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Survey Report

Insurance Marketplace Realities 2026 – Senior Living

October 2, 2025

Cost of litigation, social inflation and large verdicts continue to be a concern for the senior living industry.
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Rate predictions: Senior Living
  Trend Range
Senior living healthcare professional liability Increase (Purple arrow pointing top right) Flat to +15% (with excess experiencing the larger rate increases)
Property Increase (Purple arrow pointing upwards) Flat to +7%
Auto liability Increase (Purple arrow pointing top right) +10% to +20%
Workers compensation Increase (Purple arrow pointing top right) -5% to +5%

Key takeaway

  • Loss development and difficult venues continue to be intensely scrutinized.
  • Markets are frequently reluctant to deploy significant capacity in litigious venues such as NY, NJ, CA and FL. Other less-than-desirable venues are Philadelphia, PA and Cook County, IL.
  • On smaller risks, higher CMS ratings and satisfactory state surveys are instrumental in supporting the continuance of cost-effective and low-deductible program offerings.
  • Often, increasing retentions is not providing equitable premium relief for the additional risk assumed by the insured.
  • Capacity continues to be $5 million to $15 million depending on the carrier.
  • Some carriers are cutting back on excess capacity, only offering $5 million when previously $10 million was offered.
  • New market entrants can provide additional capacity.
  • UM/UIM and hired & non-owned auto is becoming a concern for excess carriers.
  • Cost of litigation, social inflation and large verdicts continue to be a concern.
  • Defense costs coverage should be outside the limits of liability when possible.
  • Strive for abuse to be included all the way up the excess tower as capacity is currently available.
  • Tail vs. discontinued operations — preferred to purchase tail and remove from existing policy.
  • Coverage concerns:
    • Look for abuse sublimits
    • Class action exclusions
    • Punitive damage exclusions
    • Communicable disease vs. limited pandemic/epidemic/COVID (coverage varies among carriers)

  • We’re seeing continued emphasis on risk engineering inspections and in cases where an in-person inspection cannot be completed, we’re seeing formal requests for proof of attic sprinklers and other fire-safety related measures as a pre-requisite to providing property terms.
  • Look out for 100% coinsurance requirements, increased water damage deductibles and scrutiny over business income values as insurers continue to look for ways to mitigate exposure.
  • Senior living property markets are limited and risks with historical losses are experiencing higher than average rate increases or being carved out from coverage altogether.
  • Given the limited number of markets in this industry space, it pays dividends to foster an ongoing partnership with your property insurer and to be receptive to risk control recommendations. Providing thoughtful rationale as to why certain recommendations cannot be complied with will be much better received by the marketplace than not responding.

  • Drivers lists continue to be a pre-requisite to providing terms for many markets, and if you haven’t previously compiled this data, it will pay dividends by opening the door for new markets to consider your risk.
  • Strong MVR review criteria, adherence to minimum personal auto limit requirements and focus on driver training show the underwriting community that your auto risk is something that you’re paying close attention to and will instill greater confidence on this line of coverage, where historically underwriters struggle to generate enough premium to support their perceived risk.
  • Resident transport exposure is of paramount concern, and your controls in this area can be a critical determiner of whether a market can provide terms or not. Many markets can only entertain a modest level of resident transport risk.
  • We continue to help organizations evaluate the benefits of partnering with ride share companies via programs such as Uber for Seniors and Lyft Silver.

  • There continue to be multiple workers compensation insurers who have a strong appetite to write senior living organizations on a monoline basis without a requirement for supporting lines of coverage.
  • Continued scrutiny over the classification of 1099 (independent contractor) classified individuals.  Carriers are applying stringent measures in this area, and many times the carrier will look to require ICs to be classified as employees for workers compensation purposes.
  • Non-owned auto exposures continue to be a source of concern for underwriters and are underwritten closely from a workers compensation perspective.
  • The strength of your return-to-work program is a key indicator to insurers in this area, and a company with a strong and uniform program will be looked upon favorably as these programs have proven to be a significant mitigator of long-term loss experience.

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).

Contact

Wayne Wills
Senior Living Industry Segment Leader, North America
email Email phone +1 404 224 5004
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