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Equity method investment - Financial Position and Results of Operations (Details) - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended
Jun. 30, 2021
Jun. 30, 2020
Jun. 30, 2021
Jun. 30, 2020
Dec. 31, 2020
Schedule of Equity Method Investments [Line Items]          
Assets $ 35,412,309   $ 35,412,309   $ 34,932,860
Liabilities 30,311,078   30,311,078   30,028,249
Total liabilities and shareholders' equity 35,412,309   35,412,309   34,932,860
Bankers Healthcare Group, LLC          
Schedule of Equity Method Investments [Line Items]          
Assets 1,882,147   1,882,147   1,330,317
Liabilities 1,573,156   1,573,156   1,088,135
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest 308,991   308,991   242,182
Total liabilities and shareholders' equity 1,882,147   1,882,147   $ 1,330,317
Revenues 178,984 $ 92,790 336,607 $ 190,734  
Income (Loss) from Continuing Operations, Net of Tax, Including Portion Attributable to Noncontrolling Interest $ 62,353 $ 37,674 $ 120,915 $ 70,145