March 5, 2012
W. Stancil Starnes
Chairman and Chief Executive Officer
Investor Presentation
Investor Presentation
Raymond James & Associates
Raymond James & Associates
33nd Annual Institutional Investors Conference
33nd Annual Institutional Investors Conference

This presentation contains Forward Looking Statements and other information designed to convey
our projections and expectations regarding future results. There are a number of factors which
could cause our actual results to vary materially from those projected in this presentation. The
principal risk factors that may cause these differences are described in various documents we file
with the Securities and Exchange Commission, such as our Current Reports on Form 8-K, and our
regular reports on Forms 10-Q and 10-K, particularly in “Item 1A, Risk Factors.” Please review
this presentation in conjunction with a thorough reading and understanding of these risk factors.
This presentation contains Non-GAAP measures, and we may reference Non-GAAP measures in
our remarks and discussions. A reconciliation of these measures to GAAP measures is available in
our latest quarterly news release, which is available in the Investor Relations section of our website,
www.ProAssurance.com, and in the related Current Reports on Form 8K disclosing that release.
FORWARD LOOKING STATEMENTS
2
NON-GAAP MEASURES

The only pure-play, publicly-traded insurer
in the healthcare professional liability line
Handout Slides 2-6

Unmatched financial performance
Handout slides 7-13

Unequaled Value for Our Insureds
Handout slides 14-21

A Clear Strategy for an Uncertain Future
Handout slides 22-29

Handout slides 30-31

March 5, 2012
W. Stancil Starnes
Chairman and Chief Executive Officer
Investor Presentation
Investor Presentation
Raymond James & Associates
Raymond James & Associates
33nd Annual Institutional Investors Conference
33nd Annual Institutional Investors Conference

March 5-6, 2012
Investor Handouts
Investor Handouts
Raymond James & Associates
Raymond James & Associates
33nd Annual Institutional Investors Conference
33nd Annual Institutional Investors Conference

ProAssurance
We are the only pure-play, publicly-traded
healthcare professional liability (HCPL)
insurance company in America

ProAssurance Corporate Profile
Specialty writer of professional liability insurance
Primarily Healthcare Professional Liability (HCPL)
Only pure play public company writing predominately HCPL
Market Cap: ~2.7 billion
Shareholders’ Equity: $2.0 billion
Total Assets: $5 billion
Annualized dividend yield is 1.1% / $0.25/share
Rated “A” by Fitch and A. M. Best
11

This is ProAssurance
Evolving strategy is successfully adding business across the
risk spectrum as the delivery of healthcare changes
Distribution is Independent Agent (64%) and Direct (34%)
Direct in Alabama, Florida and in all states for Podiatric business
Dual distribution in DC, Texas and parts of Missouri
2011 Policyholders: ~71,500
2011 Gross Written Premium: $566 million

ProAssurance Geographic Profile
Broad geographic diversification
Locally-based decision differentiates ProAssurance by
addressing each state’s unique medical/legal challenges
13
Corporate Headquarters
Corporate Headquarters
(Birmingham)
2010 Market Share: Six-Ten
2010 Market Share: Six-Ten
ProAssurance Footprint
December 31, 2011

HCPL Stands Apart in Insurance
14
Long-tail vs. short tail
Prolonged period of “benign profitability”
Premiums levels remain well above levels of 2000
Significant policyholder retention
No large commercial carriers have entered the
market in a meaningful manned
Significant barriers to entry in underwriting and
claims handling
No Catastrophe exposure

The Performance of ProAssurance
We ensure that we deliver an unparalleled level of
service and financial stability that truly
differentiates our coverage and our Company

Consistent Success in All Financial Climates
16
Historical Book Value Per Share
Inception to 12/30/11
CAGR: 16%
Cumulative:1832%
10 Year Summary (2001 -2010)
CAGR: 16%
Cumulative: 342%

Consistent Success in All Financial Climates
Share price rewards long term holders with a
variety of investing styles
17
Historical Book Value Per Share
Inception to 2/24/12
CAGR: 15%
Cumulative:1605%
10 Year Summary (2002 -2011)
CAGR: 16%
Cumulative: 354%

ProAssurance: Investment Profile
18
$4.1 Billion Overall Portfolio
$3.7 Billion Fixed Income Portfolio
Average duration: 3.9 years
Average tax-equivalent Income yield: 4.5%
Investment grade: 96%
Weighted average: AA-
12/31/11
Key portfolio actions in Q4
Added dividend-paying equities
Added to high yield investments
CUSIP-level portfolio disclosure on our website:
www.proassurance.com/investorrelations/supplemental.aspx

Committed to Effective Capital Management
Balancing future needs with current market reality
Dividend is current $1.00/share/year
Complements our prudent share repurchase program
$315 million spent to repurchase 6.0 million shares since 2005
Enhancing shareholder value by repurchasing
shares at prices that build Book Value
19
Share Repurchase History

Steady Return in an Unfavorable Environment
Meeting our long-term ROE target of 12% -14%
Components of Return on Equity (in millions)

Driven to Excel / Focused on Shareholder Value
Maintaining profitability
Sustaining book value growth
Producing sustainable shareholder value
Focusing on long-term—ready for the market turn
21
Current Prices Continue to Offer a Compelling Buying Opportunity
Current Price to YE 2011 Book: ~1.3x Average Since Inception: 1.4x

The Passion of ProAssurance
We ensure that we deliver an unparalleled level of
service and financial stability that truly
differentiates our coverage and our Company

The Promise of Treated Fairly
23
The touchstone for every decision and
interaction at ProAssurance
Affirms our existing, enduring commitment to
every stakeholder
Insureds
Agents
Investors
The public
Employees

Underwriting for Profitability Not Market Share
Underwriting process driven by individual risk
selection and assessment of loss history, areas of
practice, and location
Rates contemplate specific ROE expectations
Frequent rate/loss reviews ensure adequate prices
Rate filings consider the results of the past five to
seven years to ensure a single year does not unduly
influence results
Stringent underwriting standards maintain rate
structure and enhance profitability
24

Calendar Year Combined Ratio: ProAssurance Consistently Outperforms
ProAssurance Outperforms the Industry
Five Years: ProAssurance Average: 73.5% / Industry Average: 83.3%
Ten Years: ProAssurance Average: 94.2% / Industry Average: 106.3%
All Years: ProAssurance Average: 93.6% / Industry Average: 109.7%
Source: A.M. Best Aggregates and Averages, Medical Malpractice Lines of Business
25

Differentiate Through Claims Defense
We leverage our financial strength to gives our insureds the
opportunity for an uncompromising defense of their claim
Differentiates our product
Provides long-term financial and marketing advantages
Retains business and deters future lawsuits
Increasingly important as claims data becomes public
ProAssurance: 79% Favorable Outcomes
Industry: 72% Favorable Outcomes
Source: PIAA 2010 Claim Trend Analysis
ProAssurance Excluded
Five Year Average
2006-2010
26

The Bottom Line Benefits of Strong Defense
Our ability and willingness to defend claims
allows us to achieve better results
Source: Statutory Basis, A.M. Best Aggregates & Averages
Some totals may not agree due to rounding
ProAssurance vs. Industry
Average Loss Ratio (2006-2010)
Legal
Payments
Loss
Payments
64.3%
44.2%
61.5%
53.6%
41.6%
76.0%
36.8%
ProAssurance Stand Alone
Loss Ratio (2006-2010)
27

Conservative Approach to Reserves
Consistent reserving practices provide protection
against a loss trend reversal and capital erosion
Net Favorable Reserve Development
Net Reserve per Open MPL Claim1
1 Statutory basis; Loss & LAE
Acquired company data included at end of acquiring year

Effective Risk Management
Online and in-person risk management showcase our
expertise and differentiates our Company
Over 70% of insured physicians were touched by risk
management in 2011
Over 84,000 speciality-specific risk management
publications delivered each year
29

Prospects for ProAssurance
We are confident that our deep expertise and solid
financial strength have prepared us for the
challenges of the evolving healthcare market

ProAssurance’s Growth Outlook
Growth opportunities will be shaped by a healthcare
landscape that will see enormous changes—with or
without federal healthcare reform
We are expanding our hospital capabilities and commitment
Building on two decades of hospital experience
We continue to enhance our commitment to individual
providers and small groups
There will be M&A in our future but our growth
may be less dependent on M&A than in the past
31

ProAssurance’s Growth Strategy
Leverage our reach, expertise and financial strength
with larger accounts
Largest non-profit healthcare
system in the US
Now in Michigan, expanding
into other states throughout 2012
Insuring Ascension-affiliated
physicians through coordinated,
jointly insured programs
Financial involvement of both entities creates incentive to reduce risk
32
*www.ascensionhealth.org/annualreport/health.php
Ascension Health’s Ministry Locations*

ProAssurance’s Growth Strategy
Joint physician/hospital insurance products to
addresses the unique risk tolerance and claims-
handling expectation of each insured
Already creating broad interest in the market with
several policies in force
Providing sophisticated alternative risk
programs for organizations as they increase in
size and sophistication
We have proven experience in facilitating self-
insurance and captive insurance programs
33

ProAssurance’s M&A Strategy
Consolidation will continue and will remain episodic
Fewer significant targets
Remaining companies of size are in important strategic
areas
We prefer “health care centric” but will consider
closely related liability lines
Legal/regulatory environment must be favorable
Not all M&A opportunities should be pursued
We have not “bet the company” on any transaction
34

ProAssurance Operational Strategy
Maintain our profitability and book value growth
Ensure outstanding performance in a challenging
financial market and a demanding line of insurance
Focus on long-term
Maintaining balance sheet strength and institutional
expertise to prepare for a changing market
Leverage financial strength
Protects the balance sheet
Maintains our leading market position
Builds strength for the next cycle turn
35

Healthcare Reform
Known: More customers for us
May accelerate the growth of hospital-owned practices and
consolidation into larger groups
Provides an opportunity for us due to our geographic reach,
long-term experience in hospitals and our financial strength
We have enhanced our ability to write new classes of
business through acquisitions
May hasten the need for consolidation of smaller insurers
Unknown: Effect on the medical/legal environment
Increased patient frustration with the system
Possibility of more unexpected outcomes
36

Tort Reform
No meaningful Tort Reform in healthcare reform laws
No prospect for Federal Tort Reform
State Tort Reform battles now being fought in the
courts with mixed results
We do not depend on Tort Reform for success
Our results are solid in states with and without Tort Reforms
Prices are set, and reserves established, as if there is no tort
reform, until results reflect otherwise
37

The Performance of ProAssurance
We ensure that we deliver an unparalleled level of
service and financial stability that truly
differentiates our coverage and our Company

Driven to Excel / Focused on Shareholder Value
Maintaining profitability
Sustaining book value growth
Producing sustainable shareholder value
Focusing on long-term—ready for the market turn
39
Current Prices Continue to Offer a Compelling Buying Opportunity
Current Price to YE 2011 Book: ~1.3x Average Since Inception: 1.4x

Investment Portfolio Detail
ProAssurance remains conservatively
invested, to ensure our ability to keep our
long-term promise of insurance protection

ProAssurance Portfolio Detail: Asset Backed
41
12/31/11
Subject to Rounding
Asset Backed: $717 Million
Weighted Average Rating: “AA+”
Breakdown of Agency MBS Holdings
Key CMBS Details Provided on Following Page
Sub-Prime: $8.1 mil Market Value (AFS)
$1.2 mil net unrealized loss

$81.2 million Fair Value in non-agency CMBS
Book Value: $76 million (2% of fixed income portfolio)
We have experienced no losses on our CMBS positions
ProAssurance Portfolio Detail: CMBS
42
12/31/11

ProAssurance Portfolio Detail: Municipals
43
Municipals: $1.2 Billion / Average Rating is AA
Investment policy has always required
investment grade rating prior to applying the
effect of insurance
Weighted Average Rating: AA
12/31/11

ProAssurance Portfolio Detail: Equities & Other
44
Equities & Other: $253 Million
12/31/11

ProAssurance Portfolio Detail: Corporate
45
Corporates: $1.4 Billion
Weighted Average Rating: A
12/31/11

ProAssurance Portfolio Detail: Various
Rated A1/P1 or better
Money Markets:
Moody’s: Aaa
S&P: AAA
Weighted average rating
Moody’s: AA3
S&P: AA-
A. M. Best: A+
Treasury / GSE: $352 Million
Short Term: $119 Million
BOLI: $53 Million
12/31/11

Conservative Use of Debt and Low Leverage
Low Debt to Cap Ratio
No strain on cash flow
47
Debt to Equity
No Debt Prior to 2001
Strong Capital Position
Prepared for an improving market

Long-Term Financial Strength Sets Us Apart
Ensuring the strength of our balance sheet is our top financial priority
Financial strength differentiates us in the market
The claims defense philosophy that differentiates us in the market leverages our
financial strength
48
Shareholders’ Equity
94% Increase Since 12/31/06
Total Assets

Net Investment Income
Net Premiums Written
($ in millions. Excludes discontinued operations)
Net Income
Operating Income 1
49
1 Excludes the after-tax effects of net realized gains or losses, non-policyholder litigation
results and
guaranty fund assessments or recoupments

Pricing discipline becomes even more
critical in a low interest rate environment
Lack of investment yield may be a hard
market catalyst
Return on Equity and Investment Returns
50
Assumes a 1:1 premium to surplus ratio for physicians
professional liability claims-made coverages
Combined Ratio Required to
Generate a 13% Return on Equity
Long-Term ROE Target is 13%
The choice: chase yield or extend duration
We are maintaining duration, looking for
opportunities
The Yield Trap
Revised to reflect yields at 12/31/11

Capital Growth: 2006-2010
in $000’s except total equity (000,000’s)
51

2011 Financial Highlights

| Year Ended December 30,
| 2011 | 2010
Gross Premiums Written | $ 565,895 | $ 533,205
Net Premiums Earned | $ 558,507 | $ 505,407
Net Investment Income | $ 140,956 | $ 146,380
Net Income (Includes Investment Losses) | $ 287,096 | $ 231,598
Operating Income | $ 278,514 | $ 219,457

| December 30, 2011 | December 31, 2010
Total Assets | $ 4,998,878 | $ 4,875,056
Shareholders’ Equity | 2,164,453 | 1,855,863

Investment Effect on P&C Industry ROE
Combined Ratio / ROE - a 100% Combined Ratio Isn’t What It Used to Be
* 2009 and 2010 figures are return on average statutory surplus.
2008 -2011 figures exclude mortgage and financial guaranty insurers
Source: Insurance Information Institute from A.M. Best and ISO data.
Combined Ratios Must Be Lower in Today’s Depressed
Investment Environment to Generate Risk Appropriate ROEs
53

Additional Discussion Materials

The Ohio Example: 2005 - 2009 Data
Comprehensive, reliable data provided by the Ohio Department of Insurance
Broad range of competitors and business approaches
55
www.insurance.ohio.gov/Legal/Reports/Documents/2009ClosedClaimReport.pdf
Fewer Claims Closed With Indemnity
More Claims Defended in Court
2.5x Lower Average Indemnity Payment per Closed Claim

New Claims Opened Each Year
Claims Trends Remain Favorable
Fewer cases to try following significant decline in frequency
Severity trends steady and manageable
No observed effect from the economic downturn
Trends are much the same in states with or without Tort Reform
56
ProAssurance Claims Tried to a Verdict

ProAssurance: Business Profile
Largest independent publicly traded writer of MPL insurance
Fourth largest overall writer
57
DPW: SNL & Highline Data 2010

Local Knowledge and National Reach
Medical/Legal environment varies by state
Often varies within states
Regulatory environment differs greatly
May limit the ability to ensure that rates accurately
reflect loss trends
Can affect the ability to introduce policy or
procedural changes
Overall business climate differs and can change
Demographics of the medical population and
consumers
58

The Case for Growing Through M & A
Legal and regulatory environment must be favorable
Not all M & A opportunities should be pursued
The key is understanding why companies are available
We don’t “bet the farm” and can acquire without “breaking the bank”
We prefer “healthcare centric” but look for closely related liability lines to leverage expertise
(attorneys E & O for example)
Our strategy adapts to the available opportunities for profitable growth
De Novo vs. Acquisition
Soft Market
Hard Market
M & A
de novo
Expansion
Internal
Growth
All avenues
open
because of
pricing
power
M & A is
preferable
because of
pricing
pressure
M & A and the Insurance Cycle

ProAssurance and Today’s Market
We are in a period of “benign profitability”
Prices have been falling yet profitability remains at attractive levels
We have seen no new large scale market entry from larger commercial
competitors
No expansion by mid-decade start-ups
Consolidation beginning in that segment
Start-up pricing advantage has vanished in current market conditions
60

ProAssurance and Today’s Market
ProAssurance’s retention remains at historically
high levels
Continued underwriting vigilance is being used
today to ensure future success
61

ProAssurance Business Outlook
We ARE writing new business that we believe will meet
our profitability goals
$68 million in new physician business in 2011
Approximately $48 million due to AMPH
Includes approximately $6.5 million in first year claims-made
premium in the Certitude tm program
Major competitors continue to be largely disciplined in
pricing
No new market entrants
62

Understanding Recent Loss Trends
Frequency stable after
historic declines
Lawyers are the gatekeepers
Must weigh the cost of a trial vs.
chances of success
Likelihood of success is affected by
many factors
Societal perceptions of lawsuits against
physicians
Effects of the overall tort reform debate
and headlines across the country
Reforms enacted in some states
Medical utilization is down
Fewer chances for medical incidents
Better quality of care reduces the
number of medical misadventures
Severity uptrend remains
steady at 3%-4%
Closely tied to inflation
Primarily medical cost inflation
Jury sentiment in reaction to
headlines has moderated, but
not eliminated, runaway
verdicts in recent years
Tort Reforms have limited
non-economic damages in a
number of states
63

The Residual Cost of a Plaintiff Verdict
Financial Effects
Higher MPL premiums
May affect quality scoring under new payment regimes
Credentialing Implications
Disclosure required when applying for licensing, privileges
and treatment panels throughout their medical career
Reputational Damage
May affect referrals
Online disclosure can affect acquisition of new patients
Emotional Stress before, during and after
Influences future treatment behavior and patient relationships
64

Effective, Experienced & Invested Management