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Doctor “didn’t have a choice” but to explore captives in order to manage risk

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Dr Ira Richterman, CEO of Ohio-based OMNI Orthopaedics president of Cayman-domiciled medical malpractice captive StarKap, has told Captive Intelligence that he and the other physicians within the captive had limited choice but to turn to captives in order to continue working as physicians.

“The goal for us in the captive industry was to be able to manage our risk and control our expenses, in order for us to continue to provide healthcare,” he said.

“We’ve been doing it a long time, as a small group of physicians, we are self-motivated in our arena, and that’s why we put this together.

“We only insure ourselves, from the point of view that we believe that we want all the physicians to be the owners too, so we want them all to be part of the game.”



Richterman noted that there is a split in opinion between those who believe the captive needs reinsurance and those that do not.

“Half of us don’t believe we need reinsurance, while half of us like the little bit of security that we have,” he added.

As a compromise, Richterman said that StarKap takes half of its own reinsurance risk.

“So, we ourselves are underwriting our own reinsurance to compromise between the splits in our group of those who want it and those who don’t.”

At this point, Richterman noted that the captive is vertically oriented and purely homogeneous malpractice insurance.

However, he highlighted that some members have merged in recent times and as a result, the captive is now at a size where it is considering bringing its own healthcare insurance into some form of self-insured model.

“We understand it, we get it, and we’re large enough now that we’re going to start to explore diversity within our captive by having other risks,” he said.

He also pointed out, that in the future, the captive members may look to write additional lines such as cyber through the captive. “It’s not within the captive yet because we don’t have a strong enough grasp to take that risk ourselves, but maybe in time when there’s more knowledge and experience in that industry,” Dr Richterman added.

GCP Short: Unexpected challenges on global programmes

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Karen Jenner, TMF Group
Christophe Bourdaire, TMF Group

This GCP Short, produced in partnership with TMF Group, is all about where unexpected challenges may occur when running a global programme and some of the solutions.

Joining Richard for an 18 minute discussion are Karen Jenner, IPT Client Engagement Director, and Christophe Bourdaire, IPT Quote Content Director, who run through several scenarios and examples of challenges that can be encountered and how they may be overcome or dealt with.

For more information on TMF Group’s captive services, visit their Friend of the Podcast page on our website.

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GCP Exclusive: The merger of RISCS and Cutts-Watson Consulting

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Oliver Schofield, RISCS
Malcolm Cutts-Watson, Cutts-Watson Consulting

In this GCP Exclusive, Richard is joined by Oliver Schofield, Managing Partner at RISCS, and Malcolm Cutts-Watson, Founder and Executive Chairman at Cutts-Watson Consulting, as they break the news on the merger of the two independent consulting firms into RISCS CWC.

Olly and Malcolm discuss how the conversation started last year, the motivations behind the merger and what their ambitions are. They also explain what role they are keen to play and the services they can provide to insurance buyers and the global captive insurance market.

For more information on RISCS CWC, visit their Friend of the Podcast page here.

RISCS and Cutts-Watson Consulting to merge independent firms

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Oliver Schofield and Malcolm Cutts-Watson have announced their intention to merge their two independent captive consulting businesses – RISCS and Cutts-Watson Consulting.

The new entity, to be named RISCS CWC, will have a global footprint, including physical presence in the UK, Guernsey, France, South Africa and the Cayman Islands, and provide services from captive feasibility and health checks to alternative risk finance consulting and board and governance reviews.

Schofield will be chief executive of the combined organisation, responsible for day-to-day operations and business development, and Cutts-Watson will be non-executive chairman.

The pair announced the planned merger at an event in Guernsey on 19 January, and speaking exclusively on the Global Captive Podcast outlined the overall vision and ambition for RISCS CWC.

Cutts-Watson explained that having launched CWC in 2015, strong growth of the business prompted him last year to begin considering what the “next chapter” would look like.

“Whilst we had a very sustainable business, I was always conscious of the resilience of a relatively small business and also very keen to keep the growth going and there’s a limit to what you can do as a smaller business,” he explained.

“The idea of going back into the corporate world and finding a corporate to buy the business really didn’t appeal. I was looking for someone or something that had a similar sort of culture, a similar view on life and also someone I could enjoy working with.”

Schofield and Cutts-Watson have known each for many years, both having worked in the alternative risk and captive sector since the 1980s, and in recent years had worked together in supporting the development of Labuan as a captive domicile.

Schofield said the approach from CWC was received “very positively”.

“Here at RISCS we have a desire to grow,” he said. “We have a desire to build on the strategic hires that we made France, in South Africa, the Cayman Islands and Jersey during the course of 2022.

“Being able to team up with Malcolm, and his colleagues is a logical step forward.”



Schofield said the fact RISCS CWC will now have double the number of people working under the umbrella, it is a “very exciting proposition” as they serve clients all over the world.

“We will be operating out of six hubs all over the world, but our ambition doesn’t stop there as far as growing,” he added. “We’ll be very much looking to increase the size further, as we get into 2023.”

The independent nature of both businesses will remain an important feature of the combined operation, with Schofield and Cutts-Watson also having no ambition to enter captive management.

“We want to remain independent because we can be much more flexible and nimble when it comes to being able to provide our solutions,” Schofield added.

“From our perspective, this combination enables us to collectively broaden our offer, increase our footprint, strengthen our team, and crucially, it enables us to continue to be domicile, underwriter, and broker agnostic, ensuring that we remain truly independent in our approach, in our thoughts and the delivery of our solutions.”

To hear the full 25 minute conversation between Captive Intelligence editor Richard Cutcher, Oliver Schofield and Malcom Cutts-Watson, listen to the Global Captive Podcast episode here, or on any podcast app.

Medical malpractice’s “never ending” hard market ensures captives crucial to US healthcare

Due to the rising costs of medical malpractice insurance, those working in the health industry are being forced into captive utilisation to “continue to practice medicine”.

The Cayman Islands has been the go-to captive jurisdiction for US healthcare organisations with around a third of Cayman captives related to healthcare. Captive Intelligence spoke to captive owners, managers and consultants on the topic while at the Cayman Captive Forum in December 2022.

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Vermont licences 41 new captives in 2022

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Forty-one new captives were licensed by the State of Vermont during 2022, taking its year-end total of active captives to 608. There is a further 31 dormant captives in the state.

Almost 40 individual cells were also established during the year, meaning there are now more than 500 active cells housed within 59 sponsored captives in Vermont.

The growth numbers are the sixth highest the state has recorded since passing captive legislation in 1981. Five new captives have already been formed in 2023.

“While we are happy to have another year of record growth, we never stop asking ourselves how we can be better,” said Sandy Bigglestone, deputy commissioner of captive insurance at Vermont’s Department of Financial Regulation (DFR).

“We are actively looking into how to improve our statutes and internal processes to be most efficient and useful for businesses and look forward to providing the best service to them in the year ahead.”



The 41 formations are made up of 30 pure captives, six new sponsored captives, two agency captives and two Risk Retention Groups (RRGs).

The majority of new captives are owned by American businesses or organisations, but there were also two formed from Canada, one Mexican captive and one Austrian.

There are 17 different industry sectors represented in the new cohort, with healthcare (7), construction (5) and real estate (4) leading the way.

“Throughout the pandemic captive insurance has been a great tool for the health care industry,” said Christine Brown, director of captive insurance, DFR.

“Hospitals and health care providers have had emerging risks and fewer available insurance options. Captive insurance has given them a way to have more control over that risk that’s also financially sustainable.”

The Vermont Department of Economic Development is hosting “Captive Insurance Day” for legislators at the Statehouse, in the capital Montpellier on 18 January, as part of ongoing efforts to educate and raise awareness of the sector and its importance to Vermont.

“The captive industry has remained steady throughout the pandemic, and is thriving here in Vermont,” said president of the VCIA, Kevin Mead.

“The momentum is strong to keep developing this great industry. We continue to raise awareness about captive insurance around the world, and we look forward to expanding our efforts in the year ahead.”

Italian corporates begin move to re-domesticate European captives

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Italian-owned captives have begun the process of re-domesticating back to Italy after negotiations with the regulator IVASS neared agreement.

Captive Intelligence understands the first Italian captive could be operating by the end of June with a second following later this year. Both captives are currently domiciled in European Union countries.

The strategy will be to form a new insurance entity in Italy, which acquires the shares of the legacy captive and completes a transfer of assets and liabilities. This should avoid a more costly run-off of the legacy captive.

Overseas captives, owned by Italian corporates, have come under greater scrutiny in recent years from the country’s tax authorities, especially with regards to transfer pricing.



As a result some captives, if domiciled in a jurisdiction with a significantly lower tax rate than Italy’s, are already paying a top-up tax to the Italian authorities.

Unlike in France, which passed captive specific legislation at the end of last year, the captive community in Italy is not pursuing a new legal framework as references to captives are already on the statute books.

The EU-wide Solvency II stipulates capitalisation and reserving requirements, but there is no equalisation provision (unlike in France and Luxembourg).

A stricter governance regime, compared to other European domiciles, will be enforced by the regulator meaning any captives that move ‘home’ or are formed in Italy are likely to be self-managed with key functions such as audit, compliance, risk and actuarial needing to be managed in-house rather than fully outsourced.

There are very few reinsurance companies in Italy, let alone captives, so it is new territory for the regulator.

As with France, it is not expected or an ambition of IVASS or the local insurance community for Italy to grow into an international domicile attracting captives from overseas.

It is envisaged that it will become a good option for Italian corporates and their own captives, although Captive Intelligence is also aware of new Italian-owned captives being established elsewhere including two expected to be licensed in Switzerland this year.

As examined in this April 2021 long read, there has been growing movement in Europe to consider home domiciling captives but there is debate as to the cost effectiveness and suitability of utilising ‘untested’ domiciles.

Paul Corver to retire as group head of legacy at R&Q

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Paul Corver, group head of legacy M&A at R&Q Insurance Holdings, will retire later this year, according to an internal memo seen by Captive Intelligence.

Going forward, R&Q will have co-heads of its global legacy M&A team, with Huw Battrick and Parri Spector, reporting directly to global CEO Andy Pinkes.

Corver joined R&Q in 2008. He and R&Q have been leaders in the captive legacy space, concluding high profile captive acquisitions and portfolio transfers with captives owned by companies including AstraZeneca, Lufthansa, General Electric and Unilever.

The memo highlighted the important role Corver has played in the development of R&Q’s legacy business since joining and “during his career has established himself as a leading practitioner in the market”.

Spector will continue to work with Ben Masel and the corporate development organisation regarding Gibson Re and other legacy initiatives. 

Battrick will have leadership responsibilities for the UK and Europe team, and Spector for the North America, Bermuda and Caribbean team. 

“I am personally grateful to Paul for his partnership and support and look forward to working with him and the team as we transition to our new operating model,” Pinkes said in the memo.

“Please join me as we thank Paul for his many contributions to R&Q and congratulate Parri, Huw, and Chris on their new responsibilities.”

The memo did not specify an exact departure date, but said Corver would work with the leadership and new co-heads to ensure a smooth transition.

Upward trend of adding medical cover to international EB programmes

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More captive-backed international employee benefits programmes are underwriting medical covers although it often remains a later addition, according to Nicola Fordham, chief underwriting officer at MAXIS Global Benefits Network.

Speaking on a GCP Short where she was joined by Nekisha Tyrrell, head of underwriting at HSBC Insurance (Bermuda) Limited, HSBC’s captive, Fordham said around two thirds of MAXIS’ captive portfolio is now including medical cover.

The captive reinsuring medical cover means it is participating in the corporate’s medical insurance plan, which can include items such as non-urgent care, specialist treatment, operations, physio treatment and dental.

Captive employee benefits programmes have traditionally begun with long-term illness, life and disability covers.

“Perhaps the original points of putting employee benefits into a programme, particularly a captive programme, was around leveraging the underwriting margins that were there,” Fordham said.

“And for medical, you don’t tend to have such wide margins. The reason being because there are so many more claims that come under your medical treatment.”

The HSBC captive and employee benefits programme is operated on a ‘not for profit’ basis, meaning they target breaking even.

“We cover our margins and then where we do experience any profits, we have a pool that eventually goes back to local companies for wellness initiatives,” Tyrell said.

She added that including medical in the captive had been a positive experience to date.

“Because we work so closely with HR teams, we’ve been able to provide comfort locally that we’ll be flexible enough because there are things that are not necessarily covered locally, but because it’s 100% reinsured into our captive, we can take those claims on,” Tyrrell explained.

“We’ve been able to provide benefits that may have been a bit more generous than they’ll get in the market because again, we write it 100%.”

Fordham said that because medical is typically lower margin business, and often written on a breakeven basis such as in HSBC’s case, the motivation for companies going down this route is more about delivering better care to staff, and attracting and retaining talent.

“You’re talking about covering your people,” she added.

“You want your people to be at work, being productive, being able to do the job that you are paying them for. So being able to ensure that if they need medical treatment or their family needs medical treatment, that they can access that because you can provide the appropriate insurance.”

Listen to the full discussion between Nicola Fordham, chief underwriting officer at MAXIS Global Benefits Network, and Nekisha Tyrrell, head of underwriting at HSBC Insurance (Bermuda) Limited, here or on any podcast platform by searching for ‘Global Captive Podcast’.