Physician Leadership in Action: MICA’s 50-Year Legacy
With Dr. Brooks’ retirement in the late 1980s, MICA entered a new era of leadership and growth. Having already proven that a physician-led insurer could succeed, the company now faced a medical liability environment that is still continuing to evolve. From its inception, MICA was built on a collaborative partnership between insurance professionals and physicians, working together while keeping its focus as a member-owned mutual company. Under Dr. Robert Crawford, MD, and later Brendon Hirschberg, MD, a general surgeon from Flagstaff, and James Carland, MD, MICA maintained its physician-led foundation while adapting to new challenges in the marketplace.
Meeting the Challenges of a Changing Liability Environment
As other carriers failed, raised premiums sharply, or withdrew coverage altogether, MICA took a different approach. From 2001 to 2006, it adjusted rates carefully, keeping increases slower, smaller, and lower than the industry overall. MICA also pushed for reforms that made MPL litigation more objective in Arizona and protected Utah physicians’ ability to defend their care in both trial and arbitration.
Concurrently, MICA broadened its member support. It expanded risk management resources through emerging digital platforms and opened its doors to physicians displaced by failing carriers, nearly doubling policyholder membership. When hospitals lacked professional liability coverage, MICA stepped in temporarily to fill the gap until dedicated hospital carriers returned.
This period of growth also brought greater independence. As leadership transitioned to Dr. James Carland, MD, an Arizona pediatrician and MICA’s fourth President/CEO (1997-2023) and Chairman (2003-present), the company ended its arrangement with its management firm and became a truly independent mutual insurance company.
Mark Twain is credited with the aphorism: “History doesn’t repeat itself, but it often rhymes.” When Dr. Carland assumed his role in 1997, claim frequency and costs had already begun to rise again, echoing the late 1980s and late 1990s. MICA continued to support its members through careful rate management in the 2000s. Occasional adjustments were balanced with a long history of flat rates and modest periodic decreases, reflecting the company’s long-standing commitment to stability. This approach, combined with ongoing advocacy for reforms that make professional liability coverage more predictable, reinforces MICA’s member-focused philosophy.
Years later, the COVID-19 pandemic came, and virtually shut down the judiciary and interrupted the settlement of claims, virtually shutting down the court system, and threatening the safe provision of medical care. Recognizing the financial strain on member practices during this time, the Board of Trustees declared an extraordinary dividend of $12 million in 2020.
Marking 50 Years of Physician Leadership
From what some once described as an insurance company operating “out of a shoebox” with little chance of success, and what others pejoratively dismissed as a “bedpan mutual,” MICA has become a substantial resource for its members and a benefit to the broader population of patients they serve.
Today, MICA stands as a preeminent MPL carrier in the U.S., with the personnel, the experience, and the focused mission to protect its members. The mission to ensure that medical professional liability coverage and resources remain available at the lowest sustainable cost was first set by the Board of Trustees in 1976 and has guided MICA for decades.
As MICA marks its 50th anniversary, its steadfast commitment to protecting healthcare professionals and their patients, along with a long-standing tradition of sharing success through dividends, reflects the enduring principles that will continue to shape its mission for the future.