Life Insurance Business Data Model: AI-Ready Edition | Capstera

The Life Insurance and Annuities Business Data Model: AI-Ready Edition is for business and enterprise architects who need to know what information life insurance and annuities work runs on before an AI agent touches it. It covers 16 subject areas, 92 entities, 664 key attributes and 313 relationships. Every entity and key attribute is classified for sensitivity, with the AI uses and data-quality requirements an agent depends on. It holds the 83 entities every insurer shares and the 9 specific to life insurance and annuities, from Business Architecture for Insurance: AI Transformation Blueprint.

What's Inside

The same model comes in three files: the full model in Word, a workbook to filter and extend, and a guide to the scales and the license.

• 16 subject areas and 92 entities, each with a definition, its typical system of record, sensitivity class, AI uses and data-quality requirements
• 664 key attributes with sensitivity and AI relevance, and 313 relationships with cardinality
• Under each entity, the capabilities that need it and the agents that read it, by name and ID
• The Business Data Model (Word): every subject area and entity in full
• The workbook (Excel): subject areas, entities, attributes and relationships in sheets you can filter and extend
• The guide (Word): the scales the model refers to, the data foundation, and the license
• Free corrections, and new versions free for 180 days

Every file names your organization and carries your license ID.

The 16 Subject Areas

The 92 entities are grouped into 16 subject areas. The list gives what each holds and how many entities it has.

• Policyholders and Insurance Products (5 entities): Who holds the organization's policies and the products they hold.
• Rating and Product Filing (7 entities): The rating plans, rate changes, policy wording and filings that set what each product costs and says.
• Producers and Distribution (9 entities): The producers who sell the organization's insurance, their appointments, pay and conduct.
• Delegated Authority (3 entities): The authority the organization delegates to partners to underwrite or handle claims, the business they report and the audits of it.
• Submissions and Underwriting (9 entities): The submissions and applications the organization receives and the underwriting decisions made on them.
• Insurance Contracts and Coverage (5 entities): The insurance contracts the organization issues, what they insure and the cover selected.
• Policy Servicing (4 entities): Changes, renewals, cancellations and reinstatements of contracts in force.
• Premium Billing (5 entities): How premiums are billed, paid, chased and refunded.
• Claims (9 entities): Claims made under the organization's contracts, from notification to decision.
• Claim Settlement and Recovery (5 entities): What is paid on claims, appeals of decisions and what is recovered from others.
• Insurance Fraud (5 entities): Fraud signals, referrals, investigations and findings.
• Actuarial and Reserving (4 entities): The assumptions, studies and reserve estimates the organization prices and reserves with.
• Reinsurance (5 entities): The reinsurance the organization buys, what it cedes and what it recovers.
• Capital, Investment and Supervisory Reporting (6 entities): Liability projections, investment mandates, the capital position and the returns submitted to supervisors.
• Quantitative Model Control (2 entities): The quantitative models the organization relies on and their validation.
• Life Insurance and Annuities (9 entities): Beneficiary designations, policy loans and surrenders, annuity contracts and payouts, death notifications, underwriting evidence and nonguaranteed element declarations.

Who Uses It

Data owners and stewards, data architects, and AI and analytics engineers who need to know what an agent may read, how sensitive it is and how good it must be first; and business architects who link capabilities to data.

How It Fits With the Other Products

The capabilities named under each entity are defined in the Insurance Capability Model: AI-Ready Edition. The agents are specified in Business Architecture for Insurance: AI Transformation Blueprint, which contains this data model and adds the value streams, use cases, controls, an operating model and a roadmap. The Life Insurance and Annuities Value Streams are sold on their own too.