Our History

For 40 years, the CRICO insurance program has provided industry-leading medical professional liability coverage, claims management and patient safety resources to its members. In 1976, the crisis of insurance availability led the Harvard Medical Institutions to form a “captive” medical professional liability insurer, 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, we represent the largest medical professional liability carrier in Massachusetts, distinguished by the varied size and structure of our member organizations. Coverage is limited to employees of, and physicians sponsored by, a member institution, each of whom must meet CRICO’s eligibility criteria.

Our Corporate Structure

The CRICO insurance program operates through a group of companies owned by and serving the Harvard medical community. It is structured as follows:

• Controlled Risk Insurance Company of Vermont, Inc. (a RRG) provides primary and excess insurance coverage.
• Controlled Risk Insurance Company, Ltd. (domiciled in Grand Cayman, BWI) delivers additional insurance and reinsurance.
  • CRICO International is a wholly-owned subsidiary of CRICO Cayman, established in December 2009 to provide expanded Medical Professional Liability (MPL) and Errors & Omissions (E&O) coverage to insured clinicians and organizations practicing outside of the United States.
• 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. RMF has three affiliated divisions:
  • CRICO Strategies was established in 1998 to extend CRICO's patient safety mission through broad dissemination of products and services designed to reduce medical error and malpractice exposure. Strategies offers clinical risk intelligence and an opportunity to exchange dialogue and best practices among a national client base.
  • 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.
  • 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.