Artificial intelligence is your new insurance claims agent. For years, insurance companies have used “InsurTech” AI to underwrite risk. But until recently, the use of AI in claims handling was only theoretical. No longer. The advent of AI claims handling creates new risks for policyholders, but it also creates new opportunities for resourceful policyholders to uncover bad faith and encourage insurers to live up to their side of the insurance contract.
Most readers are familiar with Lemonade, the InsurTech start-up that boasts a three-second AI claims review process. However, as noted in a Law360 article last year, Lemonade deferred any potential claim denials for human review, so the prospect of AI bad faith is still untested. Now it is only a matter of time before insurers face pressure to use the available technology to deny claims as well.
So what happens when a claim is denied?