Unpaid Claims - Reconciliation (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Liability for Unpaid Claims and Claims Adjustment Expense, Activity in Liability [Abstract]
Cumulative incurred claims, net	$ 2,385,940	$ 1,547,806	$ 962,373
Less: cumulative paid claims, net	2,249,623	$ 1,443,830	$ 894,877
Net unpaid claims, including claims adjustment expenses	$ 136,317