InsurTech Thesis
InsurTech Thesis
InsurTech Thesis
As the ancient world evolved, maritime loans with rates based on favourable travel
seasons surfaced. Around 600 BC, the Greeks and Romans formed the first types of
life and health insurance with their benevolent societies. These societies provided
care for families of deceased citizens.
Standalone insurance policies not tied to contracts or loans surfaced in Genoa in the
14th century. This is where the first documented insurance policy came from in 1347.
Pedro de Santarém penned the first book printed on the subject of insurance. The
literature was developed by 1488 but was not published until 1552.
In U.S. history, the first insurance company was based in South Carolina and opened
in 1732 to offer fire coverage.
1818 saw the advent of the life insurance business in India with the establishment of
the Oriental Life Insurance Company in Calcutta. General Insurance in India has its
roots in the establishment of Triton Insurance Company Ltd., in the year 1850 in
Calcutta by the British.
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The Code of Hammurabi (image top right) was one of the earliest and most complete written legal
codes proclaimed by the Babylonian king Hammurabi, who reigned from 1792 to 1750 B.C. The
Hammurabi code of laws, a collection of 282 rules, established standards for commercial interactions
and set fines and punishments to meet the requirements of justice
Indian Insurance - catching up and poised to grow
Despite witnessing growth over the past two decades, insurance penetration and
density in India still lag considerably behind that of more developed nations.
However, this is on the cusp of change, fueled by progressive regulations and
increasing consumer affluence & awareness.
While the global protection gap indicates the premium to cover the gap, 2 other
metrics help to understand the penetration from a macro level - Insurance
Penetration and Insurance Density.
The insurance penetration in India has grown from 2.9% (FY04) → 5.2% (FY10) → 3.3%
(FY16) → 4.2% (FY22). Regulations by IRDAI have most often been the reason for
movement in penetration. For example, between FY11 to FY16, caps on commission
and lock-in periods on ULIPS were introduced, affecting insurance penetration and
density. During FY17, IRDAI introduced mandatory third-party insurance for
two-wheelers & cars for 3 & 5 years, respectively, which further boosted these metrics.
2. Progressive regulations
IRDAI in its press note4 stated its vision as ‘Insurance for All by 2047’. The aim is that
every citizen has an appropriate life, health, and property insurance cover, and every
enterprise is supported by appropriate insurance solutions. Regulators have eased
the regulation on multiple vectors like investment, product development &
distribution to achieve these objectives.
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Insurance pentration numbers obtained from IRDAI annual report, Swiss Re, Sigma
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Insurance pentration numbers obtained from IRDAI annual report, Swiss Re, Sigma
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IRDAI Press note - https://irdai.gov.in/web/guest/document-detail?documentId=1624671
● To increase capital flows and ease the capital raise process, regulators have
allowed PE funds to invest up to 25% without being named as promoters They
have also increased the FDI limit to 74%. The threshold for raising capital
without regulator approval has been increased.
● To enable product innovation & growth, regulators have:
○ Eased up sandbox and approval-related regulations;
○ Introduced use & file procedures to help insurers launch products
without approval.
○ Provision for review of rejected applications.
● To enable wider reach/penetration, regulators are drafting new policies &
amending existing policies w.r.t commission payment, caps on commission,
caps on the number of tie-ups agents can have, etc.
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Source - MoneyControl
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Elite household - Annual Household Income of more than ₹ 26 Lakhs p.a.; Affluent household - Annual
Household Income of more than ₹ 13 Lakhs - 26 Lakhs p.a.
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BCG Estimates
InsurTech Funding - $40 Bn invested in Insurtech globally in last 5 years8
Globally, InsurTech funding has grown 4.5X from $ 1.7 Bn (2016) to $ 8 Bn (2022),
driven by late-stage investments, indicating that companies that are scaling and
have proven market fit with strong fundamentals are getting funded across stages.
From the above chart, it is apparent that while 2021 was an anomalous year with
excessive funding, 2022 remained strong with funding inflow. Companies like WeFox,
Pet Insurance, and Coalition raised late-stage rounds in excess of $200M in 2022.
While deal count & value of early-stage investments fell across many sectors in 2022,
both deal count and value increased for InsurTech, indicating investors' continued
interest in InsurTech.
Indian InsurTech funding grew at a modest rate of 2X from $ 276 M (2017) to $ 536 M
(2022). These have been primarily driven by funding in insurance carriers like GoDigit
and Acko who have raised total funding across years of $543M & $500M, respectively,
or distributors like Policy Bazaar, TurtleMint, and Insurance Dekho, who have raised
$674M, $250M & $150M respectively.
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All data under ‘Funding in Insurtech’ section is obtained from Tracxn & Gallagher Re report
Chart: Indian Insurtech Funding Trend
Chart: Indian Insurtech Funding trend in seed, early & late stage individually
Seed and early-stage funding (albeit a small base) has been on an upward trend,
indicating new companies being funded in the sector.
Late-stage investments have been available for businesses with proven business
models. For example, Zopper raised Series C of $75M in 2022. Zopper is an API
platform that helps B2C insurance companies to integrate with carriers for seamless
flow.
While Indian InsurTech is in its infancy, it has already seen notable successes in India
- 3 unicorns (PolicBazaar, Digit & Acko); and one successful exit (PolicyBazaar IPO at a
market cap of $6.7 Bn), indicating viable exit options.
Historically, funding in InsurTech has lagged in India. However, with several macro
drivers and tailwinds, it is expected to increase. Prominent multi-stage funds have
made investments in this space and continued to follow on till later stages.
Globally, there are large companies present in other parts of the value chain as well,
however, in India, we are yet to see companies building in those spaces and growing.
A key risk factor is the limited customer set (max 100 insurers) for such companies in
India compared to the US and EU, where there are thousands of insurance
companies to sell to.
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Deal data obtained from Tracxn
Indian Insurance - Driven by life insurance, non-life/general catching up.
In India, the insurance sector represents a substantial $120 Bn segment (4.2% of the
GDP), comprising ~$90 Bn in life insurance and ~$30 Bn in non-life insurance.
The non-life insurance segment is primarily driven by Health and Motor Insurance,
contributing 36% ($11 Bn) and 32% ($10 Bn), respectively. Other insurance segments
include fire, marine, commercial, crop, etc.
Life insurance segment has certain characteristics which makes it tricky for any
start-up to build a meaningful outcome. These include:
Having said that, we believe there is an opportunity for becoming a full-stack life
carrier with distribution strength, who could capture market share and become a
significant player in this segment, akin to how GoDigit captured the general
insurance segment. For other business models within the life segment, while there is
scope for some innovation, building a meaningful outcome might be challenging
given the market dynamics.
We shall now shift focus to general insurance where we believe, there is a higher
possibility of innovation and growth.
The 2 key sub-segments within general insurance are health and motor. Until 2022,
motor was the largest segment, and is now replaced by health insurance. Health
grew at 14.9% CAGR from 2017 to 2022, whereas motor grew by a modest 3.1% CAGR
during the same time frame.
The average share of out-of-pocket expenditure on health remains very high in India
at 55% (i.e. if a person incurs ₹ 100 on medical expenses, ₹ 55 is spent out-of-pocket).
The global average for out-of-pocket expenditure is 33%. Developed nations like the
USA have an out-of-pocket expense share of 11%, and France is at 9%. Further, India’s
total healthcare expenditure as a % of GDP is low at 3.6% vs. the global average of
8.8%.
Strong tailwinds and government focus on building a Unified Health Interface (UHI)
across the nation under the Ayushman Bharat Digital Mission are likely to drive the
growth in health insurance.
The Ayushman Bharat Digital Mission (ABDM) is a digital health program launched
by the Indian government to support integrated care and universal health coverage
in India. The mission aims to strengthen India's digital health ecosystem to support
all Indian citizens by providing them with Ayushman Bharat cards, enabling them to
access healthcare services across the country.
Chart: Components of Ayushman Bharat Digital Mision (ABDM)
ABDM is expected to have the following implications for the insurance industry:
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Value-based care - Value-Based Care (VBC) is a health care delivery model under which providers —
hospitals, labs, doctors, nurses and others — are paid based on the health outcomes of their patients
and the quality of services rendered.
Themes that are likely to play out in Insurance Segment
Health insurers are shifting from insurance covering just in-patient care to
comprehensive coverage, including out-patient, diagnostics, pharmacy, and wellness
services. Insurers are offering wellness propositions to their customers and designing
products with elements of preventive care embedded in them.
The comprehensive coverage can be broken down into two parts - Core services,
which shall be covered under insurance, and value-added services, which encourage
policyholders to ensure their overall wellness and preventive care.
● teleconsultation costs,
● lab-tests costs,
● doctor consultation cover,
● annual preventive health,
● check-up cover,
● physiotherapy sessions,
● diet, and nutrition e-consultation.
Insurers plan to leverage all the possible data sources and machine learning to assist
them in coming up with newer, better pricing models to appropriately price risk.
Theme III: Smooth and seamless claims management
Claims are the most critical touchpoint where the customers expect as little friction
as possible. The claims journey is very different for each product within health
insurance itself. There is an opportunity to solve customer issues related to claims
management using data, machine learning, and blockchain.
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Pre-authorization is a requirement by health insurance companies that patients obtain approval for a
health care service or medication before the care is provided. The pre-authorization process involves the
physician or hospital submitting a request to the insurance company to approve a specific medicine,
medical device, or procedure. The insurance company then evaluates the request to determine whether
the item is medically necessary and covered by the plan
Theme IV: Fraud Detection - Potential Global Play
Insurance fraud is a significant problem. In the USA alone, total losses due to
fraudulent claims are estimated to be around $308 billion annually. Insurance fraud
in India amounts to about ~$4 bn every year and the amount is set to grow in
proportion with the Insurance market as a whole.
Frauds are of two types - (i) soft fraud, and (ii) hard fraud. Soft fraud involves
exaggerating the damage caused by a real accident. (Eg: showing hospitalization
charges of ₹ 1L instead of ₹ 95,000). Hard frauds, on the other hand, involves faking
an incident that could trigger the insurance claims (Eg: faking illness).
Using technology, interconnected systems, data and analytics, fraud detection and
prevention can be achieved. Given this is a software play, this can become a global
opportunity and does not have to be restricted to India alone.
Gen AI has several use cases in the insurance industry. These include:
Embedded Insurance
Examples:
Parametric Insurance
Parametric insurance is an upcoming trend, with the most common use cases
related to natural disasters and weather conditions. Parametric insurance contracts
cover the possibility of an event occurring rather than the actual losses incurred due
to the event. The contracts define a specific parameter, such as wind speed, rainfall,
or earthquake magnitude, and a predetermined payout amount. The payout is
triggered when the parameter is met, and a third party is responsible for verifying
that the parameter was triggered
Examples:
Concluding Thoughts