Insurance loss adjusters have never had a reputation for being generous. But at least they were human. Things are changing quickly and not in your favor. A report from Futurism details how AI automation is now a major trend in the personal insurance, health, home and auto insurance that most of us rely on.
Is your doctor’s opinion even part of the process?
It seems your doctor’s opinion doesn’t carry as much weight now. A Palm Beach Post investigation found that Iris Smith, an 80-year-old who suffers from arthritis, may have fallen victim to AI-powered pre-approval denials.
In another case, UnitedHealth is currently facing a class action lawsuit alleging that AI denials of Medicare care contributed to patient deaths. Meanwhile, a survey from the National Association of Insurance Commissioners found that 84% of health insurers are using AI, with 68% using it for prior authorization approvals.
Most people give up and don’t even appeal these denials because the process is too confusing or stressful, which is exactly the outcome you as an insurance company want.
The worst part is that we know that AI is not always accurate and is prone to hallucinations. It’s one thing if it makes a mistake while writing a report, but it’s a whole different ballgame if it ends up denying someone the medical attention they really need.
Is there someone who represents your interests?
Florida Representative Lois Frankel is having none of it. She told the Palm Beach Post she plans to fight any expansion into other states. “We believe that Medicare was built on the promise that when your doctor says you need care, when you are injured and need care, Medicare will be there for you, not AI.”
But if the past is any indication, their fight alone won’t be enough. Florida lawmakers tried to pass a bill in 2025 that would require human review for AI-generated denials. It passed the House, died in the Senate, and a Trump executive order rejecting federal AI regulations didn’t help.
The silver lining, if you can call it that: Nonprofits like Counterforce Health now offer free AI tools that will analyze your denial letter and write a tailored appeal that makes it easier to fight back. At this point it’s AI versus AI, and the world is getting bleaker by the day.
