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About Lone Star

Lone Star Alliance, Inc., a Risk Retention Group (RRG), or LSA, provides medical professional liability insurance to physicians, groups, health care facilities, and allied health care professionals.

We provide flexible, comprehensive coverage nationwide to support groups and individual practices wherever they grow. And, we create custom-made coverage to give you exactly what you want.


LSA is an affiliate company of Texas Medical Liability Trust (TMLT) for management and administrative services, and is reinsured by Texas Medical Insurance Company (TMIC).

LSA was established to provide medical professional liability and related lines of insurance to physicians, physician partnerships, professional medical corporations, other health care practitioners, and health care facilities in multiple states.

LSA is domiciled in Washington DC and began writing business in December 2013. It is currently filed and approved in 49 states and the District of Columbia.

TMLT is the leading provider of medical professional liability insurance in Texas. Protecting physicians since 1979, TMLT retains a wealth of talent and experience in claims management, risk management, and underwriting.

LSA, TMLT, and TMIC are all rated A (Excellent) by A.M. Best, the premier rating agency of insurance entities worldwide. TMIC is a wholly owned subsidiary of TMLT.

Together, LSA and TMLT meet the needs and exceed the expectations of the physician community. We offer a highly competitive product with excellent protection and an unwavering commitment to defend the reputations of our clients.

At a glance

  • Rated A (Excellent) by A.M. Best.
  • Reinsured by TMIC, also rated A (Excellent) by A.M. Best.
  • Authorized to do business nationwide. Domiciled in Washington D.C.
  • Provides claims-made, occurrence, and per-patient policies.
  • Flexibility in both coverage and limits for groups and individuals. Customized programs are available.

Policies include:

  • Cyber liability;
  • Regulatory actions protection (Medefense);
  • Employment practices liability (EPLI);
  • Premises liability coverage;
  • Shared limits; and
  • Medical director.