The aggregate value of insurance underwriter M&A in North America increased in 2023, marking a positive trend amidst a wider decline in overall dealmaking. According to an analysis by S&P Global Market Intelligence, while the level of deal activity in the insurance sector decreased by 2% with 96 transactions in 2023 compared to 98 in 2022, the aggregate transaction value saw a significant uptick to $16.23 billion, a 16.8% increase from the previous year's $13.89 billion.

The largest deal of the past year involved Brookfield Reinsurance Ltd.'s planned acquisition of American Equity Investment Life Holding Co. for $3.59 billion. Other significant transactions included KKR & Co. Inc.'s $2.7 billion stake acquisition of Global Atlantic Financial Group Ltd. and S.USA Life Insurance Co. Inc.'s $1.91 billion pending purchase of National Western Life Group Inc.

One notable deal that faced challenges was Elevance Health Inc.'s planned $3.5 billion purchase of Blue Cross and Blue Shield of Louisiana, which encountered delays. Blue Cross and Blue Shield of Louisiana announced a pause in the transaction, citing the need for policyholders to better understand the benefits of the acquisition. This pause was the second for the deal, with the previous halt occurring in September 2023 due to regulatory concerns.

The report also highlighted changes in deal appetite within the industry, noting a significant decline in life and health deals from 39 transactions in 2021 to 19 in 2023. Similarly, the number of life and health deals decreased from 27 in 2022. However, managed care deals nearly doubled, increasing to 11 in 2023 from six in 2022. Reinsurance deals also saw growth, rising from five to eight during the same period.

Overall, while the broader North American M&A landscape experienced a decline in both the number of transactions and total transaction value, the insurance sector proved to be a notable exception with an increase in deal value, showcasing resilience amidst challenging market conditions.