Cayman Islands

The Cayman Islands is the world's second-largest captive domicile and the leading domicile for healthcare captives, regulated by the Cayman Islands Monetary Authority (CIMA) under the Insurance Act, 2010, as amended. International insurers are licensed as Class B (B(i) where at least 95 percent of net premiums come from related business, B(ii) where more than 50 percent are related, and B(iii) where 50 percent or less are related), Class C (fully collateralised insurance-linked structures) or Class D (open-market reinsurance). As of Q3 2026, CIMA reported 720 Class B, C and D insurers, writing US$62.3 billion of premium and holding US$202.9 billion of assets. Of that population, 337 were categorised as pure captives and 149 as group captives. Medical malpractice was the primary class of 127 licensees, and North America accounted for 632 licensees (88 percent). Class B segregated portfolio companies numbered 177, with 634 segregated portfolios and 68 portfolio insurance companies; those counts sit inside the 720 and are not additional licensees. In 2025 CIMA issued 42 international licences and cancelled 19. Through the 2026 year to date, issues and cancellations were 28 and 28, leaving the international total at 720. Every captive must appoint a licensed local insurance manager. CIMA states that a complete Class B or Class C application takes six to eight weeks. The Islands levy an annual licence fee rather than a premium tax, and CIMA describes the domicile as having no corporate or personal taxes.