Schedule III - Supplementary Insurance Information (Details) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2016
Dec. 31, 2015
Dec. 31, 2014
Supplementary Insurance Information, by Segment [Line Items]      
Deferred policy acquisition costs and value of business acquired $ 194,787 $ 190,648 $ 184,100
Claim liabilities 487,943 491,765 390,086
Liability for future policy benefits 321,232 352,370 328,293
Unearned premiums 79,310 80,260 82,656
Other policy claims and benefits payable 0 0 0
Premium revenue 2,890,641 2,783,154 2,128,566
Net investment income 48,913 45,174 47,540
Claims incurred 2,472,191 2,318,715 1,747,595
Amortization of deferred policy acquisition costs and value of business acquired 37,700 43,594 43,638
Other operating expenses 456,194 475,127 453,556
Net premiums written 2,885,504 2,777,053 2,127,719
Managed Care [Member]      
Supplementary Insurance Information, by Segment [Line Items]      
Deferred policy acquisition costs and value of business acquired 0 0 0
Claim liabilities 349,047 348,297 249,330
Liability for future policy benefits 0 0 0
Unearned premiums 2,889 3,489 4,340
Other policy claims and benefits payable 0 0 0
Premium revenue 2,648,469 2,549,522 1,896,142
Net investment income 15,102 11,779 15,010
Claims incurred 2,347,547 2,196,693 1,629,095
Amortization of deferred policy acquisition costs and value of business acquired 0 0 0
Other operating expenses 375,262 393,407 374,244
Net premiums written 2,648,469 2,549,173 1,896,142
Life Insurance [Member]      
Supplementary Insurance Information, by Segment [Line Items]      
Deferred policy acquisition costs and value of business acquired 177,811 172,284 164,367
Claim liabilities 42,858 44,601 43,670
Liability for future policy benefits 321,232 352,370 328,293
Unearned premiums 8,122 6,596 5,158
Other policy claims and benefits payable 0 0 0
Premium revenue 156,856 148,115 142,485
Net investment income 24,877 24,457 23,717
Claims incurred 86,924 82,561 74,850
Amortization of deferred policy acquisition costs and value of business acquired 12,530 17,661 18,260
Other operating expenses 60,821 52,338 50,531
Net premiums written 152,506 144,262 142,485
Property and Casualty Insurance [Member]      
Supplementary Insurance Information, by Segment [Line Items]      
Deferred policy acquisition costs and value of business acquired 16,976 18,364 19,733
Claim liabilities 96,977 99,796 97,451
Liability for future policy benefits 0 0 0
Unearned premiums 68,299 70,175 73,158
Other policy claims and benefits payable 0 0 0
Premium revenue 87,945 87,633 92,143
Net investment income 8,891 8,706 8,600
Claims incurred 40,766 42,600 46,330
Amortization of deferred policy acquisition costs and value of business acquired 25,170 25,933 25,378
Other operating expenses 18,826 19,533 18,991
Net premiums written 87,158 85,734 89,092
Other Non-reportable Segments, Parent Company Operations and Net Consolidating Entries [Member]      
Supplementary Insurance Information, by Segment [Line Items]      
Deferred policy acquisition costs and value of business acquired 0 0 0
Claim liabilities (939) (929) (365)
Liability for future policy benefits 0 0 0
Unearned premiums 0 0 0
Other policy claims and benefits payable 0 0 0
Premium revenue (2,629) (2,116) (2,204)
Net investment income 43 232 213
Claims incurred (3,046) (3,139) (2,680)
Amortization of deferred policy acquisition costs and value of business acquired 0 0 0
Other operating expenses 1,285 9,849 9,790
Net premiums written $ (2,629) $ (2,116) $ 0