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A.M. Best Upgrades Ratings of Coastal MedicalInsurance Ltd.

OLDWICK, N.J. -- A.M. Best Co. has upgraded the financial strength rating (FSR) to A- (Excellent) from B++ (Good) and has assigned an issuer credit rating (ICR) of "a-" to Coastal Medical Insurance Ltd. (Coastal) (Hamilton, Bermuda). The outlook for the FSR is stable, and the outlook assigned to

the ICR is stable.

The ratings reflect Coastal's excellent capitalization, generally favorable operating results generated by a very low expense structure and customized risk management programs, experienced senior management team and conservative reserving and investment philosophies.

Partially offsetting these positive rating factors are the company's limited market scope and relatively high retention levels. However, these concerns are mitigated due to explicit as well as implicit parental support, based on the strategic importance of Coastal within the overall risk management program of the Meridian Health System (Meridian) and its mission of providing affordable, stable coverage to its insureds.

Meridian's risk management and insurance department provides important supporting services to the parties indemnified and reinsured by Coastal. Meridian's risk management program for the hospital system establishes risk control policies and procedures, which include safety education, data collection and evaluation, claims management and risk financing. The ratings also take into consideration the role Coastal serves in providing hospital and physician professional and general liability insurance to Meridian.

For Best's Ratings, an overview of the rating process and rating methodologies, please visit www.ambest.com/ratings.

Founded in 1899, A.M. Best Company is a global full-service credit rating organization dedicated to serving the financial and health care service industries, including insurance companies, banks, hospitals and health care system providers. For more information, visit www.ambest.com.

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