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Survey Report

Insurance Marketplace Realities 2026 – Managed Care E&O, D&O and Cyber

October 2, 2025

While market rate conditions have eased, underwriting factors, such as increased exposures, may still lead to premium increases.
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Rate predictions: Managed Care E&O, D&O and Cyber
  Trend Range
Public MCOS
E&O
Increase Up to +5%
D&O
Increase Flat to +3%
Blue Plans
E&O
Increase Up to +5%
D&O
Neutral increase Up to +7.5%
Hybrid entities
E&O
Increase Up to +10%
D&O
Increase Up to +10%
All other MCOs
E&O
Neutral increase Flat to +5%
D&O
Neutral increase Flat to +5%
Private company, other lines of business
EPL
Neutral increase Flat to +5%
Fiduciary
Neutral increase Flat to +5%
Crime
Neutral increase Flat to +5%
Cyber liability
Increase -5% to +5%

Key takeaway

Carriers continue to offer flat to modest rate increases for errors and omissions (E&O) and directors and officers (D&O) coverage. However, entities with limited access to primary markets, such as third-party administrators (TPAs) and pharmacy benefit managers (PBMs), are experiencing elevated pricing and tighter coverage terms.

Systemic risks, unexpected litigation, rising bodily injury claim values, behavioral health exposures and regulatory pressures remain key concerns for insurers. These factors are driving continued application of coverage restrictions, particularly for large and complex organizations.

Additional pressures stem from economic conditions, evolving federal and state health policies and broader considerations including climate change, ESG factors, inflation and political dynamics. Organizations that demonstrate strong underwriting profiles may benefit from more favorable rates, though coverage terms and conditions generally remain consistent across the board.

In general, the overall public company D&O market is trying to flatten or in some cases, seek small increases. For companies with increased risk factors such as claims, M&A activity, or significant growth in their market cap, insurers will seek premium increases. The overall private company D&O market is still competitive.

Cyber liability market trends

Premium stabilization has continued through the third quarter of 2025, which has led to slight premium increases to follow clients’ revenues and exposures. The premium increases we anticipated toward the end of this year have yet to materialize given better than expected loss ratios.

Improvements in cybersecurity practices among policyholders have contributed to reducing vulnerabilities that could lead to losses, thus bolstering insurer results. Underwriting decisions are heavily influenced by the security controls a company has in place in conjunction with pricing and attachment points.

Competition is strong among markets, certain risks may receive multiple quotes and incumbents are eager to retain business. Increased limit factors (ILFs) have come down in excess placements due to intense competition, especially on large towers, where there have been significant premium decreases. Capacity is plentiful in the market, partially thanks to new facilities able to provide significant excess capacity with the flexibility to be deployed anywhere on a program above the primary layer.

Download the full managed care report to the right.

Disclaimer

WTW hopes you found the general information provided here informative and helpful. The information contained herein is not intended to constitute legal or other professional advice and should not be relied upon in lieu of consultation with your own legal advisors. In the event you would like more information regarding your insurance coverage, please do not hesitate to reach out to us. In North America, WTW offers insurance products through licensed entities, including Willis Towers Watson Northeast, Inc. (in the United States) and Willis Canada Inc. (in Canada).

This article may contain information or materials created or provided by third parties over whom Willis Towers Watson has no control or responsibility. These third-party information or materials are not under Willis Towers Watson’s control, and Willis Towers Watson is not responsible for the accuracy, copyright compliance, legality, or any other aspect of such third-party information or materials. The inclusion of such third-party information or materials does not imply endorsement of any third parties by Willis Towers Watson or any association of Willis Towers Watson with any third parties.

Contacts


Kathy Kunigiel
Senior Managed Care E&O Placement Specialist

Jonathan M. Herman
Managing Member, Herman Law Firm
email Email

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