Today's Insurance Pulse
Heritage trims reinsurance program, saving $63.2M
Heritage Insurance Holdings renewed its 2026 reinsurance and catastrophe‑bond program with a total limit of $2.2 billion, down from $2.5 billion placed in 2025. The renewal includes $712 million of multi‑year coverage, $550 million from cat bonds and $162 million from private markets. Pricing softness allowed Heritage to cut renewal costs by $63.2 million.
Also developing:
CMS Proposes Extension of Prior Authorization Rule to Cover Drugs: 6 Notes
CMS has issued a proposed rule that would extend its 2024 prior‑authorization interoperability framework to include prescription drugs. Starting Oct 1 2027, Medicaid, CHIP, and ACA plans would be required to support three pharmacy data standards, enable real‑time formulary checks, and submit electronic prior‑auth requests. The proposal also shortens decision windows—24 hours for standard Medicaid drug requests—and mandates public reporting of drug prior‑auth metrics beginning in 2028. The move follows voluntary cuts by insurers that have already reduced prior‑auth volume by 11%.
AFGE: Plan To Access Fed Workers’ Health Data Likely Violates HIPAA
The White House Office of Management and Budget has unveiled a plan to obtain personally identifiable medical records from the insurers that cover federal employees and their families. The American Federation of Government Employees (AFGE), the nation’s largest federal‑worker union,...
CMS Issues Hospital IPPS Proposed Rule for FY 2027
The Centers for Medicare & Medicaid Services (CMS) released a FY 2027 proposed rule that would raise Medicare inpatient prospective payment system (IPPS) rates by a net 2.4%, adding roughly $1.9 billion in hospital payments. The increase reflects a 3.2% market‑basket rise...
Insurance Distributors Should Buy Carriers
Large independent insurance distributors are urged to acquire carriers to control product development and speed‑to‑market, a shift enabled by AI and abundant private‑equity capital. Currently, third‑party distribution accounts for about 60% of U.S. life‑insurance sales and a growing share of...
MedPAC Urged by AHA to Scrutinize MA Impacts on Hospital and Post-Acute Provider Finances
The American Hospital Association (AHA) urged the Medicare Payment Advisory Commission (MedPAC) to closely examine how Medicare Advantage (MA) affects hospital and post‑acute provider finances. At its April 9‑10 meeting, MedPAC discussed MA enrollment trends and payment incentives, while the AHA...
FY 2027 Inpatient Rehabilitation Facility PPS Proposed Rule Summary
On April 2, 2026, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule (CMS-1845-P) to update the Medicare Inpatient Rehabilitation Facility prospective payment system (IRF PPS) for fiscal year 2027. The proposal adds new therapy documentation standards,...
Risk Management for Small Business: Services and Examples
Small businesses confront a spectrum of threats—from lawsuits and property damage to cyber attacks and cash‑flow volatility. Effective risk management follows a four‑step cycle: identify, evaluate, prioritize, and then avoid, reduce, transfer, or accept each risk. Professional services—including business continuity...
Court Rules for Berkshire Unit in COVID Fraud Coverage Case
A federal court ruled that National Liability & Fire Insurance Co., a Berkshire Hathaway unit, has no duty to defend or indemnify attorney Manfred Sternberg in a fraud lawsuit alleging diversion of nearly $2 million intended for COVID‑19 test kits. The...
Eli Lilly Launches Foundayo Oral GLP‑1 Weight‑loss Pill in U.S., Priced From $149 per Month
Eli Lilly announced that its oral GLP‑1 weight‑loss medication Foundayo (orforglipron) is now available for purchase in the United States, with a retail price of $149 per month for self‑pay patients and as low as $25 per month for insured...
Swiss Re’s Shareholders Elect Jean-Jacques Henchoz as New Board Member and Approve Dividend
Swiss Re’s shareholders approved former Hannover Re CEO Jean‑Jacques Henchoz as a new board member, confirming his term through the 2027 AGM. The same AGM saw the re‑election of all existing directors and the compensation committee. Shareholders also endorsed a higher...
FHA Premium Cuts Move Market Shares, Not the Affordability Needle
The Federal Housing Administration’s recent mortgage‑insurance‑premium (MIP) reductions have not lowered overall housing costs but have instead shifted market share from GSE‑backed loans to FHA. Empirical analysis shows a 2.5‑point boost in price appreciation in neighborhoods with high FHA presence...
Thai Authorities Push for Mandatory Medical Insurance for Scooter Crashes
Thai health officials are considering mandatory medical insurance for tourists who rent scooters, after foreign patients generate roughly $3.1 million in unpaid hospital costs each year. In Phuket alone, Vachira Phuket Hospital reported a $300,000 loss from unpaid treatments, including a...
Credit Score Influences Home Insurance Like Disaster Zones
Your credit has as much of an impact on your homeowners insurance premium as whether or not you live in a disaster-prone area. https://t.co/PQ2K1kvGSE
PacifiCorp Case Appellate Ruling Could Jeopardize $1B in Oregon Wildfire Victim Damages
An Oregon Court of Appeals reversed a 2023 jury instruction, remanding a class‑action case that could jeopardize more than $1 billion in damages against PacifiCorp for the 2020 wildfires. The panel said the instruction was legally erroneous because evidence about four...
Cat Wind E&S Rate Decreases of 20%–30% Becoming Common Amid Capacity, Competition: CRC
The CRC Group’s 2026 Property State of the Market report shows cat‑wind insurance pricing in the excess‑and‑surplus (E&S) market falling 20‑30% as capacity reaches historic highs. Abundant reinsurance capital lets primary carriers write larger limits at lower cost, intensifying competition...
Zurich Expands Into Poland
Zurich Insurance Group announced a strategic expansion into Poland, acquiring a local insurer and committing roughly €150 million (about $162 million) to establish a new regional hub. The move will broaden Zurich’s portfolio in the country, focusing on commercial, cyber and specialty...
Guest Post: The Audit Committee: D&O Underwriting Is Behind Delaware Law
Stephen Hourigan argues that Delaware courts have redefined audit committees, demanding management‑independent, real‑time reporting, yet D&O insurers still base underwriting on outdated governance metrics. He cites Boeing, Wells Fargo, Walmart and McDonald’s cases to show that traditional audit‑committee scores missed structural...
Unconnected Dots: Why We Don’t Prevent Fraud
The article argues that fraud networks thrive by scattering digital identities across accounts, emails, and domains, making payments to invisible actors. It promotes digital entity resolution—linking fragmented data points—as the essential tool to identify and block these hidden fraudsters. Recent...
Protecting Access to Care for Our Most Severely Ill Patients
Long‑term care hospitals (LTCHs) deliver intensive, extended treatment for the most severely ill Medicare beneficiaries. Since the 2016 dual‑rate payment system, Medicare reimbursements to LTCHs have dropped roughly 45%, contributing to a 25% decline in operating LTCHs over the past...
Deloitte's Rakesh Rajagopal Leads Predictive Insurance Automation Push
Deloitte Consulting’s Rakesh Rajagopal is steering AI‑driven predictive automation across major U.S. insurers, embedding intelligence into SAP financial platforms to replace manual, fragmented processes. The initiative promises faster claims handling, tighter compliance and a scalable architecture for multi‑country insurers.
California Launches $267 Million Hospice Fraud Crackdown, Charges 21 Suspects
California’s Department of Justice announced a $267 million fraud bust targeting bogus hospice services, filing charges against 21 suspects after Operation Skip Trace seized identities and billing records. The case underscores vulnerabilities in Medi‑Cal oversight and prompts a wider review of...
OPM Seeks Medical Records of 8 Million Federal Workers, Sparking Privacy Outcry
The Office of Personnel Management (OPM) has issued a rule requiring insurers that cover federal employees and retirees to submit detailed, identifiable medical and pharmacy claims for roughly 8 million people. Critics say the move threatens privacy, could enable political targeting,...
Dutch Central Bank Releases Model for Assessing Nature Shocks
De Nederlandsche Bank (DNB) has released a quantitative model that translates nature‑related shocks into financial risk parameters for banks and insurers. The tool converts events such as extreme weather, ecosystem collapse, and biodiversity loss into probability‑weighted loss estimates that can...
Triple-I Urges Caution Amid ‘Somewhat Below Average’ Atlantic Hurricane Season Forecast
Colorado State University projects a somewhat below‑average 2026 Atlantic hurricane season with 13 named storms, six hurricanes and two major hurricanes, compared with the climatological average of 14, seven and three. The forecast attributes reduced activity to a moderate‑to‑strong El Niño,...
Climate Conditioned ILW Strategy Can Outperform: Reask / LGT ILS Partners Research
Reask and LGT ILS Partners released a working paper showing that a climate‑conditioned Industry Loss Warranty (ILW) strategy outperforms traditional static modeling. The researchers back‑tested 36 regional ILWs over a 40‑year span (1985‑2024) using ECMWF SEAS5 seasonal forecasts and Reask’s...
How Expiring ACA Enhanced Premium Tax Credits Hurt Business
The expiration of the ACA’s enhanced premium tax credits has forced self‑employed entrepreneurs to see their monthly health‑insurance costs jump from zero to $2,300, dramatically tightening household budgets. In 2025, more than 4.4 million of the 5.2 million small‑business owners who relied...
Ping An Pushes AI Deeper Into Claims and Emergency Response
Chinese insurer Ping An is deepening its artificial intelligence deployment across claims processing and emergency response functions. The firm now routes roughly 80% of its annual customer service interactions through AI-driven platforms, accelerating settlement times and reducing manual workload. New...
Insurtech Trio Thrives Amid Record Industry Profitability
how has the #insurtech trio performed in a year of spectacular profitability for the insurance sector? https://t.co/9v9qlzrsRL via @LinkedIn @jeffroth77 @GalenDShaffer @JimMarous @FGraillot @nigelwalsh @SpirosMargaris @jblefevre60 @robgalb @RonnoArnold @hedgequote @Nick_Lamparelli @antgrasso @hugues_bertin @globaliqx @psb_dc @an_battista
Evercore ISI Flags Mounting Pressures Across P&C Insurance
Evercore ISI’s Q1 2026 preview flags a broad softening of pricing across commercial, personal and reinsurance lines in the U.S. property‑and‑casualty market. The firm cites AI‑driven broker disruption and autonomous‑vehicle technology as key forces eroding traditional margins. It expects insurers...
Apr 10 Policy Watch: HHS Updates Criteria for Selecting Vaccine-Committee Members
The U.S. Health and Human Services Department renewed the Advisory Committee on Immunization Practices charter, shifting from professional‑society representation to a broader, geographically and specialty‑balanced membership. The EPA finalized a rule extending permissible natural‑gas flaring to 72 hours and easing...
AM Best Upgrades Rating of Fidelity Investments Captive
AM Best has upgraded the financial strength rating of Fidelity Investments’ captive, Fidvest US LLC, to A (excellent) from A‑ (excellent) and raised its long‑term issuer credit rating to “a” from “a‑”. The rating outlook was also revised to stable, down...
Utmost Worldwide Guernsey Fined £1.96m over Financial Crime Risk Failures
Guernsey's financial regulator fined Utmost Worldwide's island branch £1.96 million (about $2.5 million), the largest penalty it has ever issued. The fine stems from a decade‑long underestimation of financial‑crime risk in its life‑assurance business, especially the use of unregulated brokers in South...
Iran Confusion Makes the Case for Causal Modelling
Risk managers are grappling with the tangled uncertainties of the Iran‑US conflict, where traditional scenario testing—relying on past crises—fails to capture the unique dynamics of oil prices and prolonged infrastructure damage. Alexander Denev showed that Anthropic’s Claude LLM can construct...
ACORD Finds Majority of Insurance M&A Deals Create Shareholder Value Amid Strategic Shift
ACORD’s latest carrier M&A report, covering nearly 500 deals across 84 countries from July 2023 to December 2025, finds that just over two‑thirds of transactions generated positive shareholder returns. Scale‑and‑scope acquisitions now rank third in popularity and posted the only negative average...
Tune Protect Malaysia Selects Akur8 to Enhance P&C Pricing
Tune Protect Malaysia, the general insurance arm of Tune Protect Group, has partnered with Akur8 to deploy its AI‑driven actuarial pricing platform across its property‑and‑casualty portfolio. The solution leverages machine‑learning models to accelerate model development, provide transparent, explainable outputs, and...
How to Understand Emerging Risks
The article argues that the risk landscape is evolving faster than insurers’ traditional models can keep pace. While centuries of actuarial data have underpinned pricing, new hazards such as climate extremes, cyber attacks and pandemics demand fresh assumptions. Insurers must...
Climate Change Set to Spike Bills, Cripple Insurance, Real Estate
A new California report warns climate change is not only inflating power bills, but threatens to decimate the insurance and real estate markets https://t.co/GUSzAK71H1
KatRisk Expands Global Cat Modelling Capabilities Through RED Acquisition
KatRisk has acquired RED, a specialist provider of catastrophe models covering earthquake, flood, landslide and wind risks. The deal fast‑tracks a high‑fidelity U.S. earthquake model and integrates RED’s European earthquake platform into KatRisk’s SpatialKat system. By merging RED’s multi‑peril expertise...
Pine Walk Launches Bermuda-Headquartered Mezura Capital Partners
Pine Walk Capital, the MGA platform of The Fidelis Partnership, has introduced Mezura Capital Partners, a Bermuda‑based capital solutions firm. The new entity joins Pine Walk’s recent launch of Carnovis Specialty, an alternative risk transfer MGA led by former Allianz...
Victoria Car‑theft Insurance Claims More than Double, Sparking Premium Hikes
The Insurance Council of Australia disclosed that car‑theft insurance claims in Victoria have more than doubled, pushing payouts higher and prompting insurers to raise premiums. The surge underscores a growing underwriting challenge for the state’s motor‑vehicle market.
MGA Deals Surge as Scale and Specialization Drive Growth
Managing General Agency (MGA) mergers and acquisitions have accelerated, with carriers and private‑equity firms seeking scale and specialized technology. K2, backed by Warburg Pincus, now runs about 40 MGAs, wrote $1.9 billion in premiums in 2025 and targets $2.3 billion in 2026,...
EIOPA Publishes Technical Specification for Small and Non-Complex Undertakings and Groups Criteria Under Solvency II
On 7 April 2026 EIOPA issued a technical specification that defines how small and non‑complex insurers (SNCUs) and their groups (SNCGs) are identified under the revised Solvency II regime. The document details quantitative thresholds, qualitative requirements from Articles 29a and 213a, and nine risk‑indicator calculations....
Cytora and Vulncheck Partner to Embed Exploit and Vulnerability Intelligence Into Insurance Workflows
Cytora has teamed up with exploit‑intelligence specialist VulnCheck, alongside European partner Infinite Insight, to embed machine‑consumable vulnerability data directly into its digital risk processing platform. The integration lets commercial insurers automatically enrich underwriting submissions with real‑time exploit and software‑vulnerability insights...
UK Regulators Set to Tighten Oversight of Private Equity-Linked Insurance Structures
UK regulators, led by the PRA, are preparing stricter rules for funded reinsurance structures that insurers use to offload liabilities to offshore reinsurers often backed by private‑equity capital. The move follows concerns over growing interconnectedness between insurers, pension risk transfers...
Watch: As AI Makes More Health Coverage Decisions, the Risks to Patients Grow
Health insurers are touting artificial intelligence as a cost‑saving tool for coverage decisions, a claim echoed in recent earnings calls. The Trump administration has launched a pilot using AI to streamline Medicare prior‑authorization, signaling federal support for algorithmic triage. However,...
Australia to Underwrite Refiners' Spot Fuel Trades
Australia’s Export Finance Australia (EFA) will underwrite spot‑market fuel and crude oil purchases for refiners Viva Energy and Ampol, reducing financial risk and enabling access to otherwise uncommercial cargoes. The government can direct the additional fuel to regions facing tighter...
Where Nobody’s Looking: Europe’s £400 Billion Graveyard of Forgotten Insurance Policies
Europe’s life‑insurance sector hides a £400 bn graveyard of closed‑book policies that most insurers view as dead weight. Specialized consolidators are buying these legacy portfolios at 17‑36% discounts, migrating them onto shared platforms, and extracting predictable cash flows for decades. The...
Palomar Seeks $375m Cal-Quake & Hawaii Named Storm Cover with Torrey Pines Re 2026-1
Palomar Insurance Holdings is launching its seventh catastrophe bond, targeting $375 million to secure California earthquake and Hawaii named‑storm reinsurance through the Torrey Pines Re 2026‑1 series. The issuance comprises four tranches—three covering California quake risk and one covering Hawaii storm...
Reinsurers Better Prepared for a Softening Market than Ever Before: JP Morgan
JP Morgan’s latest report finds reinsurers are more resilient than ever despite an expected softening market. Insured catastrophe losses in Q1 2026 are projected at about $10 billion, well below the historical $15 billion norm and far less than the $45 billion seen in...
Atrium Partners with Sofix to Launch AI-Powered BrokerBrief for Claims Operations
Atrium, a Lloyd’s‑market insurer, has teamed with insurtech firm Sofix to launch BrokerBrief, an AI‑driven tool that automatically analyses and summarises early‑stage claim notifications. Integrated into Atrium’s existing claims management system, the solution creates structured, continuously updated claim briefs attached...