UK is ‘mandated’ to discuss insurance in Cayman Islands and England, official says

A University of Kentucky lawyer told trustees last week that UK officials make trips to the Cayman Islands and London, England, because it’s a requirement for the university’s insurance company, Insure Blue.

UK spent thousands of dollars on trips to the Cayman Islands and London, England, in recent years for meetings about its captive insurance company, Insure Blue, according to the university’s legal counsel and public records. William “Bill” Thro, general counsel for the university, said last week that the fine print of the purchase of UK King’s Daughters Medical Center and subsidiary corporations in 2022 requires some discussions about its limited liability company would happen there.

Thro reminded the UK Board of Trustees Tuesday that they approved this.

“If you look at the footnotes of that resolution, we noted that, ‘Hey, this is domiciled in the Cayman Islands, and everything is subject to approval of the Cayman Islands government authorities,’” Thro said at a UK Board of Trustees Healthcare Committee meeting Monday.

Five top UK officials took 185 trips including some in state and others internationally from 2023 to 2025, according to a Herald-Leader review of publicly available travel records. They spent almost $270,000 on travel including to the Cayman Islands and London during those years. The university denied the Herald-Leader’s requests for many documents related to the trips.

The university holds two Insure Blue board meetings per year, including one which “must be in Cayman Islands,” Thro said.

“That’s just the general rule, it’s actually sort of mandated by direct regulation,” Thro said. “The other (meeting) we hold in London, where we go to Deloitte’s Market to buy the insurance.”

Deloitte London Market is a consulting firm that provides risk management to insurance companies internationally. Its global headquarters are in London, and its U.S. headquarters are in New York City. The nearest office is in Louisville.

Insure Blue is used to protect UK HealthCare’s physicians and nurses from claims of medical malpractice and professional liability, according to Thro.

The university covers medical malpractice claims up to $1.5 million, but UK buys more insurance from Insure Blue when claims range from $1.5 million to $10 million, Thro said. For claims of malpractice that cost between $10 million and $40 million, the university buys reinsurance from Deloitte in London.

“Deloitte’s people … insist, if at all possible, that we meet with them in person …,” Thro said. “So once a year, we go to London to negotiate, to meet with the underwriters and to buy our reinsurance.”

The university chose to buy captive insurance, Insure Blue, in the Cayman Islands because its government oversees the most number of captive companies in the world, which makes them well-versed in the matter, according to Thro.

“The reality is that the Cayman Islands have more healthcare captive insurance companies, like Insure Blue, than any other jurisdiction,” Thro said. “You’re going to have a healthcare captive insurance company, the Caymans are the place to be.”

The state of Vermont and the Cayman Islands had the top two most captives in the world in 2025, according to Captive Resources, an Illinois business consulting firm, and Vermont’s government website.

He said the operations of UK’s insurance company are transparent because they hold public meetings, are subject to the Open Records Act and have “the same immunity as the university.”

“So anybody here or any place else that has an internet connection can, in effect, watch the board meetings,” Thro said.

Hollie Swanson, a professor whose term on the UK Board of Trustees expired Tuesday, said the board was unaware administrators took these trips until the Herald-Leader reported their travel records on June 9.

“Why couldn’t you just tell us that in our board meetings?” Swanson told the Herald Leader after Thro told the board about the international travel.

Swanson criticized Insure Blue as well as Compass Group, a public-private partner of UK, and Champions Blue, a nonprofit holding company for UK Athletics, in a speech to the board upon her departure.

“As the corporate structure gains more branches, fulfilling the fiduciary responsibility of the board becomes more challenging,” she said. “In addition, the corporate model focuses on efficiency and revenue, whereas the nonprofit focuses on its mission of service. In our corporate model, we have seen top-down decision-making replace true shared governance.”