OPINION: Africa’s moment to lead in smart and personalised health insurance

What was once seen as a futuristic vision is now a daily reality—health claims approved in minutes, AI tools detecting fraud before it occurs, and predictive analytics helping people stay healthier.

These innovations are not imported; they are powered by African data and infrastructure. As technology, regulation, and collaboration converge, Africa’s experience is offering lessons for other emerging regions pursuing similar digital transformation.  

By the end of the forum, the tone had shifted from experimentation to execution. Delegates agreed that the continent already has the digital foundations and regulatory clarity to scale AI responsibly across health finance. The task now is to connect what exists—to turn data into shared intelligence that builds trust and delivers tangible value to customers, companies, and communities alike. 

Globally, insurers are learning to scale AI responsibly. Whether in Nairobi, Lagos, Johannesburg or the Gulf, most are still moving from pilot projects to production. What distinguishes Africa is the quality of its groundwork. Over the past decade, steady investments in mobile connectivity, digital-policy systems and claims automation have created clean, structured, interoperable data—exactly what AI needs to thrive. 

These digital rails are now maturing into intelligent systems. Routine tasks such as claims validation, reconciliation and compliance checks can be automated, freeing human expertise for underwriting, customer care and innovation. Data that once sat in silos is being analysed in real time to improve pricing accuracy, reduce fraud and anticipate client needs. Efficiency has become a gateway to intelligence. 

Strong governance underpins this transformation. Kenya’s 2019 Data Protection Act gives citizens the right to human review of automated decisions, while the African Union’s 2024 AI Strategy embeds transparency and accountability into policy across member states. These frameworks give boards and regulators confidence to scale innovation safely, proving that Africa’s AI revolution is being built on responsibility as much as speed. 

Early evidence already supports this confidence. Across markets, insurers adopting AI for claims and risk management are reporting measurable results—lower loss ratios, faster processing times, and higher customer satisfaction. In Kenya and Nigeria, claims that once took weeks are now settled within hours.

Staff once tied up in manual verification are being redeployed to client service and analytics. These are not isolated examples, but signs of a deeper structural shift in how the industry operates. 

The same connected data and technology driving operational efficiency is also transforming the very purpose of health insurance. By linking medical, behavioral and financial information securely, insurers and health partners can move from paying for illness to investing in wellness.

In Kenya, health insurance is already managed in real-time, enabling insurers to design more personalized products, reach new market segments faster and operate with greater efficiency and profitability.

In Rwanda, predictive algorithms trained on antenatal-care data now flag high-risk pregnancies early, enabling targeted interventions that save lives. In Uganda, image-analysis tools detect malaria parasites with expert-level precision, expanding diagnostic capacity in rural clinics. In South Africa, AI-powered wellness programs guide members toward preventive habits, showing early evidence of major cost savings in chronic-disease management. 

Across other emerging markets—from the Middle East to Southeast Asia—insurers are starting to adopt similar models, proving that connected data and responsible AI are becoming universal enablers of more resilient, customer-centred health systems. 

Every claim in this new model becomes a learning event. Insurers can identify risk patterns that drive prevention; healthcare providers can design better care pathways; and customers can gain confidence that their cover supports long-term well-being, not just short-term treatment. Economic logic is equally powerful.

Predictive analytics can reduce claims costs, stabilise premiums, and release capital for growth. For CEOs and boards, this represents a new equation: profitability and health no longer exist in tension—they reinforce each other. 

Africa’s opportunity lies not in starting from scratch, but in building on what already works. The continent’s mobile infrastructure, regulatory clarity and culture of collaboration provide a head start in developing connected, AI-enabled insurance systems that serve people and markets more equitably. What will determine success in the coming years is leadership—executives who view connected data and responsible AI not as side projects but as central business strategy. 

Artificial intelligence will not replace Africa’s insurance systems; it will make them smarter. The groundwork laid from 2015 to 2025 has evolved into a platform for real-time insight, preventive care, and customer trust. Africa’s story is no longer one of catching up—it is one of contributing to the global standard for how technology and governance can advance together to strengthen an industry and serve society. 

About InsurTech Forum Nairobi 2025 

The InsurTech Forum Nairobi (ITFN) is an annual platform that brings together insurance executives, regulators, and technology leaders to explore innovation in Africa’s insurance and financial services sectors. The 2025 edition focused on Connected Data and Artificial Intelligence, drawing participants from across the continent. 

Authors 

Pieter Prickaerts is CEO of CarePay (M-TIBA in East Africa), a next gen health insurance platform and partner for insurers and TPAs to enter new segments and markets profitably.   

Ayisi Makatiani is CEO and Co-Founder of Caava Group, an AI-driven InsurTech ecosystem that leverages connected data platforms to help insurers expand, digitise, and grow profitably across Africa.