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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

#101

Post by mindslight »

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?"

It's also abusive for Amazon to delay your order for a week with their Super Spiteful Shipping, pushing you to sign up for their sunk cost fallacy subscription. When I'm in the middle of some project, I've got no qualms about ordering 2 or 3 different types of some part I need to hedge. I've been burned too many times with ordering only one type, having it have a problem, and then having to wait again. Constant games with prices is another one that induces orders from me that are destined to be returned. When a price drops significantly, the times I've asked customer service about having the price adjusted they tell me to just return and rebuy (hoping I'll be too lazy), so that's what I do. It's abuse all around, I'm not going to put moral weight on my own shoulders while the amoral company has no such burden.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#103

Post by eagsalazar2 »

We are witnessing the greatest ripoff in world history. First they illegally scrape the entire history of human text, art, video, then they create products to replace humans, next the wealth of those fired humans is transferred to wealthy VCs and large businesses.

And all the while these crooks are claiming it's so humans can focus on more important things. Yeah right. If we're lucky, AI won't improve and there will be a huge backlash, like outsourcing in the early 2000s. If AI gets better, actually good enough to do most work currently done by humans, well then probably something really ugly happens.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#104

Post by zamadatix »

eagsalazar2 wrote: post #103

We are witnessing the greatest ripoff in world history. First they illegally scrape the entire history of human text, art, video, then they create products to replace humans, next the wealth of those fired humans is transferred to wealthy VCs and large businesses. And all the while these crooks are claiming it's so humans can focus on more important things. Yeah right. If we're lucky, AI won't improve and there will…

A "The Monkey's Paw" version of "I wish copyright law would be handled differently".

Re: You Know Who Hates AI? Insurance Claims Adjusters

#105

Post by zamadatix »

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."

The few cases where this is an advertised arrangement should be excluded from the usual situation where returns are meant for defects/errors.

Even then, the one clothes example (shoes - which had been returned stained and with socks in the box) mentioned in the above still wouldn't seem like a valid return by any stretch.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#106

Post by jonhohle »

> Between May 2025 and May 2026, employment in the sector dropped a staggering 21 percent, according to BLS data. For early-career adjusters, the decline was even sharper: Entry-level postings have fallen 50 percent since 2025…

When your business model has gotten to the point where people cheer for a guy who murdered one of their CEOs, it’s not surprising that people would not be interested in joining and may see being murdered as an occupational risk beyond what their personal actuarial tables allow.

On the outside, I was able to use a consensus model to reach a successful settlement. I wouldn’t say I won, but was made whole after having to file in court.

If AI is making their lives miserable on the inside as well, I fully support it.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#108

Post by thecosas »

eagsalazar2 wrote: post #103

We are witnessing the greatest ripoff in world history. First they illegally scrape the entire history of human text, art, video, then they create products to replace humans, next the wealth of those fired humans is transferred to wealthy VCs and large businesses. And all the while these crooks are claiming it's so humans can focus on more important things. Yeah right. If we're lucky, AI won't improve and there will…

I know some would label this view as "Luddite" with derision, but learning some of the background of the actual Luddites, the parallels are hard to ignore. If you're interested, 99pi did a solid episode recently [1].

Yes it's ALSO to a promote a book, but still... there's a lot more to it than just mindlessly raging against a new technology.

[1] https://99percentinvisible.org/episode/552-blood-in-the-mach...

Re: You Know Who Hates AI? Insurance Claims Adjusters

#109

Post by labcomputer »

antasvara wrote: post #49
glimshe wrote: 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".

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.

Part of the problem is the distribution of images (and text) you get from claims is not the same as what the model was trained on. A classic problem in ML.

Another part of the problem is that a model not specifically fine-tuned to make a total loss determination won't know the relevant factors, nor how an insurance company's concept of a total loss differs from the public's.

And still another part of the problem is that most total loss claims aren't what you, dear reader, are imagining: They are very rarely "the car is a thin pancake after being crushed by a meteor".

The much, much more common scenario is: "50% of the body panels sustained at least paint damage, both headlight modules need replacement, and the front wheels look funny. Given that the vehicle has an MSRP of $FOO, $BAR miles, no prior collision history on carfax, and is a popular color, is it cheaper to repair or total the vehicle?"

Of course, the model can turn over the hard cases to a human adjuster... but then what are we doing here? It only takes 10 seconds for the human adjuster to handle the "crushed by a meteor" case also.

Source: Listening to my SIL rant about being asked to stop training bespoke total loss models and just send it by 1-shotting a commercial LLM.

Re: You Know Who Hates AI? Insurance Claims Adjusters

#110

Post by criddell »

throwaway2037 wrote: post #87
wellpast wrote: post #63

Two months ago I had a water pipe burst in my house. Now I am in the claims process with the large insurance co., using Claude to basically run my side of the claim — reading the policy, organizing and filing the ALE receipt scans, reading and notifying me of messages from the agents, calling out when they are delaying too much or not fulfilling their promises, challenging their decisions on what to cover based on th…

> On the other hand, Claude is calling out her BS and delays, which have been atrocious—so much so that Claude is now adamant that she has gone too far and that I should be filing a complaint with the state insurance bureau. My first guess: She is wildly overworked and that is an insurance company strategy. This is an interesting customer strategy. Have you escalated your concerns to her management? Have you explaine…

Of the two options you presented, escalating to management or filing a complaint, which is the carrot?
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