Insurers are investing in data, governance and skills, but only one in three has the foundations in place to scale beyond pilots
LONDON, Jan. 14, 2026 /PRNewswire/ -- Health insurers around the world are moving beyond experimentation and laying the groundwork for sustainable use of artificial intelligence, according to a new global benchmarking report from the International Federation of Health Plans (iFHP). While adoption remains uneven, the report finds clear momentum in operational efficiency, decision support and organisational readiness that is reshaping how insurers approach AI.
The report, AI in Health Insurance: A Global Benchmark, draws on more than 25 interviews with senior leaders from iFHP member organisations across Europe, the UK, the United States, Australia and Africa, alongside structured benchmarking across five dimensions: AI implementation, digital infrastructure, innovation practice, talent development, and culture, regulation and internal governance.
While experimentation is widespread, the findings show a growing gap between insurers running pilots and those positioned to embed AI at enterprise scale. Only around 32% of insurers are classified as having advanced digital infrastructure capable of supporting AI reliably. The findings show that operational and enabling functions have become a proving ground for AI, with insurers reporting measurable reductions in processing time, improved accuracy and freed staff capacity. Pricing and risk teams are increasingly using AI to strengthen analysis and scenario testing, while maintaining clear human accountability. Although member-facing and clinical use cases remain cautious, insurers are using these early phases to build trust, governance and data capability before scaling.
Importantly, the report highlights a shift in focus from isolated pilots to foundations that enable long-term value. Many insurers are investing in cloud platforms, data pipelines, skills development and governance frameworks in parallel with experimentation, positioning themselves to scale AI more reliably over time.
Key findings
- AI adoption does not follow a single maturity curve. Insurers progress at different speeds across functions and capabilities, often reflecting deliberate sequencing choices, regulatory constraints and legacy architecture rather than lack of ambition.
- Operational use cases are the most mature, delivering faster cycle times and freeing staff capacity for higher-value work.
- Pricing and risk functions use AI primarily as decision support, improving speed and insight without automating accountability.
- Member-facing AI remains stuck in pilots, with trust, regulatory scrutiny and reputational risk slowing deployment.
- Foundations matter more than pilots. Insurers investing in data platforms, governance and skills alongside experimentation are far better positioned to scale.
Christopher Watney, Chief Executive of the International Federation of Health Plans, said:
"This research shows an industry learning quickly and investing deliberately. Insurers are using early operational gains to fund stronger platforms, skills and governance, recognising that sustainable AI adoption is a capability-building exercise, not a race to automate."
Chinwe Onyema, Head of Strategic Development & Partnerships at International Federation of Health Plans and contributor to the report, said:
"The most encouraging signal is not how many pilots insurers are running, but how seriously they are taking the foundations needed to scale. We are seeing growing clarity about where AI adds value today and where patience and discipline are required."
The report will be discussed at an iFHP executive briefing on 28 January 2026 and is intended to support boards and senior leaders as they shape responsible, effective AI strategies in regulated health insurance markets.
Our aim is to publish an accompanying report aimed at practitioners, which provides a concise AI Playbook with checklists, sequencing guidance, vendor and due diligence templates and guidance on governance approaches to translate these findings into action.
About International Federation of Health Plans
International Federation of Health Plans (iFHP) is a global association of health insurers and payers dedicated to strengthening private healthcare systems through collaboration, knowledge exchange and shared learning. Our network spans more than 40 countries and includes health plans, third-party administrators, and HMOs of all sizes, ranging from national funds to multinational organisations.
Related iFHP Research
The International Federation of Health Plans regularly publishes research on the strategic, systemic and technological challenges facing health insurers, including Rethinking Healthcare Funding: Applying Systems Thinking, which explores how systems-based approaches can improve the sustainability of healthcare financing; Rethinking Technology's Role in Adolescent Mental Health, which examines the implications of digital tools for mental health outcomes in youth; Building a Vision for Moving from Payer to Partner, which sets out how insurers can evolve from transactional payer models toward more collaborative roles within healthcare systems; and the International Healthcare Cost Comparison Report 2024, which provides comparative insights into healthcare prices and cost drivers across international markets.
Connect with iFHP on LinkedIn and listen to our podcasts on Spotify.
Visit www.ifhp.com.
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