Travelers Middle Market is writing healthcare auto and property again
Insurance Insider, September 2026. Westwood's Michael Richards, Ralph Schiller and Dale Nelson sit down with Elle Koesters, middle-market underwriter at Travelers Commercial Accounts, to find out what she wants to see, what she will pass on, and how to get a submission to the right desk.
For a while Westwood has been working on the assumption that Travelers had pulled back on commercial auto for healthcare. That turns out to be old information.
"The auto is case by case," Elle Koesters told the team. "We've been seeing a lot more, and we're able to write a lot more."
For a brokerage whose book is built on nursing homes, home health and the transport risks that come with them, that is the headline of this conversation. The rest of it is about where the lines are.
Where Elle sits, and where submissions go
Elle underwrites in Travelers' Independence office outside Cleveland, Ohio, in the Commercial Accounts unit of Middle Market. Middle Market is split into several business units. Alongside Commercial Accounts there are Construction, Technology, Excess Casualty and National Property, plus the separate Select unit for small business and a Life Science and Technology unit.
Submission flow is simple. There is no shared inbox. ACORD applications, loss runs and anything else on the account go straight to Elle's email. If a risk belongs to another unit, she routes it. "There's a lot of us at Travelers and we don't want to miss an opportunity for anyone."
The same applies to size. If an account is too small for Middle Market she will say so straight away and point it at Select, where the quote will come back faster.
Healthcare: what Travelers will and won't write
Westwood's niche is healthcare, roughly 110 classes under the Allied Health umbrella, from medical professionals to residential operations such as host homes and sober living. Elle was candid about where Travelers Middle Market fits inside that.
Where they can compete
Skilled nursing facilities: property and auto. This is the class Elle named first as competitive.
Patient transport fleets: buses and vans taking residents to activities, appointments or the store, with proper controls in place.
Larger fleets attached to a healthcare operation, for example a 30-home nursing chain with passenger vans, maintenance vehicles and admin cars.
Medical spas: property for certain, and Elle believes most lines including PL/GL can be looked at. Modern med-spa services (fillers, Botox, peptides, GLP-1 prescribing) may sit partly with the Life Science unit.
Workers compensation, guaranteed cost and large deductible, judged class by class.
Where they are out
General liability on most healthcare classes. "The property and auto is where we get stuff across the finish line."
Adult daycare, in every line.
Sober living and placement operations, particularly where the operator owns the housing.
Individual cars used to run residents to appointments. Buses and vans with controls are fine, single vehicles are not the appetite.
Monoline auto. Auto is written alongside the property or the workers comp, never on its own.
ATVs, four-wheelers, motorcycles and standalone used-car lots on the dealer side.
Still open
Hyperbaric chambers inside a med spa: Elle had not seen one and will circle back.
Laboratories: these fall to Life Science and Technology. Elle will connect Westwood with Ryan Keisner in that unit and send an appetite sheet.
Mixed operations: a fleet where 85% of the exposure is home health and 15% is daycare could be looked at, but the daycare portion raises a flag.
Auto, with conditions
Auto is the biggest change, so it is worth being precise about the conditions Elle attached to it.
It is never monoline. Property or workers comp has to come with it.
Controls decide it. Cameras, securement on buses, driver MVRs being pulled, and a risk-control visit to check all of that.
Contracted transport needs the contracts. Dale Nelson raised a fleet under contract to Immigration and Customs Enforcement to move detainees. Elle would look at it, with the contracts in hand.
Workers comp and the Select boundary
Travelers Middle Market writes guaranteed-cost and large-deductible comp with no minimum premium. There is also no minimum premium on the package side.
That means the boundary with Select is not a number. Elle described it as Swiss cheese: some accounts you would expect to be small fall to her, and some you would expect to be middle market fall to Select. The practical rule is to send it in. She will tell you immediately if it belongs with Select, and she will pass it across.
Risk control and the 30-day rule
Travelers likes its risk-control people on site before terms are offered on a middle-market account, or on a virtual visit when time is short. Smaller deals can go to a post-bind inspection. Elle called the risk-control team a genuine resource: they have seen a lot of facilities and their recommendations are specific.
All of that takes time, so the ask is a month of lead time. A quote needed on 16 September should be in her inbox by 16 August. An account Travelers has seen before, even with an older risk-control report, buys some leeway.
Beyond healthcare
Travelers' Independence office also does well in two areas Westwood sees occasionally. Franchised new-car dealerships, including their used lot, are competitive even though Travelers does not write the open-lot coverage. Real estate, from office and industrial to apartment buildings, can be written once risk control has been out.
Travelers writes in all 50 states and coordinates with the local office on territory-specific issues, Florida being the example given.
The rest of Travelers
Several other Travelers desks came up, and they matter for routing:
Crime and cyber: Melanie Reese.
Large-deductible workers comp: Brenda Russ.
Life Science and Technology, including labs and medical products: Ryan Keisner.
Small business: Travelers Select. Westwood has asked for a separate Select training session.
What happens next
Elle is sending a full Travelers appetite overview, updated Middle Market and Life Science market sheets, and an introduction to Ryan Keisner so the team can run this same forum with the Life Science unit. Submissions go to Elle directly for now. She will forward anything that belongs elsewhere.
Insurance Insider is a Westwood Insurance series. The full conversation is available on video and as a podcast episode.