AI in Healthcare and Health Insurance – A Roundtable Peer Discussion
February 2026
Author
Joe Alaimo, ASA, ACIA
Executive Summary
In November 2025, the SOA Research Institute convened a panel of industry experts to discuss the advancements and implications of generative AI (GenAI) in healthcare and health insurance. The roundtable brought together actuaries and health professionals from consulting firms and health insurance providers.
Panelists agreed that AI, particularly generative AI, is rapidly changing how healthcare and insurance organizations process data, identify risks, and support strategic decision-making. Across organizations, AI tools are being used to enhance data analysis, streamline administrative activities, and support predictive modeling in underwriting, pricing, and care management. At the same time, panelists consistently emphasized that these technologies must be applied within strong governance frameworks along with transparency and clear professional accountability.
Several recurring themes emerged throughout the discussion. AI adoption and experimentation are expanding, although maturity levels vary widely across organizations and use cases. Governance and oversight were viewed as foundational requirements for managing bias, privacy, and accountability. Trust and validation remain central concerns, with actuaries expressing caution about relying on AI outputs without appropriate verification and human review. There were significant concerns about hallucinations and non-deterministic behavior in large language models. Panelists also noted that the actuarial skill set is evolving, with growing emphasis on data science literacy, ethical reasoning, and communication skills. Looking ahead, participants expect AI’s influence to grow as healthcare systems increasingly rely on predictive analytics and automation.
Overall, the panel expressed cautious optimism about AI’s potential. While AI can significantly enhance efficiency and analytical reach, panelists reinforced the continuing importance of professional oversight, interpretability, governance, and human judgment in ensuring responsible and effective use.
Material
AI in Healthcare and Health Insurance – A Roundtable Peer Discussion
Suggested Citation
Alaimo, Joe. AI in Healthcare and Health Insurance – A Roundtable Peer Discussion. Society of Actuaries Research Institute, January 2026. https://www.soa.org/resources/research-reports/2026/ai-healthcare-health-insurance-roundtable/
Acknowledgements
The researchers’ deepest gratitude goes to those without whose efforts this project could not have come to fruition: the Project Oversight Group and others for their diligent work overseeing questionnaire development, analyzing and discussing respondent answers, and reviewing and editing this report for accuracy and relevance.
Project Oversight Group members:
Anne Carlson, ASA, MAAA
Henry Chen, FSA, FCIA, MAAA
Andrew Dilwoth, FSA, MAAA
Ying Zhao, FSA, MAAA, FRM
At the Society of Actuaries Research Institute:
Korrel Crawford, Senior Research Administrator
Dale Hall, FSA, MAAA, CERA, Managing Director of Research
Questions or Comments?
Give us your feedback! Take a short survey on this report. Take Survey
If you have comments or questions, please send an email to Research@soa.org