Bupa eyes generative AI to demystify policies

Health insurance complexity deemed major challenge

Bupa eyes generative AI to demystify policies

Life & Health

By Roxanne Libatique

Bupa Australia (Bupa) is exploring the integration of generative AI technologies to make health insurance policies more accessible and understandable for its clients.

Bupa chief technology officer Nick Wong shared insights at the Microsoft AI Tour Sydney about the potential for generative AI to transform customer service and operational efficiency.

How can generative AI help Bupa?

The discussions within Bupa aim to identify how generative AI can support the organisation’s mission to better serve its clientele without altering its foundational goals.

Wong explained that the technology could significantly change the way services and experiences are delivered, enhancing the ability to clarify the complexities of health insurance coverage for customers.

“That’s how we’ve looked at it,” he said, as reported by IT News. “The conversations, I think, are really constructive within the group.”

Challenges in the health insurance sector

According to Wong, one of the primary challenges in the health insurance sector is the complexity of policy details, such as coverage limits, exclusions, and the application of waiting periods based on individual situations.

Wong highlighted that, despite the availability of information in detailed policy documents, conveying it in a customer-friendly manner remains a hurdle. Generative AI is seen as a solution to this challenge, potentially enabling staff to provide clearer, more understandable explanations to policyholders.

“Health insurance can be quite a complicated product – ‘why am I covered for this under these circumstances if I’ve got this?’” he said. “That information is there, and it’s all codified within a very heavy textual tabled format, but articulating it to customers when they ask questions like that, very specific to their experience, can be quite hard for someone to do if they’re trying to mentally retrieve this information – and these are skilled, trained people to look at this information.”

Wong also noted that the insurance industry, particularly sectors under regulatory scrutiny, is uniquely positioned to pioneer the use of generative AI. This readiness is attributed to a strong focus on risk management and the establishment of comprehensive control frameworks, which breeds confidence in experimenting with new technologies while ensuring a balanced approach to innovation.

How Bupa prepares for generative AI implementation

To prepare for the adoption of generative AI, Bupa is focusing on building relevant skills, creating governance models tailored to AI, and fostering an environment conducive to open discussions about technology use.

Wong emphasised the importance of a culture that embraces potential technological advancements without fear.

“There is a need to not put fear into people around staying away from possibility because of what might go wrong,” he said. “We don’t go in with fear. We’re going in with vigilance and awareness but also keeping an eye on other things.”

Meanwhile, a recent report from professional services firm Deloitte emphasised that the success of generative AI implementation in the workplace depends on the human capabilities that work with it.

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