Today, technology is improving rapidly and transforming insurance business into Insurance Technology (InsurTech). InsurTech is an ecosystem of focused, innovation-based organizations that has the vision to deliver value for clients. PT XYZ is a health insurance company that is changing into InsurTech to provide opportunities focusing on flexibility, effectiveness, and accelerating the automation process of routine activities that are cost-effective and focus on user's experience. With InsurTech, XYZ will be easier to reach end users directly and buying process for customer to be easier and quicker. However, there are still so many challenges for InsurTech based on IT decision domains. XYZ's current CIO has multiple roles such also as Chief Finance Officer (CFO), Chief Support Officer (CSO), and Chief Organization Development Corporate Planning. This gives the difficulty for project's decision making. Besides, XYZ has not IT Steering Committee (ITSC) yet. This make XYZ difficulty on prioritization process, project's budget estimation, and control. This paper will explain the previous InsurTech research as the state-of-The-Art. The results and conclusion is XYZ needs to change and improve its four of IT decision domains, prioritization on all types including prioritization level, and activities related with its employees and senior executives' knowledge, skill, behaviour, and leadership.