In an industry obsessed with innovation, one of our most under-leveraged opportunities lies in something as old-fashioned as human conversation.

Take long-term care planning (LTC). Despite decades of sobering statistics, consumer education, and product development, LTC Talk Avoidance Syndrome remains alive and well—not among consumers but among the very professionals meant to guide them.

It's a systemic issue. And for insurance executives and innovators, it's also a strategic opportunity.

Long-term care risk isn't a niche issue. According to the U.S. Administration for Community Living, nearly 70% of Americans over age 65 will need some form of long-term care, yet only a fraction are financially prepared. According to a LIMRA summary from late 2024, just 3% to 4% of adults over age 50 have some sort of insurance to mitigate the LTC expenses.

The need is obvious. So why aren't more clients protected?

Because far too often, the conversation never happens.

Financial professionals avoid the topic for fear of upsetting clients, getting bogged down in emotional resistance, or simply not feeling equipped. Clients avoid the topic because the implications are uncomfortable, the costs are intimidating, and the future is always "later."

This conversational gap isn't just bad for families. It's bad for business. Every missed LTC planning conversation is a missed opportunity to build trust, create loyalty, and provide meaningful risk management.

While many in our industry focus on performance, pricing, and product features, the most powerful differentiator may be something more human: emotional security.

Emotional security is what clients feel when they know they're protected, not just financially but personally. It's the trust that's built when a financial professional helps them face tough realities—and guides them through.

In today's commoditized landscape, emotional security has become the key to unlocking client loyalty, intergenerational planning continuity, and resilience in advisor-client relationships. It's what drives referrals, repeat business, and retention during volatile markets.

Yet most financial professionals aren't trained to offer it.

This is where insurance executives have an urgent and valuable role to play.

When we talk about innovation, we often default to digital tools, AI, or frictionless platforms. These are essential, of course. But we can't innovate our way around human fear, aging parents, or adult children caught off guard by caregiving.

We need to rethink our product development priorities.

Innovation must also mean designing products that make it easier for professionals to have difficult conversations, and easier for clients to say "yes" to planning. That's not just about simplicity. It's about psychological accessibility. It's about creating solutions that align with how people actually think, feel, and make decisions.

This kind of emotionally intelligent product design bridges the gap between protection and peace of mind. It's not just solving a financial problem—it's solving a behavioral one.

If emotional security is the goal, then LTC planning is its crucible. It's where we as an industry prove whether we're willing to lead people through life's most difficult transitions or let them face the issues alone.

This isn't just a distribution problem. It's a leadership opportunity.

• Are we equipping financial professionals with the tools and training to handle emotional resistance?
• Are we creating incentives that reward meaningful planning over quick wins?
• Are our products and messaging designed with emotional behavior in mind—or just actuarial logic?

LTC Talk Avoidance Syndrome doesn't just cost consumers. It costs us trust. It limits our growth. And it undermines the promise that our industry makes: to help people live with security, dignity, and confidence—no matter what life throws at them.

For those leading the insurance and annuity space, this is a moment to ask: How do we define innovation?

Yes, it's about technology. Yes, it's about efficiency. But it's also about empathy.

The future belongs to firms that recognize emotional fluency as a strategic asset, and emotional security as a deliverable, not just a byproduct.

This means:

• Creating solutions that address behavioral obstacles, not just financial gaps.
• Supporting financial professionals in building trust through emotionally intelligent planning.
• Embracing products that offer clients flexibility, security, and peace of mind in one package.

The LTC crisis is growing. The need for solutions is clear. What's missing isn't capability—it's courage.

Let's lead with both.

Nearly every article addressing medical inflation and its effect on property and casualty (P&C) insurance claims begins with a reference to the broader trend of lower overall inflation. While the cooling effect of inflation has notably benefited the prices of goods and commodities, healthcare services remain significantly affected. According to Peterson-KFF, in June 2024, the Consumer Price Index (CPI) for all urban consumers rose by 3.0% compared with the previous year, while medical care costs increased by 3.3%. When excluding healthcare services, the overall CPI growth was limited to 2.9%. This marked June 2024 as the first month since early 2021 where medical care prices had risen faster than the general inflation rate.

Additionally, over the span of the past two decades, the price of medical care and its subcomponents has escalated by 121%, compared with an 86% increase in the prices of all consumer goods and services. This disparity amounts to 35 percentage points. Notably, healthcare expenditures accounted for 18% of U.S. GDP in 2023, underscoring the growing significance of healthcare costs within the broader economic landscape. As such, the acceleration of healthcare inflation presents significant implications for workers' compensation and casualty bodily injury claims.

Here is a view of national health expenditures by year through 2023 as prepared by Peterson-KFF:

Factors Contributing to Medical Inflation

Several key factors contribute to the persistent rise in medical costs, including:

1. Aging Healthcare Workforce: The Association of American Medical Colleges projects that within the next decade, 40% of the U.S. physician workforce will be aged 65 or older. Simultaneously, a shortage of up to 3.2 million healthcare workers is expected by 2026. The reduced availability of healthcare professionals drives up wages for medical staff, in accordance with the principles of supply and demand. These increased provider costs inevitably flow through to patients, including those involved in P&C claims.

2. Increased Costs for Medical Equipment: The prices of medical equipment, parts, repairs and services are on the rise. Hospitals and medical facilities that rely on critical equipment face growing expenses. As with other cost increases, these higher expenses are ultimately passed down the line to payers, including insurance carriers.

3. Hospital Care Price Fluctuations: According to a report published by the National Council on Compensation Insurance (NCCI) in April 2025, although medical prices softened meaningfully in the first quarter on the combination of several trends, with physician care inflation price changes smaller than in 2024, over time, higher supply costs for equipment and supplies may also lead to higher prices in physician services, facilities, and long-term care. Hospital outpatient care prices saw a moderate growth of about 4% in the last quarter of 2024, followed by an even more moderate 3% increase in the first quarter of 2025. Inpatient care prices rose by approximately 3% in 2024.

4. Third-Party Bodily Injury Claims and Billing Irregularities: Third-party bodily injury claims are often reported late, with the demand package sometimes serving as the initial notice of a claim. These claims are frequently submitted using non-standardized forms, such as UB-04 or UB-92, which may lack necessary billing codes. This raises concerns about whether the charges submitted are inflated or exceed what is considered usual and customary for services rendered in a specific geographic area. In some cases, the answer to this question is affirmative.

5. Increase in Medical Providers and Services per Visit: According to the Workers’ Compensation Research Institute, the number of workers' compensation claims involving multiple healthcare providers has increased by 19% over the past five years. Additionally, the average number of services provided per medical visit has risen by 13% since 2017. The increased number of providers per claim, coupled with more services rendered per visit, results in higher costs per claim.

Implications for Workers' Compensation and Casualty Claims

The rise in medical inflation presents significant challenges for P&C carriers. To manage these challenges effectively, insurance providers must leverage insights from claims data. By using data-driven strategies, claims organizations can identify the most effective medical providers for each case, reduce medical costs, and improve claim outcomes for injured parties.

The adoption of advanced analytics tools will enable P&C carriers to navigate the complexities of rising healthcare costs. As healthcare inflation continues to outpace general inflation, carriers that use data-driven solutions will be better equipped to manage the financial pressures associated with rising medical expenses while ensuring that quality care is maintained for claimants.

By taking a data-informed approach, P&C insurance carriers can better position themselves to mitigate the financial impact of medical inflation, improve operational efficiency, and enhance overall claim outcomes.

As first published in WorkCompWire.

Renovation remains a defining trend in the U.S. housing market. In fact, nearly half of homeowners (48%) plan to renovate in 2025. Median budgets are climbing to around $24,000, while high-end projects often top $150,000. For high-net-worth homeowners, those numbers multiply — expansions, specialty rooms and luxury finishes are increasingly common.

Yet amid design plans and contractor negotiations, insurance is often overlooked. Homeowners should always notify their insurer before any renovation project begins. Failing to do so can result in higher deductibles, denied claims or policies that no longer fit the new risk profile. For affluent households, the stakes are especially high: The wrong coverage approach could mean hundreds of thousands in uncovered loss.

1. Unreported Exposure

Risk: Projects that cost more than 10% of a home's insured value, extend beyond a year or require moving out temporarily alter the home's risk. If insurers aren't informed, claims could be contested.

Best Practice: Notify your broker early. A simple litmus test: If you're moving out, disabling security systems or investing more than 10% of insured value, call your advisor. This allows for adjustments before the risk materializes.

2. Policy Reclassification and Deductible Shifts

Risk: Large-scale renovations can require a shift from a standard homeowner's policy to a builder's risk or course of construction policy. If overlooked, deductible surprises can surface. Some carriers apply a construction-related deductible many times larger than a typical homeowner's deductible.

Best Practice: Confirm with the insurer whether builder's risk coverage is required. These policies are designed for homes "in transition." Establishing them early prevents costly disputes if a fire, water loss or theft occurs mid-project.

3. Contractor and Subcontractor Liability

Risk: Renovations introduce third-party exposures. Hiring a contractor with inadequate general liability (GL) or workers' compensation (WC) coverage creates liability exposure. If a subcontractor is injured or damages property without proper insurance, a carrier may be left without recourse.

Best Practice: Require certificates of insurance from all contractors and subcontractors. For high-value properties, ensure GL limits are consistent with the replacement value of the home. Carriers frequently request this documentation and can help validate that coverage is adequate.

4. Underinsurance During and After Renovation

Risk: Renovations increase replacement costs. Without a coverage adjustment, reimbursement may only be for the pre-renovation value. Replacement costs surged more than 55% between 2020 and 2022, driven by inflation and supply chain challenges. If the homeowner's coverage hasn't kept pace, a catastrophic loss could leave the homeowner significantly underinsured.

Best Practice: Request periodic revaluation during and after construction. Policies with extended replacement-cost features or inflation guards can help, but they aren't substitutes for accurate dwelling limits. Insuring your home to value is critical after a renovation project.

5. Vacancy, Theft, and Fire Hazards

Risk: Many renovations involve temporary vacancy or disabled security systems, which dramatically change exposure. Standard homeowner's insurance often excludes theft or vandalism after 30 or 60 days of vacancy. Fire hazards from activities like sanding floors or rewiring electrical systems elevate risk.

Best Practice: Inform the carrier if living elsewhere during a project. Confirm that belongings in storage remain covered and that valuables such as artworks, if moved off premises, are stored in approved environments. Ask whether endorsements for theft of building materials, or a course of construction policy should be added while work is underway.

Closing Perspective

The numbers are clear: 98% of homeowner's insurance claims involve property damage, with average claim severity approaching $24,000 in higher-risk areas. For wealthy homeowners undertaking renovations, those costs can climb into six figures, so you need to make sure the proper coverages are in place prior to starting your project.

Renovation is a fundamental change to a home's risk profile. Treat it accordingly. By contacting the broker early, validating contractor coverage, adjusting limits during construction, and re-evaluating after completion, the insured is protecting both their property and their investment.

After weathering the initial shockwaves of the pandemic, employers thought they had seen the worst of healthcare cost volatility. They were wrong. What started as delayed screenings and deferred care in 2020 has morphed into a sustained surge in catastrophic claims that's pushing stop-loss insurance premiums to breaking points.

According to the Segal Group, medical stop-loss premiums increased an average of 9.7% for plans that maintained their deductibles – a figure that understates the pain many employers actually experienced.

The scale of these increases is a perfect storm of cost pressures that have been building since COVID-19. The delayed impact of missed cancer screenings during the pandemic is now showing up as advanced-stage diagnoses requiring expensive treatments. Meanwhile, specialty drug spending continues its relentless climb and will account for more than half of all drug spending this year, according to Mercer.

The industry is also seeing significant increases in costs associated with premature birth and neonatal care as medical advances allow healthcare providers to save babies who wouldn't have survived in previous decades. While these outcomes represent medical miracles, they come with substantial financial implications for employers and their stop-loss carriers.

Managing the unmanageable

This cost crisis is accelerating a shift toward self-funded arrangements that provide something fully insured plans cannot: visibility into where healthcare dollars are actually going. While employers can't stop specialty drug prices from rising or prevent the continuing impact of delayed screenings, claims data transparency has become a strategic necessity for managing these unavoidable pressures.

The difference comes down to who controls the data. In fully insured arrangements, carriers essentially own the claims information. When employers receive renewal quotes, they get limited visibility into what's driving their costs.

Self-funded arrangements with third-party administrators (TPAs) break open this black box. TPAs work for the employer, not the insurance carrier, and provide accurate, meaningful claims data on a regular basis. This transparency creates opportunities that simply don't exist in fully insured plans.

The symbiotic relationship between TPAs and stop-loss carriers amplifies this advantage. Stop-loss insurers require detailed claims data to assess risk and process payments, which means employers gain access to comprehensive information about their healthcare spending patterns. This visibility enables strategic decision-making about how to navigate an increasingly expensive environment.

Strategic cost management

Armed with detailed claims data, employers can move beyond simply absorbing premium increases to actively managing their healthcare costs. The transparency provides insights that enable targeted interventions and strategic adjustments to plan design.

Given the overall higher costs associated with providing health coverage to employees, employers must analyze their deductible levels and associated claims activity on an annual basis. The data helps employers evaluate critical questions: What impact would a high-dollar claim have on cash flow at a specific deductible amount? What is the risk tolerance for higher deductibles versus the cost savings from lower premiums?

Many employers are increasing their risk tolerance to manage stop-loss costs. A common approach involves raising deductibles, which increases the employer's financial exposure but significantly reduces stop-loss premiums. This strategy requires careful analysis of cash flow capacity and risk tolerance, but the premium savings can be substantial. The key is using claims data to make these decisions strategically rather than just reacting to price increases.

Claims transparency also enables employers to identify trends before they become expensive problems. For example, if data shows a high propensity for diabetes among employees, employers can implement targeted interventions like nutritional counseling or fitness programs. Early intervention costs far less than treating advanced diabetes complications.

Best practices for the new reality

Several strategies can help employers manage rising stop-loss costs while maintaining quality coverage. The foundation is comprehensive data analysis combined with plan management.

Wellness programs are one of the most effective cost-containment strategies. Simple initiatives like offering $100 incentives for cancer screenings or annual physicals can prevent much more expensive treatments down the road. Disease management programs can be particularly effective for common conditions like diabetes, where lifestyle interventions can dramatically reduce complications and costs.

Employers should also consider comprehensive preventive care programs that extend beyond basic screenings. On-site health screenings, flu shot clinics, and partnerships with local healthcare providers can catch health issues early when they're less expensive to treat.

Finally, employers should regularly benchmark their stop-loss coverage against market alternatives. The current environment of rapidly changing costs means that yesterday's optimal coverage structure may no longer be appropriate.

The transparency imperative

The combination of rising stop-loss costs and the transparency advantages of self-funded arrangements is creating a fundamental shift in how smart employers approach healthcare benefits. The tail from COVID is still there, and it remains very prominent. The delayed impact of missed preventive care will continue driving costs for years to come.

Employers that gain access to their claims data and use it strategically will have significant advantages over those operating in the dark. The transparency enabled by self-funded arrangements with TPAs and stop-loss coverage allows employers to take an active role in managing one of the largest expenses on their balance sheets.

Healthcare costs will continue rising, but employers can choose how they respond. For many, that path leads directly to self-funded arrangements that put claims data back where it belongs: in the hands of the employers who ultimately pay the bills.

Specialty insurance underwriting plays a critical role in markets shaped by dislocation, heightened uncertainty, or generally greater complexity. Typically, higher margins are required to compensate for higher levels of volatility, but navigating this volatility is no easy task.

What Is Specialty?

Around 1000 BC, David defeated the larger, better-armed Goliath with a sling and a stone, highlighting that battles can be won through scale (Goliath) or skill (David). In insurance, neither is inherently superior, and many companies use both scale and skill across teams, business units, or subsidiaries.

Specialty risks are those excluded from standard insurance. Take inland marine, which covers property that is in transit, is under construction, has high values, or has other idiosyncratic traits. This could run the gamut from medical equipment to infrastructure to bitcoin mining to fine art. These are all excluded in common property coverage, and each requires a highly bespoke solution.

There are four types of specialty insurance risk:

Expertise. These risks require a deep understanding of the exposure and underlying loss drivers, along with prior experience and a healthy dose of battle scars. Classic liability examples would be grain elevators, snow-plow operators, or liquor liability. Inland marine is the quintessential property example. Tax liability is a niche professional lines class, focused on unintended tax liability associated with transactions or other changes in tax treatment.

Structure. These are property and liability coverages with unique structural characteristics. The classic example is excess & surplus, where freedom of rate and form gives underwriters flexibility on terms and pricing. Alternative risk transfer, often for larger clients, similarly varies retention, limits, caps, coverage options, and more. Channel relationships (binding authority, MGAs) may also include variable, loss-sensitive performance features. 

Dislocation. For these, the demand for insurance exceeds the supply, resulting in excess rate. Often, the lack of supply is due to loss-driven distress, leading to the pullback of capacity. Cat-exposed property generally represents this risk in any hard market point in the cycle.

Service. These risks require solutions in addition to risk transfer, which in turn requires non-insurance expertise. Examples include property engineering, cyber risk mitigation, or auto telematics. The intention could be to prevent or mitigate loss or provide some insight that allows an insurance carrier to have superior risk selection.

These archetypes aren't mutually exclusive, as some businesses can have several of these features. I tend to de-emphasize certain specialized risks, especially those with higher volatility across the insurance cycle such as terror or remote-return-period property, like earthquake or other non-peak zone perils. These can be profitable but (in my view) resemble picking up pennies in front of a steamroller. It works until it doesn't, and when it goes bad, the losses can be severe.

Specialty can also mean emerging risks with little track record and higher uncertainty, such as intellectual property or contingency, two of the more recent P&C market innovations – which also happen to be distressed insurance products where ultimate losses were underestimated.

Specialty Underwriting Requires Slingshot Precision

Specialty underwriting is about skill over scale. It requires more nimbleness, creativity, and precision than standard risk. There are six core pillars of great specialty underwriting:

1. Scale within the niche. Average line size needs to be balanced relative to the total portfolio. Losses inevitably will happen, and without scale there is less room for error. Balance is commonly measured by premium-to-limit ratios, to ensure there is enough depth to reasonably absorb loss when it happens.

2. Surgical underwriting thesis. Every specialty segment needs a clear rationale. The underwriter might have some unique edge or expertise. In any case, markets inevitably shift, and usually specialty niches become less attractive over time once the crowd catches on and there is more capital availability. Cycle management is a critical feature for any underwriting thesis.

3. Quantifying upside and downside. It's difficult to plan for precise outcomes, particularly in a short horizon. Underwriters need to understand the stochastic distribution of results – the probability of profit relative to the probability of loss. Underwriting and actuarial need to be deeply intertwined with underwriters who understand the quantification of the upside/downside, and actuaries needing business judgment, so the quantification is not mechanical and superficial.

4. Street smarts. It's critical to understand when math might be wrong and avoid over-reliance on models. This applies to any catastrophe model, any probable maximum loss (PML) calculation, and any return on capital model with diversified capital. Street smarts means appreciating that models are directional at best.

5. Exceptional talent. Great specialty portfolios are built by talented and passionate underwriters. Not just technically strong but with market followership across all stakeholders: brokers, reinsurers, and other underwriters. Great underwriters are humble, appreciating what is unknown. The best underwriters have passion, which they exude when they talk about their business.

6. Portfolio Balance. Given specialty's inherent volatility, it requires a portfolio of niches, ideally with non-stacking, non-correlating exposure. Diverse exposures will lower the standard deviation of results, meaning, the overall average performance should be less volatile. Portfolio breadth also allows more flexibility to dial up or dial down specific niches in response to the market cycle. There is a critical caveat, the need to avoid "de-worsification." Every niche needs to have a strong thesis and favorable outlook, or it risks dragging on results.

Conclusion

Like David defeating Goliath, specialty underwriting is all about precision and skill honed through practice. Success in specialty lines requires ensuring every line has a clear thesis for market success, a path to scale within the niche, and the right balance of risk and reward.

The way physicians are evaluated has profound consequences — not just for reimbursement but also for clinical practice, professional trust, and ultimately patient outcomes.

Yet too often, performance measurement relies on opaque or "black-box" analytics that lack transparency and fail to resonate with the clinicians whose behavior they are meant to influence. Evidence-based, transparent, and traceable methodologies are essential if health plans and providers are to find common ground and use performance data as a tool for genuine improvement and change.

Among the many friction points in payer–provider relationships, few are as consequential as performance evaluations, which — like prior authorization and reimbursement rates — directly affect both financial outcomes and professional identity.

Like the other two hot-button issues, evaluations affect income, but they also touch on the sensitive matters of clinical outcomes, practice habits, and professional judgment. Low evaluations can be viewed as criticism of a physician's performance, which strikes at the heart of their practice and their personal brand.

A longstanding lack of mutual payer-provider trust compounds this contentiousness. Plans suspect providers try to boost their income by performing as many procedures and ordering as many tests as possible, often with little thought to necessity or wasteful low-value care. Providers often perceive plans as focused primarily on financial outcomes rather than patient care.

This friction between payers and providers has been exacerbated by health plans' use of opaque methodologies – even AI – to analyze provider behavior. Health plans have long used analytics that providers consider obscure, unfair, or irrelevant. The lack of transparency and accurate attribution in these approaches has fueled the abrasion between these two crucial healthcare stakeholders.

Today's Typical Performance Reviews: Group Level and Aggregate

Health plans today primarily rely on claims data to evaluate provider performance. While clinical data would be ideal and clinical data interoperability is improving under TEFCA, it is not yet widely available at scale.

Most performance reviews occur at the medical group, practice, or health system level. Common approaches include:

• Cost-efficiency metrics such as total cost of care, usage, and readmission rates.
• Quality measures like HEDIS scores, chronic disease control, and hospital-level outcomes.
• Patient experience scores that are typically aggregated through Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys.
• AI-driven insights that are increasingly used to identify patterns and trends.

These methods provide a broad view of performance but do not identify or evaluate the wide performance variation that exists between individual clinicians. It's hard for a single physician to see himself or herself in this data — or to trust and act on it in meaningful ways.

For performance measurement to change behavior, physicians must trust it. That trust comes when systems have three essential attributes:

• Transparency – physicians can see precisely how results were derived, from evidence sources to algorithm design to data application.
• Traceability – every measure can be linked back to the clinical guidelines or research from which it was derived.
• Comprehensibility – physicians can understand the methodology and validate the logic themselves.

Evidence-Based Standards: The Foundation for Fair Measurement

The best sources for physician performance measures are evidence-based clinical practice guidelines published by medical societies and professional organizations. These guidelines are based on scientific findings, cumulative clinical experience, and the consensus judgment of practicing clinicians. They are stewarded by respected leaders in each specialty.

Another essential source is peer-reviewed research from leading medical journals such as The Lancet and The New England Journal of Medicine, which can provide convincing evidence that one clinical practice is safer or more effective than another.

Then there is the data that the measure is based on. Today, claims data is the largest and most widely available data set for measuring physician performance, and a great deal about clinician performance can be determined with claims data if it's applied correctly.

Equally important, evaluations should be applied at the individual physician level, not just at the group or system level. Aggregated metrics can mask unwarranted variation in care that lower quality and increase cost. Individually attributed measures ensure accountability, highlight clinical excellence, and surface opportunities for targeted improvement. Physicians who undergo individual reviews often report feeling empowered by evidence-based data specific to their own practice — and they are often more willing to make meaningful changes.

Of course, some clinicians, in spite of research and professional guidelines, may persist in doing things that are not aligned with evidence. In those cases, plans can apply pressure through mechanisms such as tiered or selective networks, limiting referrals, adjusting reimbursement incentives, or requiring prior authorization and more.

Finding Common Ground

Fee-for-service reimbursement fuels payer–provider mistrust by rewarding volume rather than outcomes. But even under value-based care, disagreements about performance measurement persist.

The path forward lies in performance analytics that are scientifically sound, mutually acceptable, evidence-based, and transparent to both parties. Only then can health plans and providers share a language that reduces friction, builds trust, and inspires clinicians to improve care delivery.

AI will continue to revolutionize healthcare in many ways. But when it comes to evaluating physician performance, black-box algorithms are not the answer. Evidence-based clinical analytics, grounded in transparency and traceability, remain the fairest and most effective approach — for plans, providers, and patients alike.

Only then can we engage and inspire physicians to change practice behaviors, reduce waste from unnecessary low-level care, enhance patient outcomes and truly arrive at value-based care.

Customer experience (CX) has always been vital to the insurance industry, but fundamental aspects of it have changed. Historically, agents and customer service representatives were the main points of contact with consumers and clients, and they defined CX. But today, CX is distributed across a more complex, hybrid structure; customers interact with insurers through multiple digital channels as well as trusted intermediaries, meaning insurers must support both direct and agent-led experiences to ensure the client is receiving the best customer experience possible.

Many carriers fail to meet the demands of this multichannel CX environment due to outdated, batch-based processing, lack of access to real-time data, and aging or poorly designed systems that don't support digital-first engagement. A survey of 250 producers revealed that agents increasingly support multiple lines of business—life, annuity, and P&C—demonstrating the necessity of a unified view of customer experience without the current inefficiencies and disjointedness.

Improving customer experience starts with addressing one of the biggest obstacles in insurance: data complexity.

Insurance data is complex, inconsistent and often redundant.

A single carrier can have 35,000 different data attributes in their life products alone. In addition to the natural complexity of the industry, legacy systems and decades of product layering have created overlap between data structures, making them extremely inconsistent. In some cases, a single data attribute is replicated 10 to 18 times across various internal systems.

The result of this overlap and inconsistency is that insurers lack a single source of truth when it comes to their customers. Holistic views are hard to assemble because data is spread across many systems and, in many cases, inaccessible. Business users struggle to find what they need, often using shadow systems and workarounds to piece together elements of a fragmented customer picture. Although it feels more challenging to implement, data modernization is equally important as system modernization. Without a clean, unified data foundation, carriers struggle to deliver real-time transactions, enable intelligent automation, or personalize experiences in meaningful ways.

And, if the picture can't be fully drawn, then how can a carrier build customer personas, map customer journeys, or any of the other more advanced steps in optimizing CX?

Solving the data problem isn't optional — it's the foundation for modern CX.

Unified data is essential for omnichannel success.

A single source of truth is essential for analytics, AI implementation, and optimized client service, but it remains elusive for many insurers. Legacy platforms create data silos, and multiple generations of products cause data to be inconsistently transformed and stored — determining the authoritative source at any given moment becomes a challenge. Traditional approaches to centralizing data often backfire, resulting in rigid structures that restrict access. Instead, carriers should focus on data fabrics, governance models that support usability, and democratized access. If CX platforms rely on outdated or conflicting data, any improvements will be short-lived.

True omnichannel experiences require more than channel availability. Omnichannel experiences demand consistent, connected service across every touchpoint. Agents and customer service representatives need visibility into all prior interactions, whether through digital self-service, a call center, or an in-person meeting. Agents should be able to see online transactions, even if they're incomplete, to help clients pick up where they left off. They should be able to see the attempted transaction and how it can be completed to create total understanding. Data governance across all channels is vital to making holistic CX possible.

New PAS technology helps insurers meet CX expectations.

Full spectrum transparency requires modern policy administraton systems (PAS) with real-time application programming interfaces (APIs), common data services, and unified interaction histories. Only then can the entire ecosystem of clients, agents, and employees operate efficiently to deliver a cohesive experience.

The latest PAS technology helps insurers enhance CX with a focus on modularity — like API-first design, microservices, and event-driven architecture. Modern PAS solutions support the real-time data flow critical for creating smooth and responsive CX experiences, allowing changes to propagate instantly across systems without replication.

Carriers are also embracing cross-system product bundling, intelligent workflows, advanced analytics, and, increasingly, agentic AI. These technologies reduce manual intervention, accelerate underwriting and claims, and enable dynamic, personalized engagement. Ultimately, the new generation of PAS empowers insurers to evolve with customer expectations — not just react to them.

Successful CX requires rethinking core technology.

Insurers that treat digital transformation as a front-end exercise will continue to struggle. True CX gains come from rethinking the core — modernizing policy admin systems, untangling data complexity — and embracing omnichannel strategies built on real-time, API-driven infrastructure.

In an age of automated processes, customers' expectations for a fast and responsive customer experience are only rising. The carriers that succeed will be those that can deliver seamless, data-driven, omnichannel experiences by aligning the right technology with a clear, execution-focused strategy.

You work at an insurance company, in an industry where time plays a critical role in gaining a competitive edge. Your team has an idea and a vision for a new insurance product that answers real market needs. You take it to IT, and the response is: We can deliver in two to three months. Do you really have time to wait?

For decades, the process of introducing a new tariff, modifying terms and conditions, or updating underwriting rules resembled a slow, multi-stage cycle between business, IT, and legal. Every single change, even the smallest, required developers to translate business logic into code, followed by lengthy testing and deployment.

New technologies are changing this picture for good.

A configurator for change and innovation

More and more often, the industry is talking about product configurators that, powered by business rules engines (BRE), flip the traditional dynamics of product launches. Instead of waiting on IT, business teams can create and adjust product logic on their own. With intuitive, no-code or low-code graphical interfaces, users define every aspect of how a product works. They decide how pricing is calculated, which variants and options are available, who qualifies for a policy, and under what conditions. All those complex dependencies that used to be buried deep in the code are now transparent and fully configurable.

The fundamental shift is that these tools are designed with non-technical users in mind. Instead of writing complicated scripts, they define rules in decision tables, build calculation functions, or even model entire processes through visual diagrams.

What can product configurators be used for?

One of the key roles of product configurators is speeding up time-to-market for new products and modifications. Business teams can also set up pre-defined benefit packages or dynamically segment customers to offer personalized terms.

In underwriting, configurators become the central tool for defining and updating risk assessment rules. Instead of relying on static guidelines, underwriters can continuously adjust logic to support both manual and fully automated processes. The same applies to pricing – all aspects of rating logic, from simple validations and discount/markup conditions to complex premium calculation algorithms, can be managed centrally and in real time.

Configurators also bring order to managing policy terms and conditions and integrating with policy administration systems (PAS). Mapping products and their rules into the core system becomes a straightforward, configurable process, ensuring consistency throughout the policy lifecycle. In addition, these tools often serve as a central repository for reference data such as address dictionaries, transaction codes, or vehicle classifications, ensuring data consistency across the organization and boosting operational efficiency.

How can you be sure this will work?

Traditionally, the guarantee that a solution would function as expected came from IT. When business takes on the role of product creator, there's a natural fear that something might go wrong.

However, modern configurators have built-in testing mechanisms. For example, an analyst creating a discount rule doesn't need to wait for a deployment cycle to verify it. They can instantly run single test cases or entire regression test suites to see how the change affects the entire product portfolio.

Equally important are full version control and auditability. In insurance, being able to track, compare, and roll back changes when needed is essential. Configurators maintain a complete history of every modification, making it easy to manage multiple product versions - for instance, rolling out new terms on a specific date, tailoring offers to different sales channels or customer segments. Detailed audit logs ensure complete transparency and regulatory compliance.

More than just speed

Using a product configurator should be seen as an investment that quickly pays off. The first benefit you'll notice is a dramatic reduction in time-to-market - from months down to days. That allows you to respond faster to competitor moves or regulatory changes.

You'll also gain independence from IT.

When a new product idea or modification can be tested and rolled out quickly, the organization becomes more agile and responsive.

Finally, automating manual processes directly reduces operational costs and minimizes the risk of human error.

What's next?

Analysts agree that the next stage of evolution for these tools is the integration of rule-based logic with predictive models and artificial intelligence. Imagine a system where the configurator not only executes defined rules but also leverages AI recommendations to optimize pricing in real time, automate underwriting decisions based on predictive analytics, or flag potential fraud attempts.

Personally, I can't wait to see this future unfold.

Insurance is entering the Agentic Age. Intelligent, autonomous systems that can perceive, reason, act, and learn are redefining how insurance stakeholders operate, compete, and grow. This is not simply automation taken a step further. It is a structural shift that changes the speed, precision, and economics of the entire industry.

Agentic AI consists of intelligent agents that can sense changing conditions, interpret context, make decisions, take action, and learn from results autonomously. These agents orchestrate complex processes, uniting data, enterprise logic, and contextual memory to improve continuously.

Across the industry, scaled deployments of Agentic AI are beginning to deliver measurable results. In P&C, underwriting expense ratios will decline by 15 to 20%, and claims expense ratios by more than 15%. In life, underwriting costs will drop by more than 25%, with benefit expenses reduced by nearly 20%. Claims resolutions that once took weeks will be shortened to hours or less, and payment error rates will fall by more than 30%. These are not incremental gains but step-change improvements.

Agentic AI moves beyond workflow automation and analytics. It empowers systems to combine historical, contextual, third-party, and synthetic data with connected platforms to coordinate complex processes and make informed decisions. The result:

• Faster cycle times: Underwriting processes cut by up to 75%
• Improved retention: Customer loyalty increases by 10 to 20%
• Higher productivity: Output per colleague more than doubles
• Enhanced economics: Marginal cost trends toward zero while precision improves

Agentic AI enables firms to optimize price, product, experience, and operating economics simultaneously, at scale. This is something that was previously beyond reach.

Why it matters now: Markets are moving toward real-time, predictive, and adaptive operations. Firms that deploy Agentic AI early can capture structural advantages such as lower marginal cost, faster execution, and stronger retention that compound over time. Late adopters will struggle to close the performance gap and forgo learning curve effects.

However, many firms are not ready to capitalize on Agentic AI. Legacy technology, disconnected data, manual workflows, and fragmented governance can slow execution and block leverage. This capability debt will further widen the gap between leaders and laggards.

To help overcome such challenges, consider the following strategies:

• Design connected systems: Modernize infrastructure with orchestration layers, application programming interfaces (APIs), and cloud extensions to connect legacy cores to agentic systems.
• Rethink your operating model: Redefine roles, governance, and incentives to support enterprise-wide AI adoption.
• Create consistency: Standardize workflows and embed business logic to enable intelligent orchestration from triage to resolution.

These strategies are supported by five enablers that ensure sustainable scale and impact:

• Strategic alignment
• Organizational readiness and performance management
• Governance and risk management
• Process and workflow design
• Data and technology enablement

Agentic AI is not a future concept: It is here. The question for industry firms is whether you will lead or follow. This is a strategic decision, not a tactical one. Acting now will unlock superior economics, faster execution, and durable competitive advantage. Waiting means falling behind in a market that is rapidly accelerating away from traditional operating models. The time for decisive action is now.

For the full white paper this article is based on, click here.

The insurance industry has undergone rapid innovation over the last decade, but not all sectors within the industry have evolved equally.

Property & casualty (P&C) insurers, for example, have made impressive strides in digitizing and optimizing claims. Life insurance has been slower to modernize. This disparity has resulted in a significant innovation gap between life and P&C claims processing. It stems largely from fundamental differences in claim volume, complexity, and customer expectations. But as the gap grows, it becomes increasingly unsustainable in today's fast-moving, digitally driven world.

Outlined below are the key lessons life insurers can learn from P&C's digital transformation, as well as a road map for how life insurance carriers can accelerate claims modernization while preserving trust, empathy, and compliance.

Why the Innovation Gap Exists

P&C insurers handle millions of claims annually, many of which are low-severity, high-frequency events like fender-benders or storm damage. Keeping pace with claims volumes is what provided incentives for early investment in automation, AI, and self-service to help optimize processes for both the insurer and the insured.

In contrast, life claims are often low-frequency but high-emotion, and manual processes were deemed the most acceptable approach for these emotionally charged events.

Consumer expectations have since shifted.

Wider industry pressures – demographic changes, labor shortages, the pervasiveness of AI, and more – are further catalyzing this transformation. Gartner predicts that by 2026, 30% of enterprises will automate more than half of their network activities.

The call to action is clear: Life insurers must digitize to meet modern expectations without compromising on a customer experience that balances empathy, accuracy, and compliance.

Leveraging AI for Automation

P&C insurers have already built a foundation of speed and efficiency by embracing digital-first operations. From first notice of loss (FNOL) to straight-through processing (STP) and digital documentation, many previously manual claims processes are now automated, rules-based, and augmented with AI. The result is better fraud detection and faster triage at scale.

Major auto and home insurance carriers already use automated workflows and proprietary mobile apps to resolve minor claims blazingly fast. Insurers use these platforms to submit photos of vehicle or home damage, which AI tools instantly assess, use to estimate repair costs, and process in real time. In some cases, claims are approved and paid within minutes.

Alternatively, life claims remain labor-intensive and complex, with paper death certificates, manual policy validation, and disconnected systems leading to long delays. These laggard operations no longer align with customer expectations or enable operational sustainability.

The AI models that are widely used in P&C to assess claim complexity, detect anomalies, and flag fraud in real time can similarly be applied to life insurer workflows – flagging incomplete claims, triaging straightforward cases for fast-track approval, even personalizing communication based on behavioral or demographic data.

McKinsey anticipates that by 2030, more than half of claims activities will be automated.

Digital With a Human Touch

From mobile-first claims submission to real-time status update chatbots, many P&C carriers now offer seamless self-service options that keep customers happy and informed. This has reshaped customer expectations across all lines of insurance – and life insurance is no exception.

But the inherently emotional and often painful nature of life insurance claims make clarity, transparency, and speed essential when adopting practices from P&C.

Rather than being a one-to-one template for life insurance innovation, P&C's use of customer journey mapping and design thinking offers life insurers a model for where to begin when modernizing their operations. By mapping the end-to-end life claims experience – from the beneficiary's first contact to final payout – insurers can uncover and address friction points such as multiple document requests, long silences, or poor communications.

The X-factor for implementing these changes is that, alongside automation and personalization techniques such as instant document upload and multi-channel status updates, life insurers must also create precedents for enabling swift human intervention at key moments. For life insurance, the human touch must never be far away.

Tech solutions must then strive to make the process easier without making it feel cold. Automation should never come at the expense of empathy.

Intelligence Through Data and Ecosystem Integration

Advanced data usage has long been a defining feature of P&C claims transformation. Carriers routinely use third-party data – weather reports, IoT and telematics data, government records – to populate claims automatically, assess risk, and identify anomalies in real time, resulting in faster decisions.

Life insurers can achieve the same effect by integrating with government databases, obituary application programming interfaces (APIs), health records, and even social media, to validate deaths quickly and securely.

A Matter of Life and Death

The innovation gap between P&C and life insurance claims has finally become a solvable challenge, with the barrier to entry for automation, more empathetic customer experiences, and smarter, more connected data ecosystems lower than ever before.

By adopting the automation tactics honed by P&C insurers and anchoring them in the empathy that life insurance demands, life insurers can modernize claims in a way that enhances trust, improves efficiency, and delivers lasting value.

But life insurers must act now. Because reimagining life claims through a digital lens isn't just possible: It's imperative for long-term competitiveness and customer loyalty.