LOSS AND LOSS ADJUSTMENT EXPENSE RESERVES

There were no significant changes in the actuarial methodology or assumptions relating to the Company’s loss and loss adjustment expense reserves for the three months ended March 31, 2020.

At March 31, 2020 and December 31, 2019, loss and loss adjustment expense reserves were composed of the following:



	March 31, 2020		December 31, 2019
	($ in thousands)
Case reserves	$	198,616	$	217,834
IBNR	257,053		252,754
Total	$	455,669	$	470,588

A summary of changes in outstanding loss and loss adjustment expense reserves for all lines of business consolidated

for the three months ended March 31, 2020 and 2019 is as follows:



Consolidated	2020			2019
	($ in thousands)
Gross balance at January 1	$	470,588		$	482,662
Less: Losses recoverable	(27,531		)	(43,705		)
Net balance at January 1	443,057			438,957
Incurred losses related to:
Current year	71,525			87,812
Prior years	4,172			35,053
Total incurred	75,697			122,865
Paid losses related to:
Current year	(10,649		)	(13,277		)
Prior years	(73,296		)	(87,375		)
Total paid	(83,945		)	(100,652		)
Foreign currency revaluation	(2,235		)	565
Net balance at March 31	432,574			461,735
Add: Losses recoverable	23,095			46,196
Gross balance at March 31	$	455,669		$	507,931

The changes in the outstanding loss and loss adjustment expense reserves for health claims for the three months ended March 31, 2020 and 2019 are as follows:



Health	2020			2019
	($ in thousands)
Gross balance at January 1	$	18,063		$	24,502
Less: Losses recoverable	—			—
Net balance at January 1	18,063			24,502
Incurred losses related to:
Current year	8,033			11,142
Prior years	851			2,159
Total incurred	8,884			13,301
Paid losses related to:
Current year	(1,719		)	(1,502		)
Prior years	(8,964		)	(9,972		)
Total paid	(10,683		)	(11,474		)
Foreign currency revaluation	—			—
Net balance at March 31	16,264			26,329
Add: Losses recoverable	—			—
Gross balance at March 31	$	16,264		$	26,329

For the three months ended March 31, 2020, the estimate of net losses incurred relating to prior accident years increased by $4.2 million, primarily in relation to certain general liability, health and multi-line contracts. The net financial impact of the prior year unfavorable loss development for the three months ended March 31, 2020, taking into account earned reinstatement premiums assumed and ceded, adjustments to assumed and ceded acquisition costs and adjustments to deposit accounted contracts, was a loss of $3.9 million.

For the three months ended March 31, 2019, the estimate of net losses incurred relating to prior accident years increased by $35.1 million that originated primarily from private passenger automobile contracts. These unanticipated automobile losses were the result of adverse rulings that affected a significant number of loss events that occurred in Florida between 2015 and early 2018, including many claims that had previously been considered closed. The net financial impact of the prior year adverse loss development for the three months ended March 31, 2019, taking into account earned reinstatement premiums assumed and ceded, adjustments to assumed and ceded acquisition costs and adjustments to deposit accounted contracts, was a loss of $25.7 million.