Share of insurance premiums globally 2023, by region

In 2023, the Americas was the largest insurance market globally in terms of insurance premiums written. In that year, the North, South, and Central American insurance industry wrote 44 percent of insurance premiums globally. The largest insurance company in the world in terms of net premiums written was UnitedHealth Group. Based in the United States and operating globally, UnitedHealth Group wrote net premiums worth well over 200 billion U.S. dollars.

UnitedHealth leads the U.S. health insurance sector

With the largest value of net premiums written in the U.S. in 2021, UnitedHealth Group held the highest market share of health insurance companies based in the United States. The insurer describes itself as a healthcare and well-being company with a mission to help people live healthier lives, and currently serves more than 5,000 international clients.

Premiums written vary greatly across countries and insurance markets

As previously mentioned, the United States is one of the world's leading insurance markets, with high volumes of premiums written each year. In other regions, insurance markets are considerably smaller. For instance, India's general insurance penetration in 2023 was only one percent, with no change from the previous year. As such, they ranked at the bottom of the list of leading life and non-life direct premium writing countries, with a combined written premium value of just over 120 billion U.S. dollars.