Our History

In 1976, the crisis of insurance availability led the Harvard Medical Institutions to form a “captive” medical professional liability insurer (MPL), Controlled Risk Insurance Company, Ltd. (CRICO), an offshore insurance company operating and domiciled in the Cayman Islands. Harvard’s model of creating an offshore captive—an insurer owned by the facility or health care system it exclusively insures—was later replicated by other health systems across the U.S.

Today, the CRICO program protects providers within the Harvard medical community through insurance products, claim management, and patient safety innovation. The complex and varied structures of our member organizations necessitate a broad scope of expertise at CRICO which enables us to provide comprehensive services for our members and their eligible physicians, employees, and affiliates. In our mission to promote patient safety, we promulgate our data, research, and analytic insights within our community and globally.

Our Corporate Structure

CRICO operates through several companies and is structured as follows:

• Controlled Risk Insurance Company of Vermont, Inc. (a Risk Retention Group) provides primary and excess insurance coverage.
• Controlled Risk Insurance Company, Ltd. (domiciled in Grand Cayman, BWI) and its wholly-owned subsidiary, CRICO International, provides reinsurance to CRICO Vermont
• The Risk Management Foundation of the Harvard Medical Institutions Incorporated (RMF) was established in 1979 to apply a data-driven approach to claims management and patient safety on behalf of CRICO's insured organizations. Among RMF’s divisions and subsidiaries:
  • Academic Medical Center Patient Safety Organization (AMC PSO) was established under the Patient Safety and Quality Improvement Act of 2005, to function as a national convener of AMCs offering enhanced federal, state, and local privilege for the sharing of data, data analyses, and case discussion, in the spirit of furthering the patient safety movement.
  • CRICO Strategies was created in 1998 to extend our patient safety mission beyond the Harvard-affiliated organizations through broad dissemination of products and services designed to reduce medical error and malpractice exposure.
  • Healthcare Safety Research Institute (HSRI), a tax-exempt 501(c)(3) organization, is an educational foundation that conducts teaching programs to improve the delivery of patient care and to effect beneficial changes to the culture of medicine.
  • RMF Insurance Agency, Inc. is a subsidiary of RMF. The agency provides both business and personal insurance products for all members of the CRICO community through a unique business relationship with Marsh & McLennan Agency, LLC.