Legal and ethical constraints in the use of Artificial Intelligence (AI) by Swiss health insurance companies

Experts in new technologies and economists seem to agree: robotics and deep learning by machines will change most of the economic activities in the coming decades, at a very fast pace. If in the past, technological changes mainly brought about gradual increases of efficiency in human work; robotics and the availability of big data, used with Artificial Intelligence (AI) will bring about exponential change to the working world of humanity, in the very near future. It seems almost impossible to predict with certainty what the social, economic, and psychological effect on humankind will be. Simply learning from the experience of past technological evolutions is not enough. Many experts foresee more of a disruption rather than a further, gradual development. Among various other economic actors, health insurance companies may find many benefits by introducing and developing digital technologies such as AI. However, they must consider different limits and risks, which can restrain them in the development of AI. One of those limitations is the complex legal framework that regulates data use and protection, particularly when the available massive data and sources include the personal data of individuals. Furthermore, in order to preserve their trustworthiness and reputation, they must comply with ethical boundaries to retain their current customers and acquire new ones. Only then will health insurance companies be able to take full advantage of the benefits of these new technologies and obtain valuable return for their sizeable investments in such new tools. This research has the ambition to produce recommendations to Swiss health insurance companies on how to best achieve balanced, profitable returns through the gradual development and use of AI, within the legal and ethical limits. It further considers the important hurdles and barriers which the introduction and expansion of such new technologies will meet, both internally, with their customers and in the large public, and provide some recommendations which need to be taken into account in the change management process. A thorough background study and examination of empirical data obtained from insurance experts and staff will provide a solid basis to formulate some main recommendations in how to deal with the trust of customers, the education of the staff, with legal and ethical limits and the necessary required adjustment of governance processes