I'll be honest: medical malpractice insurance was not on my 2025 bingo card for "most interesting healthcare vertical to dig into." But after sitting down with Jared Kaplan, CEO and founder of Indigo Technologies, for a recent episode of Claims Denied, I came away genuinely fascinated by the parallels between what's happening in MedMal and the broader structural shifts playing out across healthcare finance and AI adoption.
Jared is a repeat InsureTech entrepreneur who previously built a lending company that went public, spent time at Goldman in TMT, and then deliberately pivoted into one of the least sexy industries he could find. His thesis: the biggest opportunities to disrupt sit in the most boring, least competitive corners of the market. MedMal might be the poster child.
The MedMal market is roughly $13B, split evenly between independent physicians and facilities buying excess insurance over their self-insured retentions. Physicians are filling out 15-page applications with 300 questions, waiting days to weeks for quotes, and getting underwritten on 3 blunt variables: specialty, geography, and claims history. That's it. Virtually no individualized risk assessment at the physician level, in an industry touching every doctor in America.
Indigo throws out the application entirely. They pull data via a physician's NPI and run it through a proprietary model built on roughly 1,500 attributes predictive of malpractice risk by specialty and geography, one that can identify the 20% of physicians driving 60% of claims. Jared told me the predictive power was stronger than anything he'd seen in consumer lending, which is saying something.
Jared frames Indigo's entry as InsurTech 3.0.
Version 1.0 moved distribution online; version 2.0 (the ZIRP era) poured capital into growth and assumed tech would eventually solve for profitable underwriting. It didn't. Version 3.0 is the correction: you still need to grow fast, but you have to prove your technology gives you a genuine edge in risk selection.
Indigo is the embodiment of that discipline, by their account the fastest-growing company in the space, while deliberately constraining volume to protect loss ratios. Jared on Series B investors pushing for exponential growth: "We could do that tomorrow and blow up the business in 3 years, but let's not." That's the exact discipline missing from the 2.0 era, and frankly from a lot of digital health companies that scaled distribution without proving unit economics.
Indigo sells 100% through brokers. There's no viable direct-to-physician channel because physicians want a trusted intermediary navigating MedMal's complexity. That means Indigo's technology is worthless without broker buy-in, and building that trust as a 3-year-old startup against carriers with 100-year track records wasn't trivial. Brokers spent Year 2 sending Indigo their worst submissions to test whether they'd write anything just to gain scale. Indigo held the line, which cost short-term growth but bought long-term credibility.
By Year 3, the tide turned. Jared's favorite evidence is that incumbent carriers are now actively threatening distribution partners who work with Indigo. When the 100-year-old carrier picks up the phone to complain about you, you've struck a nerve.
In 2025, Indigo processed 7,000 submissions with 4 underwriters, with automated decisions climbing toward 50%. Jared expects the company to never exceed roughly 100 employees (today, 40). They quote about half of what they see and bind a quarter of what they quote for their best broker partners. They could improve that conversion by flexing on price, but won't, because it would jeopardize loss ratios. The discipline is the product.
This is where it gets really interesting for health system readers. Hospital self-insured retentions that used to sit at $5-10M are ballooning to $15-25M, driven by the nuclear verdict trend (Jared cited a $108M Jefferson, New Jersey verdict) and reinsurers pulling capacity in response. Hospitals can't just terminate their highest-risk physicians, because many are also their highest-revenue generators doing the most complex procedures.
Indigo's play is to commercialize its risk analytics for self-insured facilities, helping risk management understand risk drivers, inform credentialing decisions, allocate the internal cost of risk across medical staff instead of peanut-buttering premiums evenly, and optimize how the system buys excess reinsurance. If you're a health system CFO watching your retention double while your reinsurance tower gets more expensive, that's a tool worth a hard look.
The most provocative thread: AI-enabled clinical tools eventually getting embedded in malpractice pricing, the way home security systems lower homeowners premiums. Once there's real-world evidence that documentation software or diagnostic AI reduces errors, carriers should reward physician groups for deploying them. And physicians who skip proven safety tools could eventually face surcharges. The timeline is long (Jared estimated a decade-plus), but the direction of travel is clear, and it creates an interesting overlap with VBC's own push to reduce avoidable harm.
With $100M raised and the Series B closed, capital priorities are clear: retain more underwriting risk, fund runway to cash-flow breakeven, and build out the facilities analytics platform. The five-year ambition is to be a top-5 physician malpractice carrier with a robust self-insured analytics business.
The underlying thesis — a $13B market with concentrated incumbents, archaic technology, and a structural shift in the liability environment — is compelling. It also rhymes with what we've seen play out in health plan administration and VBC risk-bearing entities: incumbents get comfortable, technology creates a wedge, and the startups combining technical sophistication with operational credibility eventually win share. I'm rooting for Indigo, because grow fast, prove profitability, invest in tech without neglecting human trust is the playbook I wish more healthcare startups would follow.
Image from original article.
