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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, 2022
Dec. 31, 2021
Dec. 31, 2020
Schedule of Equity Method Investments [Line Items]      
Assets $ 41,970,021 $ 38,469,399  
Liabilities 36,450,629 33,158,792  
Total liabilities and shareholders' equity 41,970,021 38,469,399  
Bankers Healthcare Group, LLC      
Schedule of Equity Method Investments [Line Items]      
Assets 4,375,643 2,724,542  
Liabilities 3,821,725 2,355,256  
Equity interests 553,918 369,286  
Total liabilities and shareholders' equity 4,375,643 2,724,542  
Revenues 1,110,230 735,506 $ 457,928
Income before income taxes and equity in undistributed income of subsidiaries $ 295,186 $ 241,051 $ 171,964