AI in Insurance: The Hidden Hand Behind Claim Denials
Kenneth Spivack | Nov 05 2025 16:00

Unexpected Denials: More Than Just a Setback

Imagine being in the process of recovering from a car accident or a workplace injury. The hope of receiving financial relief through a personal injury claim keeps you going. Then, out of the blue, your claim is denied. The shock deepens as you realize that this decision might not have come from a human, but from an artificial intelligence (AI) model. The rapid rise of AI in the insurance industry is quietly changing the landscape, and it's crucial to understand its significance.

The Role of AI in Insurance Claims

To many, the use of AI in assessing insurance claims may seem like a futuristic fantasy. However, it's a reality today, with companies like UnitedHealth and Cigna using models such as nH Predict. These systems have sparked controversy for allegedly overriding physician advice and denying claims within seconds. The power of a decision is now, in some instances, in the hands of an algorithm rather than a human assessor.

Demanding Transparency and Accountability

As AI continues to shape the outcomes of personal injury claims, it becomes imperative to demand transparency in these processes. Understanding how these AI systems operate is crucial, and policyholders should feel empowered to ask insurers for clarity. This transparency is necessary for ensuring fair play and accountability for decisions that could have profound impacts on individuals' lives.

The Legal Fight Against Unjust AI Denials

When faced with AI-denied claims, it is vital to have a seasoned legal team on your side. Our process involves meticulously reviewing claims and appealing unjust denials. We're committed to aggressively challenging unfair decisions, ensuring that our clients receive the compensation they rightfully deserve.

Staying Informed: A Pathway to Better Service

Staying updated on industry trends, lawsuits, and technological advancements is central to our approach. By keeping informed, we strengthen our ability to serve clients effectively and hold insurance companies accountable for AI-driven decisions. Our dedication to knowledge equips us to handle the complexities of AI-affected claims.

You Are Not Powerless

Facing a denied claim—especially one possibly rejected by a machine—can be a disheartening and isolating experience. However, it's crucial to remember that you are not powerless. If you suspect your claim was unfairly assessed, reach out for a review. We encourage proactive actions to ensure justice and fair treatment in a landscape increasingly influenced by AI. By staying informed and advocating for transparency, you can navigate the evolving world of AI in insurance. Don't let the unseen hands of technology determine your fate without a fight.