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Powering health insurance with artificial intelligence

Artificial intelligence (AI) is making headlines across the health insurance industry. The benefits are extraordinary – from boosting claims performance to improving the detection of fraud, the latest data-driven algorithms could lead to dramatic changes across the industry in the UAE. To give you an insight, this article by Pacific Prime Dubai looks at how AI is changing health insurance and touches on what the future holds for the industry in the UAE.

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How AI is changing insurance

To start off, AI refers to computing systems that can accomplish tasks requiring human-level intelligence. The objective of health insurers when using AI in the form of machine learning software is to make predictions by identifying patterns in historical data of consumers. Not only will the application of AI make traditional mundane processes like medical underwriting more efficient, but it will also allow insurers to focus on other aspects of the insurance value chain like product development and customer service.

According to Pacific Prime’s 2018-2019 State of Health Insurance Report, the use of AI can make the process of medical underwriting more accurate and speedy, while offering new opportunities to contain costs and prevent losses. With that said, AI systems are expected to alter at least 3 areas of the health insurance industry:


Insurers and online comparison websites are able to utilize AI-powered online advertising to categorize clients according to their needs and deliver adverts that are targeted to those more likely to secure a policy. In the UAE, AI in the form of chatbots have become increasingly popular in the last few years. Chatbots or chatter robots are computer programs that mimic human conversation by using AI and machine learning. The technology offers the following benefits to clients:

  • 24-hour availability: Unless the service is unavailable due to maintenance, clients can access services and receive answers relating to their concerns without the presence of an advisor.
  • Instant and consistent answers: Chatbots are able to offer the same set of information, which is consistent for all clients.
  • Instant transactions: Certain inquiries like searching for certain services can be implemented by chatbots at a moment’s notice.

Chatbots also offer several benefits to health insurers:

  • Improved customer satisfaction: The aforementioned benefits to clients will result in increased customer satisfaction, which can lead to increased customer retention and further sales.
  • Cost savings: Utilizing chatbots could help insurers to reduce their payroll costs but instead of making staff redundant, they can be retrained and diverted to other areas of need such as product management or marketing.
  • Offer clients a better and personalized experience: Insurers can deliver information straight to the clients that are tailored to their needs.

AXA, one of Pacific Prime Dubai’s many health insurance partners, offers their clients a health app called “Xtra”. The wellness and personal coaching app includes a chatbot that can suggest ways for policyholders to meet fitness and nutrition goals.


The trends and patterns between personal characteristics and specific risks can be used by health insurers to improve and determine actual pricing for clients. In other words, pricing reflects the activities of an individual and their risk level. For example, combining the occupation of a client and their activity which is monitored by a wearable device. Real-time collection of data from this relationship alone can allow AI to open the door to hyper-personalized risk scores. This results in premiums being based on people’s actual behavior (e.g. level of fitness), and not just the risk profile of a category they fall into (e.g. their age, where they live, or family health history).

Claims management

AI can improve claims management significantly by identifying unusual and fraudulent behavior, or even predicting it before it occurs. AI can also reveal concerns and help alert insurers, which saves time and resources. For health insurers, AI can be deployed to extract relevant claims information from the masses of information passed onto the insurer, including medical invoices, social services, police reports, and so forth. According to an article by McKinsey & Company, cognitive ‘AI’ systems can help case managers efficiently screen cases, evaluate them with greater precision, and make informed decisions. This is a milestone for health insurers aiming to migrate into the realm of efficient claims management using technology like AI.

The future of AI for health insurance in the UAE

The last few years have given health insurers and the insurance industry in general a taste of what AI has to offer. From what health insurers in the UAE are witnessing, AI can be applied to cut the cost of premiums, highlight the number of fraudulent claims, allow insurance policies to be easily purchased, and much more. Combined with wearable technology and the Internet of Things (IoT), AI could spark the emergence of new products and services like warnings and predictions to help insurers mitigate risk.

However, not all will agree with this wonderful depiction of AI. Certain concerns are raised such as how AI could lead to the most vulnerable people being excluded from insurance, while introducing worrying levels of customer surveillance and data privacy issues.

In reality, the future of AI needs to be somewhere in between the two extremes, which requires government support and backing. Fortunately, in March 2019, the UAE Ministry of Artificial Intelligence launched a new program called Think AI which supports round table discussions between government and the private sector with the goal of developing legislation, policies, and initiatives for the “responsible and efficient” adoption of AI in the private sector. This is important in ensuring that AI can continue powering health insurers without the limitations and concerns that arise from the use and control of client data.

Interested in our blogs?

At Pacific Prime Dubai, we cover the latest trends relating to local and global health insurance including the cost of health insurance and employee benefits. For a selection of articles covering these topics and more, you can head to our blog. If you would prefer guides and reports, the Prime Guides page is home to a collection of reading materials that serve to simplify health insurance topics. All of the guides and reports are offered for free.

For more on AI trends in 2020, Pacific Prime’s 2019-2020 State of Health Insurance Report covers a section on how AI can be used to identify and diagnose conditions in the healthcare sector, as well as suggest precision therapies for complex illnesses.

Looking for health insurance? Get in touch with us for additional information or a free quote! We have over two decades of experience and are compliant with data privacy regulations, so rest assured your data will be safe with us.
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