Tuberculosis (TB) remains a major public health challenge in Indonesia and generates significant mortality-related risk for the life insurance sector. This study develops an integrated Susceptible–Infected–Recovered–Deceased (SIRD) model to analyze TB transmission dynamics in Southeast Sulawesi and to estimate related life insurance claims. The model is calibrated using regional TB data from 2021–2023 and validated against 2024 observations. Analytical results include equilibrium analysis and the basic reproduction number, while long-term dynamics are examined through scenario-based simulations. Epidemiological outcomes are translated into actuarial projections by converting cumulative TB-related deaths into annual incremental deaths and expected insurance claims under optimistic, baseline, and pessimistic scenarios. Parameter sensitivity is assessed using Latin Hypercube Sampling and Partial Rank Correlation Coefficients. The results show that the transmission rate is the most influential determinant of the present value of TB-related insurance claims, followed by the recovery rate, whereas TB-induced mortality has a smaller but significant effect. These findings highlight that reducing transmission and improving treatment effectiveness can simultaneously mitigate public health impacts and lower long-term insurance liabilities, demonstrating the relevance of integrating epidemiological modeling with actuarial risk assessment.