casemark/managing-insurtech-evaluations

Managing Insurtech Evaluations

When To Use

• Evaluating a new insurtech vendor or platform for underwriting, claims, distribution, or policy administration
• Comparing multiple technology solutions against carrier or MGA operational requirements
• Building a business case for adopting or replacing an insurance technology system
• Assessing digital insurance platform readiness for integration with legacy core systems
• Reviewing insurtech partnerships or investment opportunities from an operational fitness standpoint

Inputs To Gather

• Solution profile: Vendor name, product category (e.g., claims automation, parametric platform, digital MGA infrastructure, telematics, embedded insurance API), current version, and deployment model (SaaS, on-prem, hybrid)
• Carrier/MGA requirements: Lines of business affected, policy volume, premium throughput, geographic scope, and regulatory jurisdictions [VERIFY]
• Current-state architecture: Existing core systems (policy admin, billing, claims), data warehouse setup, API capabilities, and known pain points
• Evaluation criteria and weighting: Stakeholder-defined priorities (e.g., speed-to-market vs. actuarial flexibility vs. compliance automation)
• Financial parameters: Budget envelope, expected ROI timeline, licensing model preferences (per-policy, per-seat, revenue share)
• Compliance constraints: State/province filing requirements, data residency rules, NAIC model law considerations [VERIFY]

Workflow

1. Define evaluation scope

   • Confirm which insurance function the solution targets (underwriting, claims, distribution, reinsurance cession, etc.)
   • Identify stakeholders: actuarial, IT, compliance, operations, finance
   • Set evaluation timeline and decision milestones

2. Map functional requirements

   • Document must-have vs. nice-to-have capabilities against the target function
   • Include insurance-specific requirements: rating engine flexibility, form/endorsement management, bureau interface (ISO, AAIS), bordereaux reporting, treaty/facultative cession support
   • Note actuarial data needs: loss triangle export, exposure data granularity, experience rating compatibility

3. Assess technical architecture

   • Evaluate API-first design, real-time vs. batch integration, and data model compatibility with existing core systems
   • Review data security posture: SOC 2 Type II status, encryption standards, multi-tenancy isolation [VERIFY]
   • Check scalability benchmarks against projected policy/claims volume
   • Assess disaster recovery and uptime SLAs relative to carrier operational requirements

4. Build financial business case

   • Calculate total cost of ownership: license fees, implementation, integration development, ongoing support, and internal resource allocation
   • Model ROI against measurable outcomes: loss ratio improvement, expense ratio reduction, submission-to-bind cycle time, claims cycle time, or distribution reach expansion
   • Compare build vs. buy vs. partner economics
   • Factor in switching costs and contract lock-in terms

5. Evaluate vendor viability and market position

   • Review funding history, customer base (carrier vs. MGA vs. broker), retention rates, and financial stability
   • Assess regulatory track record: any state enforcement actions, DOI complaints, or compliance gaps [VERIFY]
   • Check reference accounts in comparable lines of business and premium scale

6. Score and recommend

   • Apply weighted scoring matrix across functional fit, technical architecture, financial impact, vendor viability, and compliance readiness
   • Identify implementation risks and mitigation strategies
   • Provide a clear recommendation with phased adoption roadmap if applicable

Output

The evaluation report should include:

• Executive summary: One-page recommendation with rationale, projected financial impact, and key risks
• Functional fit matrix: Requirements mapped against solution capabilities with gap analysis
• Technical assessment: Architecture compatibility findings, integration complexity rating (low/medium/high), and data migration considerations
• Financial model: TCO over 3–5 years, ROI projections with sensitivity analysis, and breakeven timeline
• Vendor profile: Viability score, reference check summary, and competitive positioning
• Risk register: Implementation risks ranked by likelihood and impact, with proposed mitigations
• Recommendation and roadmap: Go/no-go decision, phased implementation plan, and success metrics

Quality Checks

• Confirm all functional requirements trace back to documented stakeholder needs — no invented criteria
• Validate financial projections use carrier-provided volume and cost data, not vendor marketing claims
• Ensure regulatory and compliance items are tagged [VERIFY] where jurisdiction-specific rules apply
• Check that actuarial data requirements (loss triangles, exposure coding, rating algorithm transparency) are explicitly addressed
• Verify vendor claims against independent references, not solely vendor-supplied case studies
• Confirm scoring weights were agreed upon by stakeholders before applying them to avoid post-hoc bias
• Flag any solution gaps that would require custom development or third-party middleware