Reinsurance - Additional Information (Details) - USD ($)	12 Months Ended
Dec. 31, 2019	Dec. 31, 2018
Reinsurance Retention Policy [Line Items]
Agreement renewal date	Apr. 01, 2020
Reinsurance recoverable	$ 7,850,409	$ 7,956,043
Reinsurance recoverable, collateral	$ 6,051,000
Minimum [Member]
Reinsurance Retention Policy [Line Items]
Reinsurance recoverable due from unaffiliated reinsurer as percentage of shareholders' equity	5.00%
Primary insurance, Pennsylvania MCARE not applied [Member]
Reinsurance Retention Policy [Line Items]
Malpractice insurance, annual coverage limit	$ 3,000,000
Malpractice insurance, maximum coverage per Incident	1,000,000
Primary Insurance [Member]
Reinsurance Retention Policy [Line Items]
Malpractice insurance, annual coverage limit	1,500,000
Malpractice insurance, maximum coverage per Incident	500,000
Pennsylvania Medical Care Availability And Reduction Of Error [Member]
Reinsurance Retention Policy [Line Items]
Malpractice insurance, maximum coverage per Incident	1,000,000
Malpractice insurance, coverage floor	500,000
Pennsylvania [Member]
Reinsurance Retention Policy [Line Items]
Malpractice insurance, annual coverage limit	3,000,000
Malpractice insurance, coverage floor	1,000,000
Retained risk amount	300,000
Reinsurance coverage, maximum	1,000,000
Maryland, Delaware, Ohio, New Jersey, and South Carolina [Member]
Reinsurance Retention Policy [Line Items]
Malpractice insurance, annual coverage limit	3,000,000
Malpractice insurance, maximum coverage per Incident	1,000,000
Retained risk amount	300,000
Reinsurance coverage, maximum	1,000,000
New Jersey [Member]
Reinsurance Retention Policy [Line Items]
Malpractice insurance additional coverage per incident	1,000,000
Maximum aggregate liability ceded to reinsurer per the terms of reinsurance agreement	2,000,000
South Carolina and Michigan [Member]
Reinsurance Retention Policy [Line Items]
Retained risk amount	100,000
Malpractice insurance additional coverage per incident	200,000
Reinsurance retention policy, excess retention, amount reinsured	$ 100,000

Malpractice insurance additional coverage per incident.

No definition available.

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- Definition

Reinsurance agreement renewal date.

+ References

No definition available.

+ Details

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- Definition

Reinsurance recoverable due from unaffiliated reinsurer as percentage of shareholders equity.

+ References

No definition available.

+ Details

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- Definition

Reinsurance recoverables secured by collateral.

+ References

No definition available.

+ Details

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- Definition

Retained risk amount.

+ References

No definition available.

+ Details

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- Definition

Liability as of the balance sheet date for the estimated ultimate cost of settling claims and claim adjustment expense relating to insured events that have occurred on or before the balance sheet date for those liabilities owed to another party as a result of assuming another insurer's primary obligation.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 50
-Paragraph 3
-Subparagraph (cc)
-URI http://asc.fasb.org/extlink&oid=116884095&loc=d3e14764-158437

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 50
-Paragraph 3
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=116884095&loc=d3e14764-158437

+ Details

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- Definition

Annual coverage limit provided by the insurance arrangement for malpractice claims.

+ References

No definition available.

+ Details

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Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	duration

- Definition

Amount at the low end of the range in which the insurance begins to cover losses and costs associated with malpractice claims.

+ References

No definition available.

+ Details

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- Definition

Maximum coverage per malpractice claim provided by the insurance arrangement.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 954
-SubTopic 450
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6491354&loc=d3e6049-115624

+ Details

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- Definition

Amount before valuation allowance of reinsurance recoverables for losses reported to the ceding insurer but not yet paid, and for amounts expected based upon statistical projections and other measures of incurred losses and loss settlement expenses which have not yet been reported to the ceding insurer.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 20
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=99397103&loc=d3e6824-158387

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 310
-Section 45
-Paragraph 6
-URI http://asc.fasb.org/extlink&oid=99404803&loc=d3e21412-158489

+ Details

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Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	instant

- Definition

Stated amount that is the upper retention limit per entity policy.

+ References

No definition available.

+ Details

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- Definition

Amount of risk reinsured in excess of stated retention per company policy.

+ References

No definition available.

+ Details

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- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

No definition available.

+ Details

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- Details

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- Details

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