Insurance Industry Knowledge Document

1. Industry Overview

Market Structure

flowchart TD
    Insurance[Insurance Industry] --> Life[Life Insurance]
    Insurance --> General[General/P&C Insurance]
    Insurance --> Health[Health Insurance]
    Insurance --> Reinsurance[Reinsurance]
    
    Life --> L1[Term Life]
    Life --> L2[Whole Life]
    Life --> L3[Unit Linked]
    Life --> L4[Annuities]
    
    General --> G1[Auto]
    General --> G2[Property]
    General --> G3[Liability]
    General --> G4[Marine]
    
    Health --> H1[Individual]
    Health --> H2[Group]
    Health --> H3[Medicare]
    
    Reinsurance --> R1[Treaty]
    Reinsurance --> R2[Facultative]

Regulatory Framework

mindmap
    root((Insurance Regulations))
        Capital Requirements
            Solvency Margins
            Risk-Based Capital
            Technical Reserves
        Consumer Protection
            Policy Terms
            Claims Handling
            Market Conduct
        Operations
            Underwriting Rules
            Investment Limits
            Reporting Standards

2. Core Business Capabilities

flowchart TB
    subgraph ProductManagement
        direction LR
        P1[Product Design]
        P2[Pricing & Actuarial]
        P3[Product Filing]
    end
    
    subgraph Distribution
        direction LR
        D1[Agency]
        D2[Brokers]
        D3[Digital]
        D4[Bancassurance]
    end
    
    subgraph CoreOperations
        direction LR
        C1[Underwriting]
        C2[Policy Admin]
        C3[Claims]
        C4[Reinsurance]
    end
    
    ProductManagement --> Distribution
    Distribution --> CoreOperations

3. Insurance Value Chain

flowchart LR
    subgraph Frontend
        direction TB
        F1[Product Development]
        F2[Marketing]
        F3[Distribution]
        F4[Sales]
    end
    
    subgraph Core
        direction TB
        C1[Risk Assessment]
        C2[Underwriting]
        C3[Policy Issuance]
        C4[Claims Management]
    end
    
    subgraph Backend
        direction TB
        B1[Investment Management]
        B2[Reinsurance]
        B3[Finance & Actuarial]
        B4[Risk Management]
    end
    
    Frontend --> Core
    Core --> Backend

4. Technology Landscape

System Architecture

flowchart TB
    subgraph DistributionSystems
        direction LR
        D1[Quote & Buy]
        D2[Agency Portal]
        D3[Broker Platform]
    end
    
    subgraph CoreInsurance
        direction LR
        C1[Policy Admin]
        C2[Claims System]
        C3[Billing]
    end
    
    subgraph Analytics
        direction LR
        A1[Risk Analytics]
        A2[Fraud Detection]
        A3[Customer Analytics]
    end
    
    DistributionSystems --> CoreInsurance
    CoreInsurance --> Analytics

5. Key Business Processes

New Business Process

flowchart LR
    A[Lead] --> B[Quote]
    B --> C[Risk Assessment]
    C --> D[Underwriting]
    D --> E[Policy Issuance]
    
    subgraph SLA
        S1[48h Quote]
        S2[5d UW]
        S3[24h Issue]
    end

Claims Process

flowchart LR
    A[FNOL] --> B[Assessment]
    B --> C[Investigation]
    C --> D[Evaluation]
    D --> E[Settlement]
    
    subgraph KPIs
        K1[TAT]
        K2[Loss Ratio]
        K3[Fraud Detection]
    end

6. Agile Transformation Context

Common Organizational Structure

flowchart TB
    subgraph BusinessUnits
        direction LR
        B1[Life]
        B2[P&C]
        B3[Health]
    end
    
    subgraph Platforms
        direction LR
        P1[Digital]
        P2[Core Insurance]
        P3[Analytics]
    end
    
    subgraph EnablementTeams
        direction LR
        E1[DevOps]
        E2[Architecture]
        E3[Data]
    end
    
    BusinessUnits --> Platforms
    Platforms --> EnablementTeams

7. Industry Trends and Disruption

mindmap
    root((Insurance Innovation))
        Digital Distribution
            Direct-to-Consumer
            Digital Brokers
            Embedded Insurance
        Product Innovation
            Usage-Based
            Parametric
            Microinsurance
        Technology
            AI/ML
            IoT/Telematics
            Blockchain
        New Models
            InsurTech
            Platform Models
            Ecosystem Play

Reference Information

Key Industry Standards

1. Accounting Standards

   • IFRS 17/9
   • Statutory Reporting
   • GAAP

2. Data Standards

   • ACORD
   • ISO
   • NAIC

3. Key Metrics

flowchart TB
    subgraph BusinessMetrics
        direction LR
        B1[Combined Ratio]
        B2[Loss Ratio]
        B3[Expense Ratio]
    end
    
    subgraph OperationalMetrics
        direction LR
        O1[NPS]
        O2[Claims TAT]
        O3[Quote Ratio]
    end
    
    subgraph DigitalMetrics
        direction LR
        D1[Digital Sales]
        D2[Self-Service]
        D3[STP Rate]
    end