This study aims to carry out and document a systematic analysis of the literature on the importance of actuarial management in insurance managerial decision-making in the twenty-first century. After a short introduction to the business context, the paper presents an analysis of a rigorous review of the literature published between the years 2000 and 2020, which highlights the benefits and challenges of the formal application of various risk management tools. The following topics are emphasized: (i) actuarial cycle control and uncertainty management, (ii) quantitative strategic risk framework and financial modelling, and (iii) enterprise risk management with a value-based approach. This work will help future researchers to gain a better understanding of, and explicitly account for, the different contributions and benefits of actuarial management in the context of managerial decision-making in an organisation.