Thanks to AI, insurance companies now use machine learning with predictive analytics for claims. While this might seem like good news because insurance companies can process things faster, this data processing might hurt your subsequent personal injury claim. As a car accident lawyer can share, the big question for the future is: what happens when an algorithm denies your claim instead of a real human?
When Machine Learning Arrived On The Scene
Insurance companies now use machine learning and big data to evaluate personal injury claims. What this means is that these tools assign claim scores to your case. These scores influence how quickly a claim is processed, if it is challenged, if an early settlement is available, or if someone higher up needs to review it. Unfortunately, these systems and how they work are not always advertised to customers. You may not even realize that a real person never touched your claim before it was denied.
Foreseeable Challenges
With the lack of transparency around these systems, claimants may not be told why a claim was denied or undervalued. And there may not be a real person to ask why this happened. This really raises questions of procedural fairness and due process within claim handling. How fair can it be if someone cannot explain it to you?
Additionally, even though it may be just a computer code handling your claim, it is still possible for the algorithm to discriminate. This can be due to race, gender, occupation, or zip code. The worst part is that contracts with your insurance company are not currently required to spell out whether they use AI or how it is used. It is possible for some contracts to never even address the use of AI. On top of that, few jurisdictions have clear procedures for handling AI deciding a claim for a case.
For Personal Injury Victims
As our friends at Cohen & Cohen can share, these unclear models may cause claimants to face delayed, denied, or even reduced compensation. Some companies may claim that their AI provides impartial judgment, making claimants feel pressured to settle early. Working with an attorney is critical now more than ever, as it is part of their job to keep up with ever-changing laws and insurance practices to protect your case. If you believe this has happened to your insurance claim, tell an attorney who can help you with data sources, bias assessments, and algorithmic logic.
AI is making some things easier, but the opposite is also true. Although your insurance claims may be processed quickly thanks to machine learning, they may also be rapidly denied with no reason provided and no person to contact about it. Work with an attorney from the start if you or someone you love has been involved in an accident. They will speak to insurance companies on your behalf, and they can also advise you if they notice AI has taken over processing your claim.
Contact a lawyer near you for help immediately to ensure you are represented fairly through the insurance claims process.
