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Equity method investment Equity method investment - Financial Position and Results of Operations (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Schedule of Equity Method Investments [Line Items]      
Assets $ 38,469,399 $ 34,932,860  
Liabilities 33,158,792 30,028,249  
Total liabilities and stockholders' equity 38,469,399 34,932,860  
Bankers Healthcare Group, LLC      
Schedule of Equity Method Investments [Line Items]      
Assets 2,724,542 1,330,317  
Liabilities 2,355,256 1,088,135  
Equity interests 369,286 242,182  
Total liabilities and stockholders' equity 2,724,542 1,330,317  
Bankers Healthcare Group, LLC      
Schedule of Equity Method Investments [Line Items]      
Revenues 735,506 457,928 $ 366,500
Income before income taxes and equity in undistributed income of subsidiaries $ 241,051 $ 171,964 $ 182,462