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You Know Who Hates AI? Insurance Claims Adjusters

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Re: You Know Who Hates AI? Insurance Claims Adjusters

#71

Post by rtkwe »

WarmWash wrote: post #60
colechristensen wrote: post #54

Earlier quoted context omitted.

I knew a guy who would buy three different kinds of a thing and return the two he didn't like... regularly. A small number of return abusers ruin things for everybody. Then again my last two online purchases, a pair of shoes arrived stained with somebody else's socks in the box and a cordless vacuum arrived with a mismatched brush head for a different model.

It's even worse than that, because they are adamant that they aren't abusing the system, and insist that if they didn't want people doing it, they would stop taking returns.

I wonder if they were similarly blasé when companies started implementing policies to actually stop them?

That kind of argument only works where stopping the behavior is cost free, the main reason most places didn't do it before was because the number of people doing it was low so the cost of actually tracking returns rigorously outweighed the benefit of low friction returns for the 99+% of customer who weren't abusing the system. When more people start creating large numbers of returns suddenly the amount of losses they create become enough to care about stopping. (Or it becomes a low hanging fruit to squeeze more profit out of an existing business, spending customer preference/loyality for profit by cutting a small waste center)

Re: You Know Who Hates AI? Insurance Claims Adjusters

#72

Post by colechristensen »

estearum wrote: post #69
WarmWash wrote: post #60

Earlier quoted context omitted.

It's even worse than that, because they are adamant that they aren't abusing the system, and insist that if they didn't want people doing it, they would stop taking returns.

The behavior described in the immediately above comment (ordering multiples and returning ones you don't like) is not abuse. The behavior described above that (lying about a defective item) is abuse. Dealing with returns is the tradeoff that online sellers make in order not to put a store in every city or to deal with retail arrangements.

For clothing it makes sense, also much of the price of clothing is often illusory, the marginal cost for the piece of clothing is tremendously less than the price paid.

Not so for consumer electronics

Re: You Know Who Hates AI? Insurance Claims Adjusters

#73

Post by nvme0n1p1 »

estearum wrote: post #69
WarmWash wrote: post #60

Earlier quoted context omitted.

It's even worse than that, because they are adamant that they aren't abusing the system, and insist that if they didn't want people doing it, they would stop taking returns.

The behavior described in the immediately above comment (ordering multiples and returning ones you don't like) is not abuse. The behavior described above that (lying about a defective item) is abuse. Dealing with returns is the tradeoff that online sellers make in order not to put a store in every city or to deal with retail arrangements.

> The behavior described in the immediately above comment (ordering multiples and returning ones you don't like) is not abuse.

Oh yes it is. Buying something you know you don't plan to keep is abuse. If you ran a store, would you be fine with 2/3 of your orders being returned? A good litmus test for "am I being an asshole" is "what would the world look like if everyone behaved like me?"

Re: You Know Who Hates AI? Insurance Claims Adjusters

#74

Post by estearum »

colechristensen wrote: post #72
estearum wrote: post #69

Earlier quoted context omitted.

The behavior described in the immediately above comment (ordering multiples and returning ones you don't like) is not abuse. The behavior described above that (lying about a defective item) is abuse. Dealing with returns is the tradeoff that online sellers make in order not to put a store in every city or to deal with retail arrangements.

For clothing it makes sense, also much of the price of clothing is often illusory, the marginal cost for the piece of clothing is tremendously less than the price paid. Not so for consumer electronics

Oh yeah that's pretty insane for consumer electronics.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#75

Post by dash2 »

nvahalik wrote: post #32
dash2 wrote: 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…

AI isn’t replacing adjusters. Anecdotally, many of them are aging out and the demands of adjusters are increasing while the pay hasn’t necessarily gone up. While technically you don’t have to know the ins and outs of construction, it helps a lot and there are just not a lot of people who have that knowledge. And if they do, they often go into construction themselves or sell roofs. Both of which can be far more lucrat…

20% aged out in one year?

Re: You Know Who Hates AI? Insurance Claims Adjusters

#76

Post by estearum »

nvme0n1p1 wrote: post #73
estearum wrote: post #69

Earlier quoted context omitted.

The behavior described in the immediately above comment (ordering multiples and returning ones you don't like) is not abuse. The behavior described above that (lying about a defective item) is abuse. Dealing with returns is the tradeoff that online sellers make in order not to put a store in every city or to deal with retail arrangements.

> The behavior described in the immediately above comment (ordering multiples and returning ones you don't like) is not abuse. Oh yes it is. Buying something you know you don't plan to keep is abuse. If you ran a store, would you be fine with 2/3 of your orders being returned? A good litmus test for "am I being an asshole" is "what would the world look like if everyone behaved like me?"

You should do some reading on the birth of ecommerce. This was a very explicit tradeoff that these businesses decided to make. That's why free returns are pervasive.

Now whether it's a good thing wrt the environment etc...

Re: You Know Who Hates AI? Insurance Claims Adjusters

#77

Post by rtkwe »

jordanb wrote: post #57
colechristensen wrote: post #54

Earlier quoted context omitted.

I knew a guy who would buy three different kinds of a thing and return the two he didn't like... regularly. A small number of return abusers ruin things for everybody. Then again my last two online purchases, a pair of shoes arrived stained with somebody else's socks in the box and a cordless vacuum arrived with a mismatched brush head for a different model.

The thing is this was the pitch for buying clothes online: worried it won't fit? Just return it. No questions asked! We'll even pay return shipping! It's interesting how companies are now redefining things they explicitly encouraged their customers to do as "abuse."

Well we don't know that they're talking about clothes at all. Clothing retailers are still pretty open about returns afaik because it's kind of the only way to run an online clothes store people will actually use.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#78

Post by nvahalik »

dspillett wrote: post #52
nvahalik wrote: post #32

Earlier quoted context omitted.

AI isn’t replacing adjusters. Anecdotally, many of them are aging out and the demands of adjusters are increasing while the pay hasn’t necessarily gone up. While technically you don’t have to know the ins and outs of construction, it helps a lot and there are just not a lot of people who have that knowledge. And if they do, they often go into construction themselves or sell roofs. Both of which can be far more lucrat…

> AI isn’t replacing adjusters. > Anecdotally, many of them are aging out Ageing and out and neither being replaced directly or reduce numbers coming in at the bottom/mid as others move up, is still a drop in people. If part of the reason there is less need to bring people in lower down is that a few are being expected to do the work of a few more due to automation via AI, then that is AI replacing them, just not qui…

But that's the thing—there isn't any real automation for this. An adjuster has to physically go out to someone's property. They have to take pictures. They have to inspect things. They have to coordinate with 3rd parties if necessary (like engineers).

There isn't a whole lot of room for automation in much of this.

Underwriting on the other hand, that is a different story.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#79

Post by rtkwe »

colechristensen wrote: post #54
Gigachad wrote: post #45

Earlier quoted context omitted.

It seems like companies are getting a lot less trusting with their return policies. It used to be you just email them a photo or video of the issue and they send you a replacement. Now companies won’t send one until they have received the defective one back.

I knew a guy who would buy three different kinds of a thing and return the two he didn't like... regularly. A small number of return abusers ruin things for everybody. Then again my last two online purchases, a pair of shoes arrived stained with somebody else's socks in the box and a cordless vacuum arrived with a mismatched brush head for a different model.

Places need to get a lot better about actually checking returned items if they're going to go back into the stream as a NIB item instead of open box. Amazon and other electronics places are bad about this with horror stories of getting expensive graphics cards either replaced with equivalent weight items or with the GPU chip harvested in some cases.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#80

Post by throwaway2037 »

cael450 wrote: post #67

My wife works in autism services. Insurance companies are the bane of her existence. Every six months (sometimes less), she has to write a huge report justifying services. These reports are frequently over 100 pages and she is only slotted so much time to do it, so she ends up doing a ton of unpaid work. The entire business model is to drown the practitioner in paperwork then use “peer reviewers” who are nurses that…

From time to time, I see similar claims like this on HN: "doing a ton of unpaid work". The full quote:

    > These reports are frequently over 100 pages and she is only slotted so much time to do it, so she ends up doing a ton of unpaid work.
What if she refuses to do the work unpaid? This seems like an open-and-shut case with the US Dept of Labour. There is a whole page that explains how to make a claim here: https://www.dol.gov/agencies/whd/contact/complaints Also, if she is part of a labour union, she can raise concerns with them.

    > A ton of states purposefully overburden and underfund their Medicaid systems for ideological reasons.
Can you provide some evidence for this claim? Also, does this affect the state(s) where your wife works? From what I found, 66% of Medicaid is paid for by the federal gov't, and the remaining share is funded by each state.
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