Where It All Began: Dr. Jack E. Brooks and the Origin of MICA
As MICA celebrates its 50th anniversary, we reflect on the bold leadership of Dr. Jack E. Brooks, whose vision and determination made our company possible. In 1975, Arizona’s primary medical professional liability (MPL) carrier declared MPL “uninsurable” and announced it would cease writing MPL insurance in Arizona as of March 31, 1976.
This decision sparked a medical malpractice insurance crisis that threatened healthcare throughout the state. Working with a committee composed of representatives of Arizona medical and hospital associations, Dr. Brooks led the effort to keep the carrier, but to no avail.
Arizona’s Medical Malpractice Insurance Crisis
Failure to ensure the availability of MPL insurance coverage was not an option. The lack of insurance coverage threatened all healthcare, not just physicians, so Dr. Brooks — along with his fellow physicians and their supporters — sought another way forward.
Without medical professional liability insurance coverage, patients risked losing access to care entirely in an environment of rising verdict value and rising claim frequency. Physicians would have to lead the effort to form their own insurance carrier.
In early 1976, a special legislative session was called to address the insurance issues as well as tort reform. Dr Brooks’ committee drafted emergency enabling legislation that created a special exemption to the Arizona Department of Insurance’s minimum surplus requirement to form an insurer.
This legislation also allowed the use of a mutual form of beneficial ownership and governance, created a pretrial hearing panel (that was abandoned a long time past), an Arizona Joint Underwriting Plan (AJUP) that served as a reinsurer for each policy written, and a funding mechanism for a “home grown” insurer supported by a loan underwritten by the Arizona Medical Association.
But more than creating the opportunity to found a mutual insurance company specializing in medical professional liability coverage, Dr. Brooks’ committee successfully addressed tort reforms that rationalized the tort system related to medical care. They even addressed, albeit unsuccessfully, caps on non-economic damages.
And all of this happened in the three short months of the first quarter under the leadership of Dr. Brooks.
A Physician-Led Alternative
In February 1976, MICA was established with the support of a national insurance broker. Dr. Brooks became the organization’s first Chairman and President, and within two months MICA issued its first policy for $100,000/$300,000, supplemented by $1 million in excess coverage through the AJUP. As a mutual company owned by its policyholders, MICA’s structure would eventually allow members to share in the company’s financial success, reinforcing the physician-led mission
In its early years, each new policyholder purchased a “surplus note” to help retire the Arizona Medical Association loan and strengthen MICA’s surplus. These notes functioned as interest-bearing loans, all of which were repaid in full by 1983. As planned, the AJUP discontinued its role in providing excess insurance in 1980 and was subsequently sold to Skandia Reinsurance Company in 1983. By 1984, MICA received its first AM Best rating, affirming its financial strength.
MICA was on its own to define policy limits and forms, underwrite physicians and other health care entities, handle claims, meet regulatory requirements, and independently contract for reinsurance to cover the risks it did not have the resources to prudently handle.
Within four years of its founding, MICA’s success showed that physicians, in partnership with insurance professionals, could build a true insurance company to manage their own destiny.
That partnership also created a system that better served patients, keeping care accessible while ensuring that those harmed by true medical errors could be compensated fairly. MICA has also long invested in proactive risk management programs to reduce errors and improve patient safety, reinforcing its dual commitment to supporting physicians and protecting the patients they serve.
In MICA’s early years, Dr. Brooks served as the company’s sole employee. The board engaged Marsh and McLennan, a professional management firm, to provide insurance back-office support. This arrangement left Dr. Brooks and the board with two responsibilities: to learn the intricacies of insurance and to ensure that the mission of the newly formed company was carried out and upheld.
From the outset, MICA emphasized physician control. Each policy granted the insured physician the right to consent to or decline a settlement. At the time, most medical professional liability carriers reserved this authority for themselves, settling claims for nuisance value or in amounts they deemed appropriate, regardless of the physician’s wishes.
This emphasis on physician involvement may have contributed to a notable decline in claim frequency by the early 1980s. However, that trend reversed in the mid-1980s. The rapid growth of HMOs, with their restricted access, pre-authorization requirements, and resulting patient dissatisfaction, coincided with a sharp increase in both the frequency and cost of medical professional liability claims. This, in turn, led to substantial premium increases.
As the period of high frequency and high cost of claims peaked in the late 1980s, Dr. Brooks retired and Robert Crawford, MD, a Phoenix pediatrician, assumed the roles of Chairman, President and CEO. Around this time, in 1988, MICA issued its first dividend to members — early proof of the benefits of a mutual model in action.
Building on its early financial success, MICA today holds an A (Excellent) AM Best rating and has returned a total of $746 million to members, reflecting decades of stability and a steadfast commitment to its physician-owned model.
MICA’s Growth and 50-Year Legacy
Guided by the vision and leadership of Dr. Brooks, MICA has grown from its 1976 beginnings into a physician-led insurer that now serves physicians and advanced healthcare professionals across Arizona, Colorado, Montana, Nevada, Utah, and Wyoming.
This expansion reflects the enduring strength and impact of the mission he helped establish. Today, that mission continues to support both the physicians who deliver care and the patients who rely on them — safeguarding the trust at the heart of every healthcare relationship.
The company is also expanding through its Risk Retention Group, creating new opportunities in additional states and extending the value it provides to policyholders.
To mark its 50th anniversary and honor the Arizona Medical Association’s pivotal role in its founding, MICA is supporting the first 100 new Arizona Medical Association members in 2026 with discounted memberships. This gesture reflects the same spirit of collaboration and commitment that inspired MICA’s creation and continues to guide its mission today.