For Dennis Fox (pictured), principal, senior vice president, and broker at Brown & Riding in Los Angeles, years spent moving between underwriting and wholesale professional liability brokerage have produced one conviction: placing complex healthcare risk starts with doing the underwriter's homework before a submission ever reaches a carrier. Fox leads Brown & Riding's Healthcare Practice, placing coverage for senior care facilities, allied health providers, and human and social service organizations; a corner of the market standard carriers has largely left behind.
Fox began his career in binding authority on the wholesale side; an experience he said still shapes how he builds submissions today. “Starting in binding authority on the wholesale side provided a foundation for understanding what type of rating information connects to each individual risk, whether that’s payroll, area, revenue, bed counts, or employee counts,” he said. “That knowledge has been instrumental in building out and structuring better submissions.”
That grounding, he said, now lets him flag missing information before it slows down a carrier review. “It provides more insight into addressing missing information quickly and ensuring our carrier partners have what’s needed to underwrite an account,” Fox said. “Speed of transaction is critical, and without the right information, underwriters can’t underwrite.” He described the process as essentially pre-underwriting every account before it reaches market, which he said speeds turnaround for insureds and retail agents alike.
Healthcare and senior care remain among the toughest liability classes to place, and Fox said broader access to information has changed how brokers approach them. “Access to knowledge is readily available today, and that gives us the ability to research and understand complex exposures far better, which empowers us to ask better questions of the retailers and insureds coming to us for solutions,” he said.
Artificial intelligence has accelerated that shift, Fox said, “We’ve always reviewed websites to understand an account, but historically we didn’t search for news articles, and when we did, it took much longer,” he said. “Now, with AI-assisted search, we’re able to apply an underwriting lens to our queries and generate executive summaries highlighting past claims, lawsuits, or relevant news.” The approach, he said, keeps carriers focused on an account’s true, current exposure rather than resolved issues.
Placement technology has advanced, too. Fox recalled that at previous wholesale brokerages, submissions went out to carriers at one email at a time. “Now, with today’s platforms, I can select 30 markets and press send once, and it goes out to all 30 in a unique, presentable format,” he said, calling speed to marketplace critical for large, complex accounts. Ninety-one percent of insurers have now adopted some form of artificial intelligence, part of a market forecast to grow past $13 billion by 2026.
Fox said the biggest bottlenecks in healthcare placements now sit with retail agents and insureds rather than wholesalers or carriers. “Some of the large retailers are massive, and the pace of change within them is slower than a small, nimble retailer, simply because of the volume of people who need to adopt whatever changes are happening,” he said.
The paperwork itself hasn’t gotten lighter. “You’re still having to have the insured and the retail agent complete an ACORD, fill out supplementals, pull loss runs, write claim narratives, and document corrective measures,” Fox said, adding that turnaround still depends on the insured’s urgency. AI is now speeding carrier submission clearance and policy issuance, he said, but gains upstream, from retailer to wholesaler, have not yet arrived. Personal lines and cyber liability have seen more AI-driven movement than complex healthcare accounts, he noted.
Looking ahead, Fox pointed to specialization, a trend Insurance Business America has examined in its coverage of how wholesale brokers are becoming indispensable in today's market, as the shift he expects to matter most. “Because of larger losses, unique carrier access points, and new capital entering the space through new carrier entrants, everyone is focused on working with specialists who can move the needle,” he said. “Call it the 80/20 rule: they want to work with the 20 people who are going to move 80 percent of the business.”
“Our marketplace is largely loss-driven. Standard markets have moved away, and accounts are coming to wholesale for a reason.”
He attributed the trend to a marketplace that is largely loss-driven, with standard carriers retreating from tougher classes. “Our marketplace is largely loss-driven. Standard markets have moved away, and accounts are coming to wholesale for a reason,” Fox said. “With that comes a real need for expertise and specialization, and retailers and carriers are all demanding it.” The difference between a specialist and a generalist, he said, shows up quickly in the markets a broker approaches, and that gap is only likely to widen.
