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You Know Who Hates AI? Insurance Claims Adjusters

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11–20 of 146 posts

Re: You Know Who Hates AI? Insurance Claims Adjusters

#11

So AI is going to take jobs not because AI is necessarily better or more appropriate, but because it accelerates bad decision making and makes those decisions exponentially worse.

Well, more because it pulverizes personal responsibility for bad decisions ("I didn't deny your claim, the computer did"). But yeah.

so basically manager and exec dream

Re: You Know Who Hates AI? Insurance Claims Adjusters

#12
post #5

Ultimately this isn't "AI's fault". As the article points out, clueless executives who don't understand the capabilities and limitations of specific LLMs push the technology on workers so they can say they are "using AI to improve efficiency".

Which clueless executives are we blaming? The ones who purchase products from vendors like OpenAI or AI-powered products that run API calls through OpenAI et al., or the vendors themselves who make bombastic claims about capabilities?

As an analogy, I don’t know if I fully blame my executives for buying Microsoft Teams when Microsoft Teams turns out to suck. Microsoft promised to my company’s executives that Microsoft Teams doesn’t suck just like Sam Altman promised that AI is so powerful and so capable of exceeding the capabilities of humans that it’s dangerous.

Maybe at some point some of the B2B customers of AI products will be suing their vendors for the kind of grossly exaggerated marketing we are seeing right now. I think that SaaS companies would never get away with it.

I don’t know that the executives at my company suddenly lost their mind and decided that hundreds of dollars of AI spend per employee is suddenly justified even though approving a simple $##/month/employee SaaS tool was previously a rigorous slog. The only reason the executives at my company suddenly changed their mind on frugality is becausey they were sold a lie by a huge industry.

We could consider them clueless for falling for that, or an alternate viewpoint is that they are victims of widespread fraud.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#13
post #6

LLMs are really good when your primary goal is just to fob people off. So customer support when you don't care about your customers etc. I can imagine it's very appealing when you just want to come up with semi-plausable reasons to deny insurance claims. Who cares if it's wrong? They might give up anyway and you've saved paying out! Not saying they're not good for other things, but the "waste people's time and make t…

On the flip-side, LLM's can be pretty good at coming up with almost water-tight stories for the insurance claim!

I read and article on here some months ago titled something like "Leftist usecases for LLMs" and one of them was negotiating bureaucracies, and that reminds me, I need to call back JCP&L about my Board of Public Utilities complaint that an LLM helped me out together.

You see, I live with in a rural area and especially since LED light bulbs have become the thing, it's been clear that we are delivered far less than 120v service a lot of the time. We live about 200 yards from the transformer that we share with several other houses, too many I believe. About two years ago I set up Home Assistant and bought one of those power monitoring rigs that you put on each circuit in your breaker box, mostly I just wanted data about where my power bill money was going. I work in FinOps in case anyone was curious.

Anyhoo, couple years later I'm analyzing several months worth of power bills vs the circuit meter readings to quantify where I can make some upgrades and save some money. After a day or so of this I mention to Claude about the voltage issues and sure enough, it puts together a whole packet for me documenting brownouts down to 95v and routine brownouts below 110v. It helps me fill out the BPU complaint form.

2 days later I get a call from JCP&L (unfortunately to my wife's phone because it's her name as the primary on the account). I want a new, larger transformer for myself and my neighbors, so I need to call them back today.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#15
post #5

Ultimately this isn't "AI's fault". As the article points out, clueless executives who don't understand the capabilities and limitations of specific LLMs push the technology on workers so they can say they are "using AI to improve efficiency".

Which clueless executives are we blaming? The ones who purchase products from vendors like OpenAI or AI-powered products that run API calls through OpenAI et al., or the vendors themselves who make bombastic claims about capabilities? As an analogy, I don’t know if I fully blame my executives for buying Microsoft Teams when Microsoft Teams turns out to suck. Microsoft promised to my company’s executives that Microsof…

You should. It's their fault for picking a bad vendor. It's their fault for not finding someone with taste to solve the problem. Fundamentally its their business, pretending you can blame someone else for your ultimate accountability is stupid.

Nobody is forcing you to take poison, and saying "Well Microsoft promised me it isn't poison!!!" at this point, decades into it selling poison, doesn't make much sense.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#16
post #5

Ultimately this isn't "AI's fault". As the article points out, clueless executives who don't understand the capabilities and limitations of specific LLMs push the technology on workers so they can say they are "using AI to improve efficiency".

Don't underestimate the ability of workers to completely misunderstand the capabilities and drive it from the bottom up too.

Half my colleagues are besotted with the technology and unaware that it is shaping their decision making, not the other way around.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#17
post #5

Ultimately this isn't "AI's fault". As the article points out, clueless executives who don't understand the capabilities and limitations of specific LLMs push the technology on workers so they can say they are "using AI to improve efficiency".

Given how the AI industry lies about capabilities and is pushing the rollout with all their weight, the blame doesn’t go fully on their customers

Re: You Know Who Hates AI? Insurance Claims Adjusters

#18
post #14

Follow-up question, [Do] You know who loves flock cameras? Insurance Claim Adjusters. They are using the cameras to catch fraud (where claimants try to lump previous damage with damage covered by the current claim.), etc.

How is that relevant? I’m sure we all hate flock here, but what does that have to do with the article?

Re: You Know Who Hates AI? Insurance Claims Adjusters

#19
post #3

> Between May 2025 and May 2026, employment in the sector dropped a staggering 21 percent, according to BLS data. Yeah sure. I mean, same reason why HN readers hate AI, right? It replaces their jobs. (Obviously the difference is that the poor old claims adjusters didn't spend the last two decades "disrupting" every other industry and telling everyone else to "learn to code". Ha! If you hear a faint high noise, that's…

The difference being that the role of Engineer wasn't conceived as a layer of friction between consumers and their statutory rights to the point where a U.S. Senate subcommittee probe (Senate Homeland Security Subcommittee on Disaster Management) and state-level legal crackdowns were necessary to try and address what constituted systematic fraud by property/casualty insurance corporations.

https://www.hawley.senate.gov/hawley-chairs-hearing-that-exp...

The California Department of Insurance characterized State Farm's tactics as "burying survivors in red tape at the worst moments of their lives"

https://www.insurance.ca.gov/0400-news/0100-press-releases/2...

Indeed, some of the core violations could be simply mandated as part of the inviolable system guardrails of an LLM - e.g. failed to begin investigating claims within 15 days, failed to accept or deny claims within 40 days, and failed to pay accepted claims or provide written notice of the need for additional time within 30 days, as required by law.

And at the end of the day, whatever weighting issues an LLM for Insurance Claim Adjustment has, it certainly won't steal the money and run off to a Casino with it

https://www.nicb.org/news/regional-news/broward-insurance-ad...

Re: You Know Who Hates AI? Insurance Claims Adjusters

#20

So AI is going to take jobs not because AI is necessarily better or more appropriate, but because it accelerates bad decision making and makes those decisions exponentially worse.

Well, more because it pulverizes personal responsibility for bad decisions ("I didn't deny your claim, the computer did"). But yeah.

See OpenAI putting the blame on a “rogue agent” for their own systems hacking other companies (which is a felony!!!!). When in reality they obviously control the while loop and tool call dispatching of the agents. But they decided to train attacker models, then run thousands of instances in parallel with the goal to solve hacking problems with close to no supervision and full execution privilege…
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