6 ms·

You Know Who Hates AI? Insurance Claims Adjusters

138 points by joozio 2mo ago

altacc 2mo ago
https://archive.is/FcRBG https://archive.is/FcRBG
dash2 2mo ago
> 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 sound of the rest of the world playing a violin, made of highly disruptive nanomaterials.)
- piltdownman 2mo ago
  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-exposes-insurance-fraud-by-major-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/2026/release019-2026.cfm 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-adjuster-stole-600k-hurricane-ian-victims-authorities-say https://www.nicb.org/news/regional-news/broward-insurance-ad...
- nvahalik 2mo ago
  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 lucrative. On top of that, claims software has a lot of automation but very little real AI surface area. A lot of the things AI is good at (text generation) must have certain verbiage or use legally approved templates. Granted, this may not be the case for all verticals, but this is just my observation from 20 years. (Mostly in smaller IA firms and state-based institutions). Also, my wife has pointed out that there haven’t been any major cats in the last few years. Katrina kept people working for years. A lack of big storms has also contributed to this.
  - dspillett 2mo ago
    > 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 quite as directly as “we need less people as AI makes each more efficient so there are redundancies”.
    - nvahalik 2mo ago
      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.
  - dash2 2mo ago
    20% aged out in one year?
- mrweasel 2mo ago
  There are probably two camps in IT (in terms of hating AI). One is afraid that AI will replace them, the other is about to rage quit because AI is damaging to their mental health, but being forced on them by management which is as clueless that those of the insurance claims adjusters.
tonyhart7 2mo ago
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.
- vintermann 2mo ago
  Well, more because it pulverizes personal responsibility for bad decisions ("I didn't deny your claim, the computer did"). But yeah.
  - tonyhart7 2mo ago
    so basically manager and exec dream
    - vintermann 2mo ago
      Sometimes when I use coding agents I wonder, is this what having employees feel like? But it seems like a lot of employers get entirely other things out of it.
    - Muromec 2mo ago
      illegal in EU so we will be left behind by this innovation.
    - salawat 2mo ago
      Pretty much. At least until jurisprudence makes it unambiguously clear that delegating to an AI model does not transfer liability for outcomes.
  - dgellow 2mo ago
    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…
glimshe 2mo ago
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".
- deleted 2mo ago
  [deleted]
- Grombobulous 2mo ago
  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.
  - hilariously 2mo ago
    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.
almost 2mo ago
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 them go away" use is just so perfect for the capabilities of even cheap models.
- LightBug1 2mo ago
  On the flip-side, LLM's can be pretty good at coming up with almost water-tight stories for the insurance claim!
  - Jgrubb 2mo ago
    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.
    - bigfishrunning 2mo ago
deleted 2mo ago
[deleted]
mc32 2mo ago
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.
- dgellow 2mo ago
  How is that relevant? I’m sure we all hate flock here, but what does that have to do with the article?
  - lcnPylGDnU4H9OF 2mo ago
    No clue what OP's intention was but I'll note that the software on object recognition cameras typically makes use of a vision model.
  - drunner 2mo ago
    It adds more context about how much of a scam insurance is and how they come off as hypocrites for liking to use one form of ai for themselves (camera detection) while disliking another (customers trying to get more fair payouts)
  - Der_Einzige 2mo ago
    Many groups in society are actively harmful and should be ignored? I.e. Dentists are scammers at such high rates that their opinions on how to organize society should be actively ignored. The opposite or "rule by guild" is basically https://en.wikipedia.org/wiki/Syndicalism https://en.wikipedia.org/wiki/Syndicalism which is the alternative "terrible ideology" to Socialism that would have taken off in a world where Germany won WW2
DivingForGold 2mo ago
[flagged]
- pavel_lishin 2mo ago
  This comment feels like an ad for SnapClaim.
  - Waterluvian 2mo ago
    There's a fine line between ads and customer-offered testimonials. That's why I rely on AdTest, the latest AI innovention that tests whether a post is an ad or a testimonial.
  - bloggie 2mo ago
    A SnapClaim executive ran over my dog in his Porsche and offered me a coupon for 25% off my next SnapClaim. I ran over one of his kids which scratched my bumper and hood. Insurance offered me $1250 but SnapClaim got me over $2000. Don’t let these executives get away with anything.
cm2187 2mo ago
Meanwhile insurance fraudsters love AI, and its ability to manipulate photos!
- Gigachad 2mo ago
  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.
  - colechristensen 2mo ago
    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.
    - jordanb 2mo ago
      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."
      - estearum 2mo ago
        The GP described it as abuse. That's not evidence of companies calling it abuse. As you say, this is basically intrinsic to the deal of buying clothes/shoes/etc online and obviously online retailers know that and accept it, or else they would not allow it (and in turn would not exist as businesses).
      - rtkwe 2mo ago
        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.
bix6 2mo ago
You see Bob, a company is like a clock…
- chris_va 2mo ago
  well let's hope we don't cover him
kkaske 2mo ago
When there is more efficiency its a win for AI. When there are errors its the problem of the humans that are supposed to be using AI and oversee it to "make them more efficient". This has been the main source of AI fatigue for me.
wellpast 2mo ago
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 the policy, keeping a log of all of our correspondences, logging work estimates and invoices, I cant imagine doing all this tedious work myself—w/o Claude I’d probably just rollover fatigued. Does my adjuster like this? On the one hand, I’m giving her incredibly tidy and documented receipts and logs, which I am sure is saving her time. 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.
- throwaway2037 2mo ago
  > 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 explained to her that you are considering filing a complaint with the state insurance bureau? It's the ol' stick vs carrot. I say: Start with the carrot. If that doesn't work, back to the stick!
  - criddell 2mo ago
    Of the two options you presented, escalating to management or filing a complaint, which is the carrot?
    - throwaway2037 2mo ago
      Good question: They are two types of sticks: little and big.
  - iooi 2mo ago
cael450 2mo ago
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 don’t know anything about the treatment to deny claims then waste the practitioner’s time on appeals in the hopes that people will give up. AI has obviously made this process easier and the insurance companies absolutely hate it. People have no idea how inefficient the U.S.’s healthcare system is. And it isn’t just the private companies. A ton of states purposefully overburden and underfund their Medicaid systems for ideological reasons. Then the private insurance companies adopt the same practices later.
- throwaway2037 2mo ago
  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 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.
  - nearlyepic 2mo ago
    > 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.
hereme888 2mo ago
Hah! Insurance companies proudly announce to investors how much they undercut payments. It was precisely because of AI that I had the time and language to fight a recent claims report for a totaled vehicle, and squeezed an additional 25% from them. And it was still not adequate payout. Let claim adjusters and insurance get off their high horse until they start being the bane of existence and paying what they owe clients.
SilverBirch 2mo ago
So I have three thoughts about this: The first thought is this is likely mostly survivorship bias. Yes, the claims that get to the humans are the ones that went wrong, and the mode of failure for LLMs is less that they get within 99% all of the time, it's more like 1% of the time they do something insanely dumb. At which point your customers are pissed off. That's kind of obvious, and it sucks for the humans who have to clear up the situation. But it's still a win for the vast majority of cases. Secondly, does anyone actually know how much of your insurance premium is going on the call centre staff? most people don't claim, those that do mostly have simple claims. The actual cost for insurance companies is actually paying out claims, so even if you automated all of this it likely doesn't change your economics. Historically "New" Insurance companies only really succeed by mis-pricing risk and gaining market share that way - they often then fail when that risk materializes. Lemonade sounds a lot like that. Finally, they haven't engaged with the tidal wave that's coming. Sure, AI agents handling claims is happening now. Just you wait. In a couple of years time it'll be AI agents making the claims for you and suddenly there'll be bots filing claims with infinite patience and a direct mandate to try and get as big a payout as possible. That is when it's going to get really hairy.
- briandw 2mo ago
  “does anyone actually know how much of your insurance premium is going on the call centre staff” It’s pretty easy to figure out. Insurance companies publish a loss ratio. That’s the ratio of premiums collected to claims paid out. Lemonade has industry-leading loss ratios now BTW.
techteach00 2mo ago
I'm gonna use chat gpt in a few months when getting a new lease. I'll know in real time if I'm getting robbed.
- chrisjj 2mo ago
  > I'll know in real time if I'm getting robbed. Yup - by checking your Claude usage meter.
eagsalazar2 2mo ago
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.
- zamadatix 2mo ago
  A "The Monkey's Paw" version of "I wish copyright law would be handled differently".
- thecosas 2mo ago
  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-machine/ https://99percentinvisible.org/episode/552-blood-in-the-mach...
jonhohle 2mo ago
> 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.
- maxnevermind 2mo ago
  I think Insurance Claims Adjusters as a occupation was on decline for some time even before the latest boom in AI. Since 90s I believe the most of major Insurance companies shifted a strategy, claims are seen as a source of profit and adjuster are now seen as a nuisance that often increase the payout for claims, so their role were diminished to form-fillers in different software systems.
Alien1Being 2mo ago
Meanwhile HR departments have started using Pangram like tools to detect and remove AI written job applications. The flood of nonsensical AI slop applications that HR is facing has forced this.
- thecosas 2mo ago
  Interesting thing to ponder: How much time, money, energy (et al) is being used in the (now) ever-escalating war between generating and detecting AI content? This goes for HR, education, code review, on and on.

138 points by joozio 2mo ago

https://archive.is/FcRBG https://archive.is/FcRBG

dash2 2mo ago

> 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 sound of the rest of the world playing a violin, made of highly disruptive nanomaterials.)

piltdownman 2mo ago
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-exposes-insurance-fraud-by-major-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/2026/release019-2026.cfm 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-adjuster-stole-600k-hurricane-ian-victims-authorities-say https://www.nicb.org/news/regional-news/broward-insurance-ad...
nvahalik 2mo ago
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 lucrative. On top of that, claims software has a lot of automation but very little real AI surface area. A lot of the things AI is good at (text generation) must have certain verbiage or use legally approved templates. Granted, this may not be the case for all verticals, but this is just my observation from 20 years. (Mostly in smaller IA firms and state-based institutions). Also, my wife has pointed out that there haven’t been any major cats in the last few years. Katrina kept people working for years. A lack of big storms has also contributed to this.
- dspillett 2mo ago
  > 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 quite as directly as “we need less people as AI makes each more efficient so there are redundancies”.
  - nvahalik 2mo ago
    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.
- dash2 2mo ago
  20% aged out in one year?
mrweasel 2mo ago
There are probably two camps in IT (in terms of hating AI). One is afraid that AI will replace them, the other is about to rage quit because AI is damaging to their mental health, but being forced on them by management which is as clueless that those of the insurance claims adjusters.

tonyhart7 2mo ago

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.

vintermann 2mo ago
Well, more because it pulverizes personal responsibility for bad decisions ("I didn't deny your claim, the computer did"). But yeah.
- tonyhart7 2mo ago
  so basically manager and exec dream
  - vintermann 2mo ago
    Sometimes when I use coding agents I wonder, is this what having employees feel like? But it seems like a lot of employers get entirely other things out of it.
  - Muromec 2mo ago
    illegal in EU so we will be left behind by this innovation.
  - salawat 2mo ago
    Pretty much. At least until jurisprudence makes it unambiguously clear that delegating to an AI model does not transfer liability for outcomes.
- dgellow 2mo ago
  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…

glimshe 2mo ago

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".

deleted 2mo ago
[deleted]
Grombobulous 2mo ago
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.
- hilariously 2mo ago
  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.

almost 2mo ago

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 them go away" use is just so perfect for the capabilities of even cheap models.

LightBug1 2mo ago
On the flip-side, LLM's can be pretty good at coming up with almost water-tight stories for the insurance claim!
- Jgrubb 2mo ago
  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.
  - bigfishrunning 2mo ago

deleted 2mo ago

[deleted]

mc32 2mo ago

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.

dgellow 2mo ago
How is that relevant? I’m sure we all hate flock here, but what does that have to do with the article?
- lcnPylGDnU4H9OF 2mo ago
  No clue what OP's intention was but I'll note that the software on object recognition cameras typically makes use of a vision model.
- drunner 2mo ago
  It adds more context about how much of a scam insurance is and how they come off as hypocrites for liking to use one form of ai for themselves (camera detection) while disliking another (customers trying to get more fair payouts)
- Der_Einzige 2mo ago
  Many groups in society are actively harmful and should be ignored? I.e. Dentists are scammers at such high rates that their opinions on how to organize society should be actively ignored. The opposite or "rule by guild" is basically https://en.wikipedia.org/wiki/Syndicalism https://en.wikipedia.org/wiki/Syndicalism which is the alternative "terrible ideology" to Socialism that would have taken off in a world where Germany won WW2

DivingForGold 2mo ago

[flagged]

pavel_lishin 2mo ago
This comment feels like an ad for SnapClaim.
- Waterluvian 2mo ago
  There's a fine line between ads and customer-offered testimonials. That's why I rely on AdTest, the latest AI innovention that tests whether a post is an ad or a testimonial.
- bloggie 2mo ago
  A SnapClaim executive ran over my dog in his Porsche and offered me a coupon for 25% off my next SnapClaim. I ran over one of his kids which scratched my bumper and hood. Insurance offered me $1250 but SnapClaim got me over $2000. Don’t let these executives get away with anything.

cm2187 2mo ago

Meanwhile insurance fraudsters love AI, and its ability to manipulate photos!

Gigachad 2mo ago
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.
- colechristensen 2mo ago
  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.
  - jordanb 2mo ago
    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."
    - estearum 2mo ago
      The GP described it as abuse. That's not evidence of companies calling it abuse. As you say, this is basically intrinsic to the deal of buying clothes/shoes/etc online and obviously online retailers know that and accept it, or else they would not allow it (and in turn would not exist as businesses).
    - rtkwe 2mo ago
      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.

bix6 2mo ago

You see Bob, a company is like a clock…

chris_va 2mo ago
well let's hope we don't cover him

kkaske 2mo ago

When there is more efficiency its a win for AI. When there are errors its the problem of the humans that are supposed to be using AI and oversee it to "make them more efficient". This has been the main source of AI fatigue for me.

wellpast 2mo ago

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 the policy, keeping a log of all of our correspondences, logging work estimates and invoices, I cant imagine doing all this tedious work myself—w/o Claude I’d probably just rollover fatigued. Does my adjuster like this? On the one hand, I’m giving her incredibly tidy and documented receipts and logs, which I am sure is saving her time. 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.

throwaway2037 2mo ago
> 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 explained to her that you are considering filing a complaint with the state insurance bureau? It's the ol' stick vs carrot. I say: Start with the carrot. If that doesn't work, back to the stick!
- criddell 2mo ago
  Of the two options you presented, escalating to management or filing a complaint, which is the carrot?
  - throwaway2037 2mo ago
    Good question: They are two types of sticks: little and big.
- iooi 2mo ago

cael450 2mo ago

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 don’t know anything about the treatment to deny claims then waste the practitioner’s time on appeals in the hopes that people will give up. AI has obviously made this process easier and the insurance companies absolutely hate it. People have no idea how inefficient the U.S.’s healthcare system is. And it isn’t just the private companies. A ton of states purposefully overburden and underfund their Medicaid systems for ideological reasons. Then the private insurance companies adopt the same practices later.

throwaway2037 2mo ago
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 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.
- nearlyepic 2mo ago
  > 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.

hereme888 2mo ago

Hah! Insurance companies proudly announce to investors how much they undercut payments. It was precisely because of AI that I had the time and language to fight a recent claims report for a totaled vehicle, and squeezed an additional 25% from them. And it was still not adequate payout. Let claim adjusters and insurance get off their high horse until they start being the bane of existence and paying what they owe clients.

SilverBirch 2mo ago

So I have three thoughts about this: The first thought is this is likely mostly survivorship bias. Yes, the claims that get to the humans are the ones that went wrong, and the mode of failure for LLMs is less that they get within 99% all of the time, it's more like 1% of the time they do something insanely dumb. At which point your customers are pissed off. That's kind of obvious, and it sucks for the humans who have to clear up the situation. But it's still a win for the vast majority of cases. Secondly, does anyone actually know how much of your insurance premium is going on the call centre staff? most people don't claim, those that do mostly have simple claims. The actual cost for insurance companies is actually paying out claims, so even if you automated all of this it likely doesn't change your economics. Historically "New" Insurance companies only really succeed by mis-pricing risk and gaining market share that way - they often then fail when that risk materializes. Lemonade sounds a lot like that. Finally, they haven't engaged with the tidal wave that's coming. Sure, AI agents handling claims is happening now. Just you wait. In a couple of years time it'll be AI agents making the claims for you and suddenly there'll be bots filing claims with infinite patience and a direct mandate to try and get as big a payout as possible. That is when it's going to get really hairy.

briandw 2mo ago
“does anyone actually know how much of your insurance premium is going on the call centre staff” It’s pretty easy to figure out. Insurance companies publish a loss ratio. That’s the ratio of premiums collected to claims paid out. Lemonade has industry-leading loss ratios now BTW.

techteach00 2mo ago

I'm gonna use chat gpt in a few months when getting a new lease. I'll know in real time if I'm getting robbed.

chrisjj 2mo ago
> I'll know in real time if I'm getting robbed. Yup - by checking your Claude usage meter.

eagsalazar2 2mo ago

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.

zamadatix 2mo ago
A "The Monkey's Paw" version of "I wish copyright law would be handled differently".
thecosas 2mo ago
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-machine/ https://99percentinvisible.org/episode/552-blood-in-the-mach...

jonhohle 2mo ago

> 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.

maxnevermind 2mo ago
I think Insurance Claims Adjusters as a occupation was on decline for some time even before the latest boom in AI. Since 90s I believe the most of major Insurance companies shifted a strategy, claims are seen as a source of profit and adjuster are now seen as a nuisance that often increase the payout for claims, so their role were diminished to form-fillers in different software systems.

Alien1Being 2mo ago

Meanwhile HR departments have started using Pangram like tools to detect and remove AI written job applications. The flood of nonsensical AI slop applications that HR is facing has forced this.

thecosas 2mo ago
Interesting thing to ponder: How much time, money, energy (et al) is being used in the (now) ever-escalating war between generating and detecting AI content? This goes for HR, education, code review, on and on.