000 $0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Prepared by MPL Association. Sourc
Slide 61: Physician Independence Giving Way to Corporate Employment
Physician Independence Giving Way to Corporate Employment © 2025 by SLS, Society of Laparoscopic & Robotic Surgeons. PMCID: PMC12072973 61
Slide 62: While Physicians Find Themselves Working in Larger Practices
While Physicians Find Themselves Working in Larger Practices © 2025 by SLS, Society of Laparoscopic & Robotic Surgeons. PMCID: PMC12072973 62
Slide 63: P&S Loss Ratios Improving…but is it Real?
P&S Loss Ratios Improving…but is it Real? P&S Accident-Year Net and Ceded Loss and LAE Ratios (select peer insurers) Net Ceded 120.0% 100.0% 80.0% 60.0% 40.0% 20.0% 0.0% 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Prepared by MPL Association. Source: S&P Global Market Intelligence 63
Slide 64: Prognosis for Physician MPL Market
Prognosis for Physician MPL Market MPLA outlook for the physician sector ▪ Continued modest price increases (more on this later) ➢ More individual risk rated filings showing up for RPGs ▪ Continued shrinkage of insurable exposures ➢ Vertical integration ➢ Further disruption by private equity ➢ Healt
Slide 65: Hospital Market
HOSPITAL MARKET 65
Slide 66: Both Specialists and Multiline Companies Compete for Hospitals
Both Specialists and Multiline Companies Compete for Hospitals Direct Premiums Written ($ in millions) Rank Company 2024 DPW Market Share 1 MCIC $450 15.3% 2 Berkshire Hathaway 357 12.2% 3 CRICO 220 7.5% 4 TDC 193 6.6% 5 Coverys 151 5.1% 6 BETA Healthcare Group 113 3.8% 7 Mag Mutual 109 3.7% 8 Chubb
Slide 67: What is Behind the Recent Growth in Hospital Premiums?
What is Behind the Recent Growth in Hospital Premiums? Direct Premiums Written ($ in millions) $3,000 $2,500 $2,000 $1,500 $1,000 $500 $0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Prepared by MPL Association. Source: S&P Global
Slide 68: What Else are We Hearing?
What Else are We Hearing? Talk on the street… ▪ “Price increases (prior slide) do not include changes in terms, e.g., increases in SIRs for SAM claims” ▪ “Retentions for many facilities have increased – some rather dramatically – and (the impact of losses) has been all over the board from nominal/at
Slide 69: Consolidation Slows Down in 2025
Consolidation Slows Down in 2025 Half of the announced transactions involved divestitures of smaller facilities 140 $900 $800 120 $700 100 $600 80 $500 60 $400 $300 40 $200 20 $100 0 $- 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025Q2 Number of Transactions Average Size of Sel
Slide 70: Loss Ratios for Hospitals Have Been Running Hot
Loss Ratios for Hospitals Have Been Running Hot Hospital Accident-Year Net and Ceded Loss Ratios (select insurers) Net Ceded 140.0% 120.0% 100.0% 80.0% 60.0% 40.0% 20.0% 0.0% 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Prepared by MPL Association. Source: S&P Global Market Intelligence 70
Slide 71: Prognosis for the Hospital MPL Market
Prognosis for the Hospital MPL Market MPLA outlook for the hospital sector ▪ Continued vertical and horizontal integration ▪ Larger, more complex insurance programs ➢ Insureds want/need capacity and experience in hospital underwriting and claims ➢ Most of the coverage purchased from the commercial m
Slide 72: Other Professionals Market
OTHER PROFESSIONALS MARKET 72
Slide 73: Other Professionals – The Overlooked Sector?
Other Professionals – The Overlooked Sector? Sector is growing due to increasing reliance on these professionals to deliver health care ▪ Most companies have carved out a niche, e.g., ➢ CNA - Nurses ➢ ProAssurance - Podiatrists ➢ OMSNIC – Oral surgeons ▪ Competition is increasing due to growth in ex
Slide 74: There is Competition, but Some Companies Occupy a Certain Lane
There is Competition, but Some Companies Occupy a Certain Lane Direct Premiums Written ($ in millions) Rank Company 2024 DPW Market Share 1 Berkshire Hathaway $449 23.5% 2 CNA 332 17.4% 3 W.R. Berkley 117 6.1% 4 OMSNIC 113 5.9% 5 ProAssurance 99 5.2% 6 Liberty Mutual 99 5.2% 7 Emergency Cap Mgmt 88
Slide 75: Premiums Keep Inching Up – Rate + Exposure
Premiums Keep Inching Up – Rate + Exposure Direct Premiums Written ($ in millions) $2,000 $1,800 $1,600 $1,400 $1,200 $1,000 $800 $600 $400 $200 $0 2016 2017 2018 2019 2020 2021 2022 2023 2024 Prepared by MPL Association. Source: S&P Global Market Intelligence 75
Slide 76: Massive Increase in the Number of Other Professionals
Massive Increase in the Number of Other Professionals Notably, Nurse Practitioners and Physicians Assistants 450,000 200,000 400,000 180,000 350,000 160,000 300,000 140,000 250,000 120,000 100,000 200,000 80,000 150,000 60,000 100,000 40,000 50,000 20,000 0 0 2013 2023 2013 2023 NPs PAs Data sources
Slide 77: Prognosis for Other Professionals Market
Prognosis for Other Professionals Market MPLA outlook for the sector ▪ BLS expects faster than average growth in many allied classes in the decade ending 2033: ➢ Nurse practitioners – 40% (employment change – 141,200) ➢ Physicians’ assistants – 28% (employment change – 43,700) ➢ Home health aides –
Slide 78: Other Facilities Market
OTHER FACILITIES MARKET 78
Slide 79: Other Facilities – Fastest Growing Segment
Other Facilities – Fastest Growing Segment Two distinct sectors ▪ Senior Living ➢ Historically difficult business to underwrite profitably ➢ Long-time target of plaintiff attorneys ➢ Impact of ownership (PE or otherwise) on patient care and claims? ▪ Other Facilities ➢ Broad definition – do not have
Slide 80: Other Facilities - Premiums Have Doubled Since 2016
Other Facilities - Premiums Have Doubled Since 2016 Direct Premiums Written ($ in millions) $2,500 $2,000 $1,500 $1,000 $500 $0 2016 2017 2018 2019 2020 2021 2022 2023 2024 Prepared by MPL Association. Source: S&P Global Market Intelligence 80
Slide 81: Other Facilities (Largely) Require E&S Paper
Other Facilities (Largely) Require E&S Paper Direct Premiums Written ($ in millions) Rank Company 2024 DPW Market Share 1 Berkshire Hathaway $378 15.9% 2 Liberty Mutual 326 13.7% 3 CNA 266 11.1% 4 TDC 100 4.2% 5 Starstone 96 4.0% 6 Munich Re 93 3.9% 7 Arch 86 3.6% 8 Health Care Industry Liability Re
Slide 82: Prognosis for Other Facilities Market
Prognosis for Other Facilities Market MPLA outlook for the sector ▪ Senior Living ➢ Will remain a difficult class of business ➢ Rising frequency and severity ➢ Changes in regulation—unfavorable to industry ▪ Other Facilities ➢ Continued growth in exposures and premiums ➢ Continued competition ➢ Risi
Slide 83: Claim and Verdict Trends
CLAIM AND VERDICT TRENDS 83
Slide 84: Claim Frequency and Severity – Physicians & Surgeons
Claim Frequency and Severity – Physicians & Surgeons (MD/DO) 18,000 $600,000 16,000 $500,000 14,000 12,000 $400,000 Average indemnity paid # of paid claims 10,000 $300,000 8,000 6,000 $200,000 4,000 $100,000 2,000 0 $0 Paid Claims Average Indemnity Paid Source: National Practitioner Data Bank 84
Slide 85: Trend in Large MPL Verdicts Continue to Outpace 2019
Trend in Large MPL Verdicts Continue to Outpace 2019 $10Mn + Verdicts 70 60 50 40 30 20 10 0 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 At 6/30 Full Year Prepared by TransRe 85
Slide 86: Large Verdicts Are Occurring in Most States
Large Verdicts Are Occurring in Most States Verdicts greater than $10M - 2016 to 2025YTD 86 Source: MedPro Group – Healthcare Liability Market Update
Slide 87: How Are MPL Insurers Responding?
HOW ARE MPL INSURERS RESPONDING? 87
Slide 88: Single-Digit Rate Increases for Physicians
Single-Digit Rate Increases for Physicians <-20% -10% to -19.9% -0.1% to -9.9% 0% +0.1% to 9.9% +10% to +24.9% >+25% 1% 2% 1% 3% 1% 0% 5% 6% 4% 5% 4% 4% 7% 10% 13% 15% 12% 13% 9% 11% 15% 10% 11% 23% 26% 22% 31% 27% 41% 55% 58% 59% 65% 67% 74% 71% 75% 82% 68% 62% 64% 61% 60% 51% 17% 28% 16% 17% 15% 8
Slide 89: …Which We Expect Will Continue
…Which We Expect Will Continue Sample rate filing activity over last 12 months Class Indicated Requested/Approved Phys/Surg 58.6% 9.9% Phys/Surg 36.8% 3.9% Phys/Surg 32.6% 25.0% Phys/Surg 12.7% 2.9% Phys/Surg 10.9% 4.0% Phys/Surg 4.0% 3.0% Prepared by MPL Association. Source: 2024 S&P Global Market
Slide 90: Also Seeing Higher Prices in the Other MPL Segments
Also Seeing Higher Prices in the Other MPL Segments HOSPITALS OTHER PROFESSIONALS OTHER FACILITIES 40% 20% 15% 35% 15% 10% 30% 25% 10% 5% 20% 5% 0% 15% 10% 0% -5% 5% 0% -5% -10% Lead Excess NP/PA All Other Sr. Living All Other Prepared by MPL Association. 90
Slide 91: Don't Forget the Leveraged Effect of Loss Trend on Higher Layers
Don’t Forget the Leveraged Effect of Loss Trend on Higher Layers (Assume $500,000 per claim retention; 5% annual trend) Claim Gross Ceded Net 1 500,000 - 500,000 2 600,000 100,000 500,000 3 800,000 300,000 500,000 Total 1,900,000 400,000 1,500,000 Claim Gross Ceded Net 1 525,000 25,000 500,000 2 630
Slide 92: Wrap Up
WRAP UP MEDICAL PROFESSIONAL LIABILITY ASSOCIATION 2
Slide 93: What Haven't We Talked About?
What Haven’t We Talked About? Privacy laws Assisted dying Third Part Litigation Funding Social media (+/-) Continued growth in captives One Big Beautiful Bill Vaccines Joint Commission to cut standards Healthcare deserts Telemedicine EMS shortages Liability of Med Spas Cyber attacks Cosmetic surgery
Slide 94: In summary, we expect…
In summary, we expect… Continued record jury awards Continued underwriting losses Continued consolidation in healthcare Challenges/erosions of tort reforms Acceleration in use of AI in underwriting and claims Rise in claim frequency 94
Slide 95: Value Add: Positive Enhancements to Win Business
Value Add: Positive Enhancements to Win Business Annie Matincheck, Chief Strategy Officer Business Development | Finance September 10, 2025 850 Cassatt Road positivephysicians.com 100 Berwyn Park, Suite 220 positivephysicians.com Berwyn, PA 19312
Slide 96: Technology Strategy
Technology Strategy DATA WAREHOUSE UPGRAGE CORE OPERATING SYSTEMS Central Repository for reporting, Conversion to new Core Operating Platforms: analytics and Operations. Policy rating, processing and issuance Foundation for all System transitions and Billing and Invoicing Integrations. Claims Manage
Slide 97: Portal & App Billing Tabs Overview
Portal & App Billing Tabs Overview David Allebe September 10, 2025
Slide 98: Portal & App
Portal & App The password portal and app allow you to view your entire book of business. Your team members have access to policies they manage. What the portal offers (Billing): • A view of your entire book of business • View invoices • Filter and sort invoices to find your delinquent policies • Pay
Slide 99: View Invoices
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Slide 100: Setup Autopay
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Slide 101: Pay an Invoice
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Slide 102: View Payments
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Slide 103: Change Billing Address
Change Billing Address oe — < Update Billing Address Policy PAM-002100 ‘Change Billing Address Insured Donna Eget, PC Flicy Number ered Nome Policy Term 07/15/2025-07/15/2026 Paw-oozs00 B Donna Eos, PC Status Active pty ta sas orsrcas.osn0 have iting Across Current Billing Address 120 Hetry #ONell H
Slide 104: Paperless Billing Preference
Paperless Billing Preference
Slide 105: Takeaways
Takeaways • The portal is an efficient way for you and your teams to see the status of your policies. • Encourage portal and app usage by your insureds, especially for payments. USPS is slow and unreliable. • With the portal app, agents and insureds still have access to the portal while on the go. •
Slide 106: Positive Business Development
POSITIVE BUSINESS DEVELOPMENT Stephanie Spina & Shelly Ursini September 10, 2025
Slide 107: Accessing the Portal
Accessing the Portal Step 1: Get Registered We'll need the names & emails of your team members who desire access Step 2: Live Training Once registered, we will schedule a Live Virtual training session with your team. Step 3: Feedback, please After you've been using this for a time, we will ask for y
Slide 108: Stand Alone Tail Coverage
Stand Alone Tail Coverage Highlights: • Eligible Risks: o Solo Physicians and Physician Groups o No OB, Bariatrics or Hospitalists o Must be Clean: Radiology, Pain Management, Neurosurgery • States: DE, FL, GA, MD, MI, MO, NH, NJ, NV, NC, OH, PA, RI, SC, TX • Competitive Premiums: 190% of Discounted
Slide 109: Agency Stewardship Reports
Agency Stewardship Reports Coming in 2026 New Reports will be available by Agency/Location/Producer Quarterly, Annually, and Upon Request To include such Key Metrics as: o Hit Ratio: # of Submissions Received, Declined, Quoted & Bound o Retention Ratio o Loss Ratio o Book of Business sliced by State
Slide 110: Positive Purchasing Group
g POSITIVE PURCHASING GROUP
Slide 111: Partner Voices: What Matters to You
Partner Voices: What Matters to You
Positive Physicians Holdings — Investor Presentation (September 2025) on 6ix