In terms of 2024 net premiums written (NPW), U.S. health insurance companies continue to dominate the ranking of the world’s largest insurance companies, with UnitedHealth Group Inc. retaining the top spot with net premiums of $308.81 billion, a year-on-year increase of 6.2%.
We rank the world’s largest insurance companies based on NPW and non-bank assets, based on research data from ratings agency AM Best, and list the top 25 insurance companies by both metrics in 2024.
According to the 2024 NPW rankings, 4 of the top 5 insurance companies are American health insurance companies, and 5 of the top 10 insurance companies are American health insurance companies.
Centene Corporation maintained its second position with premiums of $159.87 billion, a 6.9% increase from 2023.
Elevance Health, Inc. and Kaiser Foundation Health Plan Group remained in third and fourth place, with premiums of $144.17 billion and $128.81 billion, respectively.
Top 10 remains largely unchanged compared to 2023Except, Guonong Group rose from seventh to fifth place, with its net assets increasing by 16.4% to US$114.47 billion, the highest increase among the top ten. Meanwhile, China Life Insurance (Group) Company fell from fifth to seventh place, with a net asset value of US$110.02 billion.
Among the top ten insurance companies, only three are not registered in the United States, namely the seventh-ranked China Life Insurance (Group) Co., Ltd., the eighth-ranked German Allianz Insurance Group, and the tenth-ranked French AXA Insurance Group.
No. 12 Progressive Corp. had the highest increase among the top 25 insurers, with premiums rising 20.9% year over year to $74.42 billion.
Conversely, No. 24 Nippon Life Insurance Co. saw the largest decline in net income from equity (NPW), down 10.9% to $44.95 billion.
“AM Best has seen and anticipates continued growth in Medicare Advantage, driven by an aging population; many people are choosing Medicare Advantage plans over traditional fee-for-service Medicare,” said Sally Rosen, senior director at AM Best.
In the non-bank net assets ranking of the world’s top 25 insurance companies in 2024, Berkshire Hathaway Inc. replaced Allianz SE at the top of the list, with assets reaching US$1.15 trillion, a year-on-year increase of 7.8%. In 2023, Allianz fell from first to second, with assets of US$1.09 trillion, an increase of 6.2%.
The remaining companies in the top five were the same as last year, with China Life Insurance (Group) Co., Ltd., Ping An Insurance (Group) Co., Ltd. of China and Prudential Financial Group ranking third, fourth and fifth respectively.
Athene Holding Ltd., ranked 24th, had the largest increase, with its non-bank assets rising 20.9% to $363.34 billion. Ping An Insurance (Group) Co., Ltd. of China (ranked fourth) also grew strongly by 19.9%, with assets reaching US$984.67 billion.
The National Mutual Insurance Alliance of Japan Agricultural Cooperatives, ranked 21st, had the largest decline in assets among the top 25, with assets falling 2.6% to US$384.02 billion.