AI is handling the tedious tasks for insurance companies, and the situation is worsening.
AI is becoming increasingly proficient at rejecting your insurance claims, and the statistics are concerning.
Insurance claims adjusters have never been known for their generosity, but at least they were human. This is changing rapidly, and not for the better. A report from Futurism highlights that AI automation is becoming a significant trend in personal insurance, covering health, home, and auto policies that many of us depend on.
Is your doctor's opinion still relevant in the process?
It appears that your doctor's input is losing its significance. An investigation by the Palm Beach Post revealed that Iris Smith, an 80-year-old with arthritis, may be experiencing AI-driven preauthorization denials.
In another instance, UnitedHealth is now facing a class-action lawsuit claiming that AI-denied Medicare nursing care contributed to patient fatalities. Additionally, a survey by the National Association of Insurance Commissioners found that 84% of health insurers are using AI, with 68% implementing it for prior authorization approvals.
Most individuals don’t even attempt to appeal these denials due to the confusing and exhausting nature of the process, which is precisely what insurance companies want.
The troubling aspect is that we know AI isn't always reliable and often makes errors. It's one thing for it to err on a report, but it's entirely different when it denies medical assistance to someone who genuinely needs it.
Is there anyone defending your interests?
Florida Representative Lois Frankel is not accepting this situation. She told the Palm Beach Post that she intends to oppose any expansion to other states. “We believe Medicare was based on the promise that if your doctor says you need care, if you’re injured and require help, Medicare will be there for you, not AI.”
However, history suggests that her efforts alone may fall short. Florida legislators attempted to pass a bill in 2025 that would require human oversight for AI-generated denials. While it passed in the House, it failed in the Senate, and a Trump executive order discouraging state AI regulations did not help.
The silver lining, if it can be called that, is that organizations like Counterforce Health now provide free AI tools that analyze your denial letter and create a tailored appeal, making it easier to contest these decisions. It has become AI versus AI, and the situation seems to grow more pessimistic each day.
Rachit is an experienced tech journalist with over seven years in the consumer technology sector.
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AI is handling the tedious tasks for insurance companies, and the situation is worsening.
Artificial intelligence is now determining the approval of your insurance claims, and denial rates are rising rapidly. Here’s what’s going on and why your physician's perspective may no longer hold significant weight.
