Bupa Australia looks to GenAI to cut through insurance policy complexity

Bupa Australia is having “constructive” internal discussions on the use of generative AI, with early indications that it could be valuable in helping customers understand the intricacies of their private health insurance policies.

Chief technology officer Nick Wong told the Microsoft AI Tour Sydney that Bupa’s operations, spanning insurance and aged care, offered “a very big surface on which you could apply [GenAI] technology.”

Wong said that Bupa would not deviate from its existing goals - which included better serving its customers and residents - but said AI could alter “the means by which we can actually deliver those services and experiences”.

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

An early opportunity for the technology is to help decipher the specifics of health insurance policies, such as the way inclusions, exclusions and waiting periods are applied to people, depending on their individual circumstances.

“Health insurance can be quite a complicated product - why am I covered for this under these circumstances if I’ve got this?” Wong 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. 

“We’re trying things like using GenAI as a capability to retrieve and articulate answers to those questions in a way that’s understandable to the average human, and so for our staff who have to face into those [conversations], that can be a very meaningful use of GenAI/AI for them.”

Wong said that insurers - and those in regulated sectors generally - were well-placed to experiment with generative AI due to intense focus in recent years on risk management maturity and control frameworks.

“That actually helps a lot with confidence when you’re taking up a new technology to know it’s in our DNA to be vigilant and cautious, while still wanting to be adventurous with stuff,” he said. 

“You get the right kind of balance. 

“I think regulated organisations that have taken some of those steps are actually well positioned to [have] something to start with.”

Wong said that preparatory work for GenAI on Bupa’s side included acquiring and developing skilled capability, establishing AI-specific governance around use cases, and creating an “ability to open up the right kind of dialogue with our people.”

Wong added that culture was important, noting that “there is a need to not put fear into people around staying away from possibility because of what might go wrong.”

“We don’t go in with fear,” he said.

“We’re going in with vigilance and awareness but also keeping an eye on other things.”

Ry Crozier attended Microsoft AI on Tour Sydney as a guest of Microsoft.