<PAGE>

                                   UNITED STATES
                         SECURITIES AND EXCHANGE COMMISSION
                              Washington, D. C.  20549

                                     FORM 10-Q
                                          
                                     (Mark One)


     (X) Quarterly Report Pursuant to Section 13 or 15(d) of the Securities
     Exchange Act of 1934 For the Period Ended March 31, 1998. 
                               or
     ( ) Transition Report Pursuant to Section 13 or 15(d) of the Securities
     Exchange Act of 1934
     For the Transition Period From ________________to____________

Commission file number 0-21230 

                  MIDWEST MEDICAL INSURANCE HOLDING COMPANY
--------------------------------------------------------------------------------
            (Exact name of registrant as specified in its charter)

         MINNESOTA                                               41-1625287
-------------------------------                              -------------------
(State or other jurisdiction                                 (I.R.S. Employer of
incorporation or organization)                               Identification No.)

6600 France Ave., So., Suite 245
MINNEAPOLIS, MINNESOTA                                            55435-1891
----------------------------------------                     -------------------
(Address of principal executive offices)                          (Zip Code)

                                 612-922-5445
--------------------------------------------------------------------------------
             (Registrant's telephone number, including area code)

                                NOT APPLICABLE
--------------------------------------------------------------------------------
(Former name, former address and former fiscal year, if changed since
last report)

Indicate by check mark whether the registrant (1) has filed all reports
required to be filed by Section 13 or 15(d) of the Securities Exchange Act
of 1934 during the preceding 12 months (or for such shorter periods that
the registrant was required to file such reports), and (2) has been subject
to such filing requirements for the past 90 days.  Yes  X       No
                                                      -----       -----

The number of shares outstanding of the issuer's classes of common stock,
as of March 31, 1998:

Class A Common Stock $.01 Par Value 121,603 shares

Class B Common Stock $1,000 Par Value-1 share


                                          1
<PAGE>

                                    INDEX

                  Midwest Medical Insurance Holding Company


     PART  I.  FINANCIAL INFORMATION

     Item 1.   Financial Statements (Unaudited)

          Condensed consolidated balance sheets-March 31, 1998 and December 31,
          1997

          Condensed consolidated statements of income-Three months ended
          March 31, 1998 and 1997. 

          Condensed consolidated statements of cash flows-Three months ended
          March 31, 1998 and 1997

          Notes to condensed consolidated financial statements - March 31, 1998

     Item 2.   Management's Discussion and Analysis of Financial Condition and
               Results of Operations

     PART II. OTHER INFORMATION

     Item 6.  Exhibits and Reports on Form 8-K



     Signatures


                                       2
<PAGE>

Part I.  Financial Information
         Item 1.  - Financial Statements

         MIDWEST MEDICAL INSURANCE HOLDING COMPANY and SUBSIDIARIES

                     Condensed Consolidated Balance Sheet
                            (Dollars in thousands)

<TABLE>
<CAPTION>
                                                           March 31    December 31
                                                             1998          1997
                                                         -----------   -----------
ASSETS                                                   (Unaudited)      (Note)
<S>                                                      <C>           <C>
   Fixed maturity investments at fair value
     (Amortized cost: 1998 $156,819;
     1997 $170,590)                                      $157,508      $171,975
   Equity securities at fair value (cost: 
     1998 $36,263; 1997 $20,595)                           71,662        49,759
   Short-term investments                                   9,156        13,909
   Other investments                                       10,000        10,000
                                                         --------      --------
                                                          248,326       245,643

   Cash                                                      (971)        2,378
   Uncollected premiums - Note C                           26,164           534
   Ceded unearned premium                                   4,146             -
   Accrued investment income                                1,653         2,341
   Reinsurance recoverable                                 18,790        19,117
   Other assets                                             6,625         5,502
                                                         --------      --------

                                                         $304,733      $275,515
                                                         --------      --------
                                                         --------      --------

LIABILITIES, REDEEMABLE STOCK AND OTHER
   SHAREHOLDERS' EQUITY

LIABILITIES
   Unpaid losses and loss adjust. expenses               $108,295      $107,806
   Unearned premiums - Note C                              37,546         6,072
   Amounts due reinsurers                                   6,102         2,984
   Retrospective premiums                                   1,832         9,905
   Deferred income tax                                      5,531         3,592
   Other liabilities                                        5,286        11,389
                                                         --------      --------
                                                          164,592       141,748
                                                         --------      --------
REDEEMABLE STOCK
   Class A Common Stock                                     7,094         7,476
   Class B Common Stock                                         1             1
                                                         --------      --------
                                                            7,095         7,477
                                                         --------      --------
OTHER SHAREHOLDERS' EQUITY                                133,046       126,290
                                                         --------      --------
                                                         $304,733      $275,515
                                                         --------      --------
                                                         --------      --------
</TABLE>

Note:  The balance sheet at December 31, 1997 has been derived from the 
audited financial statements at that date but does not include all of the 
information and footnotes required by generally accepted accounting 
principles for complete financial statements.

See notes to condensed consolidated financial statements.

                                       3
<PAGE>

          MIDWEST MEDICAL INSURANCE HOLDING COMPANY and SUBSIDIARIES

                 Condensed Consolidated Statements of Income
              (Dollars in thousands, except per share dollars)
                                 (Unaudited)

<TABLE>
<CAPTION>
                                                            Three  Months Ended
                                                                  March 31
                                                          ----------------------
                                                             1998          1997
                                                             ----          ----
<S>                                                       <C>          <C>
Revenues:

  Net premiums earned                                     $10,569      $  8,364
  Net investment income                                     3,168         2,992
  Realized capital gains(losses)                            3,064          (196)
  Other                                                       113             -
                                                          -------      --------
                                                           16,914        11,160

Losses and expenses

  Losses and loss adj. exp.                                 9,382         8,393
  Other underwriting expenses                               3,067         1,576
                                                          -------      --------
                                                           12,449         9,969
                                                          -------      --------
  Income before income taxes                                4,465         1,191

  Income taxes - Note B                                     1,563           452
                                                          -------      --------
  Net income                                              $ 2,902      $    739
                                                          -------      --------
                                                          -------      --------


  Income per common share                                 $ 24.01      $   6.24
                                                          -------      --------
                                                          -------      --------

  Income per common share - 
    assuming dilution                                     $ 21.68      $   5.64
                                                          -------      --------
                                                          -------      --------
</TABLE>

See notes to condensed consolidated financial statements.

                                       4
<PAGE>

          MIDWEST MEDICAL INSURANCE HOLDING COMPANY and SUBSIDIARIES

               Condensed Consolidated Statements of Cash Flows
                            (Dollars in thousands)
                                 (Unaudited)

<TABLE>
<CAPTION>
                                                           Three Months Ended
                                                                March 31
                                                        ------------------------
                                                           1998          1997
                                                           ----          ----
<S>                                                     <C>           <C>
NET CASH PROVIDED BY OPERATING ACTIVITIES               $  (9,297)    $  (2,935)
                                                        ----------    ----------
INVESTING ACTIVITIES
  Purchases of fixed maturity investments and equity
      Securities                                         (176,645)      (28,053)
  Sales of fixed maturity investments and equity
      Securities                                          177,972        27,510
  Maturities of fixed maturity investments                      -           300
  Sales of short-term investments, net                      4,753         2,276
                                                        ----------    ----------
                                                            6,080         2,033
                                                        ----------    ----------
FINANCING ACTIVITIES
  Redemption of Class A Common Stock                         (132)          (17)
                                                        ----------    ----------

INCREASE (DECREASE) IN CASH                                (3,349)         (919)
Cash at beginning of year                                   2,378          (895)
                                                        ----------    ----------
                     CASH AT MARCH 31                     $  (971)    $  (1,814)
                                                        ----------    ----------
                                                        ----------    ----------
</TABLE>


See notes to condensed consolidated financial statements.

                                       5
<PAGE>

             MIDWEST MEDICAL INSURANCE HOLDING COMPANY and SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements
 (Unaudited)

March 31, 1998

NOTE A--BASIS OF PRESENTATION

The accompanying unaudited condensed consolidated financial statements have 
been prepared in accordance with generally accepted accounting principles for 
interim financial information and with the instructions to Form 10-Q and 
Article 10 of Regulation S-X.  Accordingly, they do not include all of the 
information and footnotes required by generally accepted accounting 
principles for complete financial statements.  In the opinion of management, 
all adjustments (consisting of normal recurring accruals) considered 
necessary for a fair presentation have been included.  Operating results for 
the three month period ended March 31, 1998 are not necessarily indicative of 
the results that may be expected for the year ended December 31, 1998.  For 
further information, refer to the consolidated financial statements and 
footnotes thereto included in the Registrant Company and Subsidiaries' annual 
report on Form 10-K for the year ended December 31, 1997. 

NOTE B--INCOME TAXES

The Company calculates its income tax provision for interim periods by 
estimating its annual effective tax rate and applying this rate to the income 
of the interim period.  The annual effective tax rate for the three months 
ended March 31, 1998 and 1997 is approximately 35% and 38% respectively, and 
are due primarily to the effects of tax-exempt income and state income taxes, 
net of federal tax benefit. 

NOTE C--UNEARNED PREMIUM and UNCOLLECTED PREMIUM

The majority of the Company's insurance policies expire at December 31 and 
renew on January 1 of each year.  The majority of the unearned premium amount 
at March 31, 1998 represents nine months of unearned premium for every active 
policy renewed or newly written from January 1, 1998 through March 31, 1998.  
Since most active policies expired on December 31, 1997, there was no 
unearned premium at that date for those expired policies.

Of the total unearned premium balance $6,072,000 at December 31, 1997, the 
majority $5,909,000, is a reserve for the issuance of free reporting 
endorsements for policyholders at death, disability or retirement.  That same 
amount is also included in the unearned premium balance at March 31, 1998.

The increase in uncollected premium from December 31, 1997 to March 31, 1998, 
$25,630,000, is due to the renewal of most active policies on January 1.  The 
full years premium is recorded as written and collectible at January 1.  
Premiums may be paid annually or quarterly. The majority of each years' 
premium is collected during the year with a small uncollected balance 
remaining at year end.

                                       6
<PAGE>

Item 2. -
Management's Discussion and Analysis of Financial Condition and
Results of Operations

CAPITAL RESOURCES AND LIQUIDITY

The majority of the Company's assets, 80%, continue to be invested in bonds, 
stocks and short-term instruments.  The Company has adopted Statement of 
Financial Accounting Standards (SFAS) No. 115 "Accounting for Certain 
Investments in Debt and Equity Securities." The Company's investments in debt 
and equity securities are classified as available for sale and therefore 
carried at fair value with unrealized gains and losses, net of applicable 
taxes, reflected as a separate component of equity. 

The investment portfolio was re-allocated in early January with $15,000,000 
of long-term bonds transferred into international equities. This is in 
conjunction with investment guideline goals to maximize total return. No 
additional changes to the portfolio are anticipated during 1998.

The retrospective premium liabilities of $1,832,000 at March 31, 1998 
represents amounts due to Iowa policyholders under terms of the Midwest 
Medical Insurance Company/Iowa Physicians Mutual Insurance Trust (MMIC/IPMIT) 
July 1, 1993 merger agreement.  That agreement provides if financial results 
for years prior to 1993 are more favorable than expected, the favorable 
development must be returned to former IPMIT policyholders who were insured 
by IPMIT on December 31, 1992 and who renew their coverage with MMIC. The 
$9,905,000 retrospective premium liability at December 31, 1997 included 
$4,905,000 for those former IPMIT policyholders and $5,000,000 liability to 
Minnesota policyholders under a retrospective premium rating plan. In March 
of 1998 both the $5,000,000 Minnesota retrospective premium liability and 
$3,100,000 of the Iowa merger agreement liability was paid to policyholders.

Cash flow from operations was negative during the first quarter of both 1998 
and 1997, $9,297,000 and $2,935,000 respectively. The primary reason for the 
negative cash flows was the payment, in March of both years, of the 
retrospective premium credit to Minnesota policyholders and the premium 
credit to Iowa policyholders under terms of the MMIC/IPMIT merger agreement. 
These payments totaled $8,100,000 in 1998 and $7,103,000 in 1997. The primary 
difference between 1998 and 1997 was losses paid, net of reinsurance. The 
timing of loss payments is purely arbitrary and management does not foresee 
any significant increases in paid losses over the near term future.

Net income for the first quarter of 1998 and 1997 was $2,902,000 and $939,000 
respectively.  These amounts were added to the Company's retained earnings.

Total equity consisting of redeemable stock and other shareholder's equity, 
increased by $6,374,000 during the first quarter of 1998. Net income of 
$2,902,000 added to equity was supplemented by an increase in the fair value 
of investments, net of deferred taxes, totaling $3,293,000, and Class A stock 
redemptions of $179,000.

                                       7
<PAGE>

RESULTS OF OPERATIONS

Net earned premiums increased $2,205,000 over the same period of 1997 
primarily as a result of new business generated from sales of large account 
self-insured retention (SIR) policies totaling $1,163,000. Base rate levels, 
with the exception of a 10% increase in Iowa, remained flat. As a result of a 
soft reinsurance market and excellent historical loss experience, a new 
reinsurance contract was negotiated effective January 1, 1998 which reduced 
reinsurance ceded from $1,800,000 to $1,350,000 for each respective quarter. 
These savings will continue to be recognized throughout the term of the 
contract, which expires December 31, 2000.

Capital gains of $3,064,000 were realized during the quarter. As the 
portfolio is being managed on a total return basis, more capital gains will 
be realized as opportunities arise. These gains are the major component in 
the increase in net income over 1997. Management has no estimate for future 
levels of capital gains realized.

Losses and loss adjusting expense increased over 1997 as a direct result of 
the increase in net earned premiums. Until an actuarial analysis is completed 
at year-end 1998, management does not attempt to analyze the effects of 
calendar year frequency and severity statistics. In lieu of the actuarial 
analysis, an estimate for losses is backed based on a ratio of net earned 
premiums that was developed in the rate making process. On a case basis, 
there are no trends. 











Part II.  Other Information

Item 6.   Exhibits

                 None

          Reports on Form 8-K

             No reports on Form 8-K have been filed.





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<PAGE>

SIGNATURES


Pursuant to the requirements of the Securities Exchange Act of 1934, the 
registrant has duly caused this report to be signed on its behalf by the 
undersigned thereunto duly authorized.




                                       Midwest Medical Insurance Holding Company
                                      ------------------------------------------
                                                     (Registrant)





Date May 13, 1998                     /s/      David P. Bounk
                                      ------------------------------------------
                                               David P. Bounk
                                               President and Chief
                                               Executive Officer




Date May 13, 1998                     /s/      Niles A. Cole
                                      ------------------------------------------
                                               Niles A. Cole
                                               Vice President and       
                                               Principal Financial Officer
                                               and Principal Accounting Officer



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