Insurance Director EA FAQs — Why do 140 IT Projects ≠ Insurance Enterprise Architecture?
- Sunil Dutt Jha
- 6 days ago
- 5 min read
Updated: 3 days ago
Most insurance organisations still treat Enterprise Architecture as an IT exercise, which is why EA efforts don’t change underwriting quality, claims outcomes, loss ratios, regulatory compliance, customer trust, or profitability.
Insurance EA ≠ Insurance IT.
This Director EA FAQ explains where traditional EA breaks down and how a true enterprise anatomy reveals the structure that IT alone cannot see, align, or repair.
It explains the logic of shadow anatomies, 12 insurance use cases, and the One Insurance One Anatomy™ advantage.
Q1: Why do 140 IT projects ≠ Insurance Enterprise Architecture?
Myth:
Insurance EA = Insurance IT (Core system replacement + digital channels + data platforms + automation).
Reality: An insurance enterprise operates through 15 departments (D1–D15) such as Product & Actuarial, Underwriting, Policy Administration, Distribution, Sales, Claims, Reinsurance, Risk, Compliance, Finance, Customer Service, Operations, and Analytics — each with its own P1–P6 execution cycle.
Insurance IT is only one department.
EA (IT) ≠ Enterprise Anatomy.
A project inventory cannot show how product intent, underwriting rules, pricing logic, claims decisions, reinsurance structures, and regulatory obligations align across the enterprise.
Q2. Why do so many IT projects fail to represent the insurance enterprise?
Because insurance IT automates only small fragments of P5 tasks, while the true operating architecture of the insurance enterprise lives in P1–P4, not in the task layer.
Every insurance department operates on a full P1–P6 structure:
P1 (Strategy) defines product portfolio, risk appetite, market positioning, and growth goals.
P2 (Processes) defines product setup, underwriting, policy issuance, endorsements, claims handling, renewals, and settlements.
P3 (System logic) defines underwriting rules, rating algorithms, eligibility logic, exclusions, claim adjudication rules, and exception handling.
P4 (Component Spec) defines product definitions, rate tables, rule libraries, policy clauses, claim forms, and datasets.
This is the architecture of the insurance enterprise.
Most IT projects touch P5 only — automating selected tasks such as quote generation, policy issuance, claim registration, or payment processing — while P1–P4 remains fragmented, manually interpreted, or inconsistently applied across lines of business.
The mismatch is structural:
IT systems automate tasks.
nsurance operates on architecture (risk and decision ) D1-D15 X P1-P4.
Because P1–P4 was never architected:
• underwriting decisions vary by channel and region
• pricing logic diverges across products
• claims outcomes differ for similar loss events
• exclusions and conditions are interpreted inconsistently
• reinsurance logic is misaligned with underwriting
• compliance rules fragment across jurisdictions
Insurance IT does not fail because systems are weak.
It fails because it is built on an incomplete representation of the enterprise.
Q3. What drives the high project count in the insurance industry?
Insurance is a rule-dense, decision-heavy enterprise where every change ripples across departments.
A product change impacts actuarial models, underwriting rules, pricing, and distribution.
A regulatory update alters policy wording, disclosures, reporting, and audits.
A claims trend forces changes in adjudication logic and reserve calculations.
A reinsurance structure change impacts underwriting limits and claims recoveries.
A distribution shift affects onboarding, commissions, and servicing logic.
High project count reflects risk and rule complexity, not IT inefficiency
Q4. What is unique about Insurance’s 15 Functions (D1–D15)?
Each insurer has a distinctive 15-function anatomy (D1–D15 × P1–P6).
Insurance highlights:
D2 Product & Actuarial – governs risk modelling and pricing intent
D4 Underwriting – governs acceptance, limits, and exclusions
D6 Policy Administration – governs lifecycle and endorsements
D8 Claims – governs adjudication, settlement, and recovery logic
D10 Reinsurance – governs risk transfer and treaties
D12 Compliance & Risk – governs regulatory and solvency rules
These functions generate the strongest P1–P6 drift when not aligned.
Shadow anatomies emerge when departments evolve independently.
Q5. What does P1–P6 look like in the insurance industry?
This explains how strategy (P1) → operations (P6) breaks down.
P1 Strategy: product mix, risk appetite, growth and profitability targets.
P2 Process: underwriting, issuance, endorsements, claims, renewals.
P3 Logic: rating algorithms, underwriting rules, claim decision rules.
P4 Components: product definitions, rate tables, clauses, datasets.
P5 Implementation: core system transactions, workflows, integrations, SOPs.
P6 Operations: underwriters, adjusters, agents applying rules differently.
Insurance drift occurs when these layers no longer form one integrated sequence.
Q6. We already have extensive architecture documentation. Why redo this?
Myth: More documentation means we understand the enterprise.
Reality: Documentation shows parts of the insurer. Enterprise Anatomy shows the insurer as one integrated model.
Think of the human body.
It has 11 organ systems. Each has its own role, but none operate independently. They function as one integrated system with thousands of interdependencies.
An insurance enterprise is the same.
An insurance anatomy = 15 Functions (D1–D15) × 6 Perspectives (P1–P6).
Traditional documentation describes systems, products, and processes separately — but never shows:
• how underwriting intent flows into claims
• how pricing logic affects loss ratios
• how reinsurance aligns with risk appetite
• how compliance rules propagate across products
• where structural risk accumulates
You get a library — not a model.
One Insurance One Anatomy™ collapses complexity into one integrated enterprise model.
Q7. How do we evolve from EA (IT) → EA (Departments) → One Insurance One Anatomy™?
Most organisations stop at EA = IT architecture.
The next evolution is:
Step 1: Elevate EA (IT)
Create the P1–P4 model of Insurance IT itself — IT strategy, IT processes, IT logic, IT components.
Step 2: Create EA (Departments) Map 15 insurance functions end-to-end (P1–P6).
Step 3: Create One Insurance One Anatomy™
Unify all departmental models into one enterprise anatomy governing risk, underwriting, claims, finance, and compliance.
This is where drift stops — and decision quality improves.
Q8. What can One Insurance One Anatomy™ do that traditional EA cannot?
Traditional EA documents systems, interfaces, and processes. It does not reveal that every insurance department operates its own shadow anatomy — its own version of strategy, rules, data meaning, and decisions.
A mid-size energy enterprise typically carries 100–300 shadow anatomies:
In a typical insurer:
• Underwriting applies one interpretation of eligibility and risk • Product & Actuarial embeds a different interpretation in pricing models
• Policy Administration implements another version in core systems • Claims applies its own decision logic during adjudication • Reinsurance operates with separate assumptions and limits • Compliance enforces rules differently across regions and products
Each department believes it is “following architecture.”
In reality, each is running a partial, local anatomy.
This creates hundreds of shadow anatomies, for example:
• underwriting rules diverging across channels • pricing logic varying by product, region, and system • exclusions interpreted differently between policy issuance and claims • reinsurance structures misaligned with underwriting intent • compliance rules inconsistently embedded in operations • capital and solvency logic disconnected from product decisions
Traditional EA documents this fragmentation. It does not eliminate it.
One Insurance One Anatomy™ does something fundamentally different.
It creates one enterprise-level P1–P6 anatomy that governs:
• risk appetite (P1) • underwriting and claims processes (P2) • rating, eligibility, and adjudication logic (P3) • product definitions, clauses, and rule libraries (P4) • implementation tasks (P5) • operational execution (P6)
Instead of hundreds of shadow interpretations, the insurer operates on:
one risk logic
one pricing logic
one underwriting logic
one claims logic
one compliance logic
This is why One Insurance One Anatomy™ can correct problems that traditional EA cannot even see:
• persistent loss-ratio volatility • inconsistent claim outcomes • regulatory exposure• reinsurance leakage • capital inefficiency • customer trust erosion
How it Impacts the 12 Core Oil & Energy Use Cases
Using One Energy One Anatomy™, the enterprise can address failures across:
Reserve Development Planning
Drilling & Well Execution
Production Optimisation
Asset Maintenance & Reliability
HSE & Safety Compliance
Production Scheduling
Logistics & Transportation
Trading & Market Alignment
Cost & Margin Control
Regulatory Compliance
Asset Lifecycle Management
Operational Performance Stability
With One Energy One Anatomy™, these use cases become predictable and controllable — because they run on one enterprise logic stack.
Traditional EA improves documentation. One Insurance One Anatomy™ restores enterprise coherence.
If EA remains limited to IT, the enterprise continues to drift—department by department, rule by rule, process by process.
An insurere regains coherence only when its entire P1–P6 structure is mapped as one integrated anatomy.
Write to us if you’d like a diagnostic walk-through of how this works in your environment.
