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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

#91

Post by nvme0n1p1 »

estearum wrote: post #76
nvme0n1p1 wrote: post #73

Earlier quoted context omitted.

> 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...

I'm aware of how ecommerce got started. The fact that some businesses did the math to estimate that only a small percentage of customers are assholes, doesn't mean they aren't assholes. With apologies to patio11, "The optimal amount of return abusers is non-zero."

Buying 3 new-in-box $1000 cameras and returning 2 of them covered with your smudgy fingerprints is abuse, no matter how you slice it. If everyone did it, those cameras would cost twice as much. I'm saddened but not surprised people are defending that behavior here.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#92

Post by nvme0n1p1 »

mystifyingpoi wrote: post #81
nvme0n1p1 wrote: post #73

Earlier quoted context omitted.

> 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 are mixing up "being an asshole" with "doing abuse". Ordering 10 t-shirts and returning 9 of them could be classified as assholery (subjectively, I'd classify it as that), while it's very likely not abuse, we'd have to check the ToS of a specific seller.

I'm using "abuse" as a general English word, not as jargon defined by a specific retailer.

Most online shops ToS say "we can ban you at any time for any reason", so their lawyers' definition of the word wouldn't be relevant here anyway.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#93

Post by dylan604 »

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.

It's not just an online thing. I know people that do retail therapy knowing full well they intend to return it. I don't have the same experience, so it is befuddling to me. Something totally different than just walking around in a store and looking but not buying.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#94

Post by [deleted] »

dpoloncsak wrote: post #61
antasvara wrote: post #49

Earlier quoted context omitted.

I don't know, it feels like "reading a claims summary and classifying the type of claim" should be the bread and butter LLM use case? Not that executives are blameless for pushing AI everywhere, but we should also be able to "blame" AI for doing poorly at a task it's supposed to be good at.

A computer can never be held accountable, therefore a computer must never make a management decision. You can't 'blame' the AI, as it can't be held accountable.

[deleted]

Re: You Know Who Hates AI? Insurance Claims Adjusters

#95

Post by SpicyLemonZest »

pelotron wrote: post #88
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…

I've always enjoyed the question, "how many layers of profit are between you and your doctor?"

In most states, the answer is fixed by law at either zero or one depending on whether you count insurance, because medical practices must be wholly owned by doctors.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#96

Post by titanomachy »

nearlyepic wrote: post #89
throwaway2037 wrote: post #80

Earlier quoted context omitted.

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://ww…

> What if she refuses to do the work unpaid? Then her client doesn’t get the help they need? That should be obvious. > This seems like an open-and-shut case with the US Dept of Labour. Even if it wasn’t for the “u” in labor I could tell you don’t live in the US.

I’m not sure they live in this universe at all.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#97

Post by dylan604 »

mystifyingpoi wrote: post #81
nvme0n1p1 wrote: post #73

Earlier quoted context omitted.

> 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 are mixing up "being an asshole" with "doing abuse". Ordering 10 t-shirts and returning 9 of them could be classified as assholery (subjectively, I'd classify it as that), while it's very likely not abuse, we'd have to check the ToS of a specific seller.

There are companies that cater to these types of people. Their purpose is to allow you to have things shipped to you so that you can pick the ones you like before return the things you do not. They claim to be personal stylists by learning what you like by what you keep and return. It's not abuse, it's how they want it to work

Re: You Know Who Hates AI? Insurance Claims Adjusters

#98

Post by infamouscow »

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…

And then people are shocked when insurance executives are publicly slayed.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#99

Post by jmm5 »

SpicyLemonZest wrote: post #95
pelotron wrote: post #88

Earlier quoted context omitted.

I've always enjoyed the question, "how many layers of profit are between you and your doctor?"

In most states, the answer is fixed by law at either zero or one depending on whether you count insurance, because medical practices must be wholly owned by doctors.

Yes, but that's still like 20 states that don't have strict CPOM laws.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#100

Post by bitexploder »

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…

Inefficiency is their business model. They just soak $$ into their system. More overall revenue even if most of it is some rube goldberg machine of apathy.
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