What is a combined ratio?
A combined ratio adds an insurer's loss ratio and its expense ratio.[S1] The loss ratio is incurred losses as a percentage of earned premiums. The expense ratio is the share of premiums spent on selling and servicing policies.[S1] Cityfort shows it for property and casualty insurers (car, home and business cover).
How is the combined ratio worked out?
Combined ratio = loss ratio + expense ratio.[S1]
The bases differ. The NAIC glossary divides expenses by written premiums.[S1] Progressive divides both by net premiums earned, and counts claim-handling costs in its loss ratio.[S3] So figures are not always like for like. A row note flags a company's own definition.
Above 100%, losses and expenses came to more than premiums on those bases. The sum leaves out investment income.[S2]
What do health insurers report instead?
A medical care ratio: benefit expense as a percentage of premiums. In their 10-Ks for 2025, Elevance Health calls it the benefit expense ratio and Humana the benefit ratio.[S4][S5] It is not the federal medical loss ratio, which is worked out differently.[S6]
Where do you find it in a 10-K or 10-Q?
SEC rules list an insurer's income statement lines: premiums, net investment income, claims and settlement expenses, and underwriting expenses.[S2] These sit in 10-K Item 8, or 10-Q Part I, Item 1.[S7][S8] The ratios are not among those lines. Progressive and Elevance Health report theirs in MD&A (10-K Item 7).[S3][S4][S7]