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Policy Claims and Other Benefits Payable - Schedule of Liability For Policy Claims and Other Benefits Payable (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Roll Forward In Liability For Unpaid Claims And Claims Adjustment Expense [Abstract]      
Policy claims and other benefits payable, beginning of period $ 307,401 $ 268,136 $ 238,157
Reinsured policy claims and other benefits payable, beginning of period 322,137 323,195 263,003
Net balance, beginning of period (14,736) (55,059) (24,846)
Incurred related to current year 176,854 162,256 143,518
Incurred related to prior years [1] (1,355) 2,230 (522)
Total incurred 175,499 164,486 142,996
Claims paid related to current year, net of reinsured policy claims received (187,453) (181,670) (203,015)
Reinsured policy claims received related to prior years, net of claims paid 22,426 57,192 29,546
Total paid (165,027) (124,478) (173,469)
Foreign currency translation (527) 315 260
Net balance, end of period (4,791) (14,736) (55,059)
Reinsured policy claims and other benefits payable, end of period 318,653 322,137 323,195
Policy claims and other benefits payable, end of period $ 313,862 $ 307,401 $ 268,136
[1] Includes the difference between our estimate of claims incurred but not yet reported at year end and the actual incurred claims reported after year end.