Solving Insurance Challenges the Agile Way 

Caryn Warner: Hello, welcome to the Sapiens Insurance 360 podcast. I’m your host, Caryn Warner, Vice President of Marketing for North America at Sapiens. And I’m so glad you’re out there listening. This is where we discuss the latest news, trends and issues from across the insurance solutions and technology spectrum. And our latest episode — the very first of our fourth season — starts now!

So it’s no surprise to anyone in insurance that legacy systems are a drag on an organization’s productivity. Data is scattered. Underwriters get buried in manual tasks. Product launches take far too long. Adjusters end up juggling more complex cases, rising claims volumes, and tighter timelines. And all the while, customer expectations keep rising and competitors are moving faster. It’s a lot, but there’s a shift happening.

More insurers are rethinking how they work using agile, AI-powered platforms to automate the grunt work, connect the dots, and move at the speed their customers expect. It’s not just about keeping up; it’s about building a smarter, more responsive business. So to discuss this revolutionary shift, I’m joined today by Gil Trotino, Director of Product Marketing for Cloud & Portfolio at Sapiens. Gil brings over 20 years of enterprise software experience and leads our insurance platform strategy, including market analysis, product roadmap, and future vision development. Gil was with us earlier this year to discuss Sapiens’ AI approach, and I’m so excited to have him back to dive deeper into what’s preventing insurers from achieving operational efficiency and how agile solutions, namely Sapiens, can help them overcome their most pressing challenges to lead the way in today’s competitive market.

Gil, welcome back!

Gil Trotino: Hi, great to be back, Caryn!

Caryn Warner: So okay, let’s start with insurers’ pain points. What are the biggest operational obstacles you’re seeing that prevent insurers from achieving the agility they need, particularly in underwriting and claims processing?

Gil Trotino: Great question! One of the biggest challenges insurers face is around fragmentation, fragmentation of systems, data and decision making. Underwriting and claims processes involve, as we know, a lot of manual handoffs, inconsistent rules, and siloed technologies which slow response time and limit scalability. At Sapiens’ we are addressing these issues in several ways with our insurance platform. One of the core ideas of our platform is what we call single source of truth, which means that we collect, consolidate, and normalize data across all core and peripheral systems, including policy, claims, billing, CRM, and many other external data sources. This enables a true, consistent 360-view, ensuring that everyone in the organization, from the agents and the brokers to the decision makers, all of them are working with the same up-to-date information. For example, if a customer calls with a question about a claim, the service rep can instantly see their entire history, including policy details, past claims, payments all in one place.

Now, another tool that we have is our no-code business logic engine, which is also embedded across our platform and is used to manage and automate business logic so businesses [and] business users can easily build and adjust decision rules such as coverage validation, fraud detection, or claim handling without waiting on IT teams. When these two solutions are combined together, then we see the magic. Then you can basically achieve true data-driven decision making. Maybe let’s explore one use case around claim management to illustrate this. For example, in the life insurance claims, our no-code decision engine automates the claim-handling process by combining business rules with AI and machine learning models. So when a beneficiary submits a claim, then engine verifies policy details, coverage status, and the required documents, also using, by the way, AI, then applies a machine learning risk score based on factors such as claim account, frequency of claims, and historical patterns. Straightforward, low-risk claims are approved automatically. What you know, how we call it, it is straight-through processing or STP, while claims with unusual patterns or missing information or fraud indicators are routed to the claim handler for manual intervention. So this approach, which is a true co-claim handling approach, streamlines the claim resolution, reduces manual workload, improves fraud detection, and ensures faster payouts for genuine claims. Finally, agility is also about faster time to market, which means the ability of the insurer to quickly launch new product pricing models or coverage types to meet emerging customer demands. Our modular platform enables us to design and deliver integrated, end-to-end business solutions that align with real-world insurance flows across underwriting, claims, policy billing, and beyond.

And because it’s also open, we can easily plug in third-party partners and complement and expand our own capabilities. Let’s take one example, a great example I think, is our recent SMEs small medium business solution. We built it to streamline small commercial insurance by combining our core systems capabilities with ecosystem partners, such as region for data enrichment. That way, agents can get pre-filled intelligent forms, and underwriters can make faster, smarter decisions all within one seamless flow. It really shows the power of building solutions around business needs, not just products.

Caryn Warner: Wow, that’s a lot for insurers to consider. Tell us, how are insurers able to scale and adapt quickly in the face of so many different challenges and options, to consider?

Gil Trotino: So insurers today face a lot of challenges that make agility very tough. Limited IT resources, unpredictable spikes in demand, complex regulatory requirements, and of course, the constant need to innovate. That’s why SaaS is such a game changer. Using a SaaS platform such as Sapiens’ insurance platform, insurers don’t have to worry anymore about managing infrastructure or scaling resources themselves. They get a very flexible cloud environment that adjusts automatically to their needs, so they only pay for what they use. Plus, with firm SLAs and built-in compliance and security, insurers can trust their systems will be reliable and up to date with evolving regulations. Most importantly, this lets insurers focus their time and energy on delivering business value rather than firefighting operational issues. Also, continuous smooth annual upgrades mean that always insurers have access to the latest innovations without disruption, helping them launch new products faster, enter new markets and handle busy seasons with ease.

Caryn Warner: So let me ask you this, and AI is something that I think you mentioned earlier, I know we talk about it all the time here. Can you walk us through how AI serves as the foundation of Sapiens platform and drives customer success?

Gil Trotino: Yeah, absolutely. First of all, Sapiens AI isn’t just another feature that we are adding on top of what we do. It’s more regarded as a, as a foundation layer built into the core of our platform. So AI is truly at the heart of the Sapiens insurance platform, powering every step of the insurance value chain, and serving all key personas from the agents and the brokers to customers and employers.

The capabilities fall into three major areas. The first one is our rule-based auto reasoning. We touched [on] this earlier, but it’s worth emphasizing again, I think. Our no-code decision automation engine empowers business teams to manage complex logic, whether this is underwriting risk rules or claim processing flows. They can do it without relying on IT. This accelerates changes, reduces errors, and increases agility.

The second element is the use of machine learning and predictive analytics. We’ve built around 30 machine learning models that enhance underwriting precision, predict customer behaviors like buying propensity or churn, and help insurers make smarter, data-driven decisions. The third component is the use of Gen AI and Copilot tools. We embed Gen AI across the platform, providing smart assistant for automatic classification, instruction, and summarization of documents, for example, and other tools that surface the right insights to inform decisions.

Caryn Warner: Well, it’s pretty clear that the deployment of AI is a game changer in so many ways. I know we’ve covered a lot of ground today. So for our final question, can you just tie everything together by explaining the key drivers behind the Sapiens SaaS solution when it comes to governance and centralized management and how it ensures consistency, compliance, and operational efficiency at scale?

Gil Trotino: Right, sure. So in today’s complex insurance environments, we know that strong governance is essential. And that’s exactly where Sapiens excels. Our SaaS platform, which I mentioned earlier, provides centralized management capabilities of critical functions such as user actions, security policies, system monitoring, and third-party integrations. This gives insurers full visibility and command over their entire ecosystem. Reducing risk and simplifying the compliance, and by combining comprehensive governance with seamless, centralized management, Sapiens empowers insurers to grow confidently while minimizing the complexity.

Caryn Warner: Wow. So that’s incredibly insightful, Gil! Thanks so much for your comprehensive explanation of what today’s insurers should be achieving from their systems in terms of operational efficiency and how Sapiens’ agile SaaS platform may help insurers better scale and succeed in an increasingly competitive landscape. Thank you so much for sharing your expertise. And to our listeners, thank you for joining us for our Season Four premiere. We have so much more exciting content planned, and as always, we’d love to hear from you. Connect with us on social media, share your feedback, and don’t forget to subscribe to the podcast so you never miss an exciting episode. Until next time, this is Sapiens Insurance 360. Thanks for listening.