| Rank / Company | Country / Base | Notes / What they cover |
|---|---|---|
| Allianz | Germany (Global) | One of Europe’s largest insurers by assets; offers health, life, and general insurance — a major player across many European countries. (kotokiven.com) |
| AXA | France (Global) | Multinational insurer with wide reach in Europe. Strong presence in life, health, and general insurance. (kotokiven.com) |
| Assicurazioni Generali | Italy (Global) | Among Europe’s largest by premiums and assets under management; offers various insurance lines. (kotokiven.com) |
| Zurich Insurance Group | Switzerland (Global) | Major insurer covering life, general and sometimes health-related insurance; active across Europe. (Fundación Mapfre Documentation) |
| ERGO Group | Germany (Global) | Provides a broad portfolio including health insurance (through subsidiaries), life, property & casualty. (Wikipedia) |
| Swiss Life | Switzerland (Europe-wide) | Leading life-insurance and pensions provider; also offers health coverage in some markets. (Wikipedia) |
| Aviva | United Kingdom / Europe | Recognized insurer across Europe, offering life, health, and general insurance products. (Fundación Mapfre Documentation) |
| AXA Group Covéa (and similar mutual/ group insurers) | France / Europe | Part of large French insurance groups — significant presence especially in personal and family insurance markets. (Insurance Business) |
| Mapfre | Spain (International) | Big name in Spain and active across Europe — offers health, property, general insurance. (Insurance Business) |
| Helsana | Switzerland (Primarily domestic) | Specialized in health (and accident) insurance — a leading health insurer in Switzerland. (Wikipedia) |