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ANNUAL REPORT

Global life and health insurance mergers and acquisitions (M&A)

16 April 2024

Quick links: North America Europe Asia Latin America


How has the life and health insurance M&A landscape changed?

Stability is often key to activity in insurance mergers and acquisitions—and 2023 was anything but stable. High inflation and interest rates caused economic uncertainty in many regions, while conflict roiled Ukraine and the Middle East and several global life and health insurance markets faced changes to solvency regulations. These pressures combined to slow M&A transactions among life and health insurers in 2023.

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But while deal volume continued its downward trend from the 2021 peak, deal value rose, and there remains demand from traditional insurers, asset managers, and private equity firms for life and health insurance business around the world.


See mergers and acquisitions by country, plus more deal data

Each year, Milliman studies global life and health insurance M&A trends. Our analysis reviews data and deals in North America, Europe, and Asia, with a new section this year for Latin America. We present the highlights of our research below. Download the full report for a country-by-country breakdown of deal specifics, key players, and future projections.


Worldwide statistics

Life and health insurance M&A deals were down—but values were up

Globally, 80 life and health insurance mergers and acquisitions were announced in 2023, down from 131 in 2022. However, total publicly announced deal values rose from US$20.4 billion in 2022 to US$21.5 billion in 2023.*

*Backing data for some deals was updated after the publication of our earlier reports. For a small number of transactions, certain pre-2023 statistics presented here may not exactly match the numbers in previous editions of the paper. See the PDF for full source information.


Deal volume

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%

Deal value

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%

map north america

North America

Deals

23

arrow-downfrom 34 in 2022


Total publicly announced transaction value

$12.5 billion

arrow-upfrom $2.7 billion in 2022

map europe

Europe

Deals

25

arrow-downfrom 34 in 2022


Total publicly announced transaction value

$3.7 billion

arrow-downfrom $12.9 billion in 2022

map asia

Asia

Deals

23

arrow-downfrom 33 in 2022


Total publicly announced transaction value

$5.0 billion

arrow-upfrom $2.0 billion in 2022

map europe

Latin America

Deals

5

equal signEqual to 5 in 2022


Total publicly announced transaction value

$200 million

arrow-downfrom $2.1 billion in 2022


Announced transactions by region


North America

Multibillion-dollar transactions lift deal value more than 300%

North American insurance M&A in 2023 was similar to 2022 levels and appeared to signal the return of more typical activity after the record highs of 2021. Although the number of deals dropped 32%, their value rose 368%, driven by four multibillion-dollar transactions.

M&A in the region is dominated by the United States, where continued high interest rates led to the exploration of different reinsurance structures. Potential changes to U.S. and offshore regulatory environments may encourage companies to review deal options, and we may see more transactions through sidecars and other alternative structures.

See the full report for details on the largest deals and key players.

Download the full report

Top deal-making countries in the region in 2023:

United States
21
Bermuda
2

Europe

The most insurance M&A deals of any region—but activity continues to decline

Europe had the most insurance M&A transactions last year of any region in our report, but publicly announced deal values were down 71% from 2022, and 2023 activity continued the trend of declining deals in the region. As in 2022, Spain had the most active market, as well as the highest publicly announced deal value in Europe.

Rising interest rates across Europe have caused unrealized losses on fixed income investments for some insurers, which has increased lapse risk and mass lapse capital requirements. The expectation of sustained high rates may lead some companies to reconsider disposing of non-core holdings, and many insurers are waiting until economic conditions stabilize before making decisions about the suitability of portfolios. Still, private equity demand for European life and health insurance business is expected to remain high in 2024 and beyond.

See the full report for key transactions in the U.K., Italy, Spain and Portugal, France, CEE, Belgium and Luxembourg, Germany, and the Netherlands.

Download the full report

Top deal-making countries in the region in 2023:

Spain
6
U.K.
4
Italy
3

Asia

Deal values rise as India, China again dominate insurance M&A activity

In 2023, the number of Asia-based life and health insurance transactions decreased 30% from 2022, but total publicly announced deal values rose 152%. India and China were again among the busiest markets, aided by recent regulations facilitating foreign investment. Still, some multinationals sold their stakes in Asian insurers in 2023.

As risk-based capital regimes are implemented across the region—increasing balance sheet volatility and capital needs—some firms may need to dispose of life insurance investments going forward. While IFRS 17 has so far not driven M&A activity in Asia, it may spur future transactions as insurers gain understanding of the regulation’s impact on their financials.

See the full report for key transactions in China, India, and Southeast Asia.

Download the full report

Top deal-making countries in the region in 2023:

India
7
China
2
Kuwait
2
Malaysia
2
Singapore
2

Latin America

Insurance M&A activity stable and likely to grow

In 2023, Latin America saw a similar number of life and health insurance M&A transactions as in 2022 and 2021. In addition, the region saw a significant number of large insurance distribution agreements between insurers and financial groups, banks, and retailers, a trend that is expected to continue.

Life and health business is projected to grow across the region as insurance uptake rises and increased digitization enables insurers to reach a wider customer base. In particular, Chile’s pension system is a recurrent source of M&A activity. Even Argentina, despite continued economic uncertainty, likely will see more foreign investment after recent political changes.   

Download the full report

Top deal-making countries in the region in 2023:

Mexico
2
Brazil
1
Chile
1
El Salvador
1

Life and health insurance M&A

Download the PDF to see more specific data on health and life insurance mergers and acquisitions around the world.

Download the full report
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About the Author(s)

Tanner McKerlie

Chew Hou Ng

Sam Burgess

Lyndsay Wrobel

Stuart Reynolds

Fernando Mesquida

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