Prudential taps AI to improve health insurance experience

Insurance giant Prudential is tapping Google’s MedLM, a family of foundation models fine-tuned for healthcare industry use cases, to transform the complex and fragmented health insurance experience for its customers.

The move makes Prudential one of the first global insurers to adopt MedLM – typically used by healthcare organisations to build AI applications that deliver better experiences for healthcare workers and patients – for claims processing and broader healthcare support.

Initially rolled out in Singapore and Malaysia, MedLM analyses medical reports, invoices, and other claim documents, providing summaries and recommendations to claims assessors, reducing manual data entry and minimising errors.

Early tests have shown impressive results, doubling the automation rate of claim reviews and assessments with improved accuracy, according to Arjan Toor, CEO for health at Prudential. This translates to faster payouts for customers and allows Prudential to manage a higher volume of claims, he added.

Toor also underscored the importance of maintaining human oversight, noting that the goal is to empower claims assessors by providing them with the tools and information to make faster and more accurate decisions, rather than replacing them entirely.

Beyond claims processing, Toor envisions a future where AI plays a more integral role in personalising healthcare journeys. “Our idea is not to make some kind of generic solution that works for everyone. The key is, how do we make [healthcare] relevant and personalised based on the specific needs of specific customers?”

Grace Park, chief data, analytics and AI officer at Prudential, explained the broader strategic value of data and AI, pointing to their role in enhancing experiences for customers and insurance agents, improving access to healthcare, and bolstering the company’s resilience.

She highlighted Prudential’s newly established AI Lab, a collaborative initiative with Google Cloud that provides a platform for the company’s 15,000 employees to contribute ideas and experiment with AI applications. This helps to democratise access to AI and foster a culture of innovation within the organisation.

Park stressed the importance of prioritising relevant data and building the right platform to integrate internal and external data sources, ultimately delivering personalised services. She also detailed Prudential’s commitment to upskilling its workforce, starting with leadership and cascading down to other employees, ensuring everyone understands and can effectively utilise AI tools.

Addressing concerns about data privacy and security around AI, particularly in the sensitive areas of healthcare and finance, Park said: “We stage-gate every process and ensure we have the right parties involved in security before an AI solution goes to market.” This, combined with one-way data sharing from Google to Prudential, ensures that customer data is handled responsibly and securely.

Looking ahead, Prudential plans to expand the use of MedLM and other AI technologies to other areas of its health business. It envisions a future where it can play a more proactive role in improving health outcomes for its customers, leveraging data and AI to connect the dots between patients, healthcare providers and insurers, ultimately creating a more efficient and patient-centric healthcare ecosystem.

“This is just the first step in using generative AI to deliver seamless, digitally enabled healthcare experiences at every step of our customers’ health journey – from the point of diagnosis, through treatment, recovery and prevention,” Toor said.