Case study · Operational resilience

When the model is a material service provider: AI resilience for an Australian insurer under CPS 230

An Australian general insurer had put AI into claims intake, customer service and fraud review, mostly through one hosted model provider. Nobody had asked what happens when that provider is slow, out of capacity or gone. Under APRA's CPS 230 that is a board-level question, and the goal was a credible answer.

Case studyInsurance · AustraliaSumanta Mukhopadhyay9 min read
#ai#architecture#governance
CASE STUDY · CASE STUDY · OPERATIONAL RESILIENCE29 Oct 2026 · 13:05 GST
At a glance
SectorInsurance · Australia
My roleFractional CTO and AI architect
EngagementAssessment, architecture and delivery leadership
ScopeCritical operations mapping, AI service provider risk, multi-provider routing, degraded modes, exit testing
What changed
  • AI dependencies mapped to the critical operations they support
  • Tolerance levels agreed for each AI-assisted operation
  • Failover to a second provider or a rules-based mode, tested in production
  • An exit plan for the primary model provider that has actually been rehearsed
  • Board reporting that names AI providers alongside other material suppliers
Model gatewayTwo hosted model providersPrivate model fallbackKubernetes inference routingRules-based degraded modeOpenTelemetryService provider registerScenario testing

Anonymised composite. Client names, identifying details and confidential figures are withheld; public facts are cited in the references.

The situation

A general insurer in Australia had moved quickly with AI. Claims intake used a hosted model to read documents and photos, the contact centre used it to draft responses, and the fraud team used it to summarise case files. Almost all of it ran through one external model provider, wired directly into each application.

CPS 230, APRA's prudential standard on operational risk management, has applied to banks, insurers and superannuation entities since 1 July 2025, with existing service provider contracts brought in at renewal or by 1 July 20261. It expects entities to identify critical operations, set tolerance levels for disruption, and manage material service providers2. The board asked a fair question: if the model provider has an outage, runs out of capacity or changes terms, what happens to claims?

Why now. Capacity is not a theoretical risk. Reporting on Microsoft's latest results notes that demand for its cloud still exceeds supply4, and AI capacity is the tightest part of that market. See the tech news update for 29 October.

What had to be true

  • AI dependencies visible in the same register as other material service providers.
  • Tolerance levels for each AI-assisted critical operation: how long, how degraded, before customers are harmed.
  • A tested alternative for every critical use, not a slide.
  • Privacy obligations met on every path, including fallbacks.
  • No rebuild of the applications: changes behind a common interface.

Architecture

Operations
Claims intakecriticalContact centre draftsimportantFraud summariessupporting
Gateway
Model gatewayone interface for all appsCriticality tagsper requestBudget and limitsper operation
Providers
Primary providerhostedSecond providerhosted, different vendorPrivate modelin-house, smaller
Degraded modes
Rules and templatesno model neededHuman queuewith capacity limits
Assurance
Telemetrylatency, errors, quality per pathProvider registerterms, exit, concentrationScenario testsscheduled
One gateway turns provider choice into configuration, so resilience can be tested without touching the applications.

The data flow, end to end

  1. RequestAn application calls the gateway with an operation and criticality tag
  2. RouteThe gateway picks the primary provider within budget
  3. DetectErrors, latency or capacity limits breach thresholds
  4. Fail overCritical traffic moves to the second provider or private model
  5. DegradeLower-priority work queues or falls back to rules and people
  6. RecordEvery switch is logged against the operation's tolerance level
Critical operations keep their capacity; everything else waits or degrades on purpose.

The hard part: deciding what to drop when capacity is short

Not every AI use is equally important, and pretending otherwise means everything fails together. The team tagged each request with the criticality of the operation it served, so the gateway could protect claims intake and shed or delay lower-priority work. The same idea appears in the Kubernetes Gateway API inference extension, where scheduling considers whether a request is critical and whether there is capacity before choosing a model server, and can drop non-critical requests when there is not5.

Flowchart of an inference scheduling request: critical requests choose from pods with the right adapters or standard pods, non-critical requests go to pods with capacity or are dropped, then candidates are filtered by lowest queue and cache use
Criticality-aware scheduling: critical requests always find a server; non-critical ones are dropped when capacity runs out. Source: Kubernetes blog, Gateway API Inference Extension authors · CC BY 4.0

Resilience for AI is mostly a prioritisation decision. Decide in advance which work gets the last available capacity.

Every fallback path also had to meet privacy obligations. The OAIC's guidance on commercially available AI products expects due diligence on each product and ongoing review, not a one-off check3, so the second provider and the private model went through the same assessment as the primary. Routing patterns are covered in LLM model routing and Kubernetes inference gateways.

How it ran

Risk and compliance
  1. Critical operations register
  2. Tolerance levels
  3. Board reporting
Engineering
  1. Model gateway
  2. Second provider and private model
  3. Telemetry and switches
Operations
  1. Degraded-mode playbooks
  2. Human queue capacity
  3. Scenario exercises
Risk set the tolerances, engineering built the paths, operations proved they worked.
Phase 1Map
  • AI uses and providers
  • Link to critical operations
  • Tolerance levels
Phase 2Abstract
  • Model gateway
  • Move apps behind it
  • Telemetry per path
Phase 3Diversify
  • Second provider
  • Private model
  • Degraded modes
Phase 4Prove
  • Failover drills
  • Exit rehearsal
  • Board reporting
Map, abstract, diversify, then prove it with real traffic.

Key decisions and trade-offs

DecisionAlternativeWhy
A single model gatewayProvider SDKs in each applicationFailover and exit become configuration, not rewrites
Second provider from a different vendorSecond region with the same vendorReduces concentration on one company's terms and capacity
Small private model as a floorHosted providers onlyA guaranteed baseline for the most critical step
Criticality tags on every requestTreat all AI traffic the sameProtects claims when capacity is short
Rehearse exit with live trafficA written exit planOnly tested plans count

What I'd do again, and differently

Again: put a gateway in front of every model call before adding a second provider; it made everything else cheap. Differently: build the evaluation set for each critical operation first. The slowest part of adding a provider was proving its answers were good enough, not wiring it in. See evaluation sets that predict production and AI incident postmortems.

If you run AI in a regulated Australian business, my work with Australian companies explains how I approach it, or analyse your challenge and bring the result to a call.

References
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    Introducing Gateway API Inference ExtensionKubernetes blog · 5 Jun 2025
FAQ

Common questions

Does CPS 230 apply to AI model providers?

CPS 230 covers operational risk, business continuity and the management of service providers for APRA-regulated entities. If an AI provider supports a critical operation, it belongs in that framework like any other material service provider; how your arrangements are classified is a question for your risk and legal teams.

What is a degraded mode for an AI-assisted process?

A defined way to keep the operation running when the model is unavailable: a second provider, a smaller private model, or rules and human handling, with known limits on volume and quality.

How do you test an exit plan for a model provider?

Run real traffic for an operation through the alternative path for a set period, measure quality, cost and latency against tolerance levels, and record what broke. A plan that has never carried traffic is not a plan.

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