Unpaid Claims - Activity in Liability for Unpaid Claims and Claims Adjustment Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Gross and net balance, beginning of period	$ 137,395	$ 136,137
Incurred related to:
Current year	272,258	272,151
Prior years	804	(7,056)
Total incurred	273,062	265,095
Paid related to:
Current year	167,360	164,034
Prior years	104,581	84,180
Total paid	271,941	248,214
Gross and net balance, end of period	138,516	153,018
Claims Development [Line Items]
Unpaid claims	138,516	153,018
Non-Insurance
Paid related to:
Gross and net balance, end of period	4,100	13,200
Claims Development [Line Items]
Unpaid claims	$ 4,100	$ 13,200