The Authors
During his 20-year career representing policyholders, Marshall has recovered hundreds of millions of dollars for his clients, successfully litigating disputed claims under a variety of insurance products, including property and business interruption insurance, commercial general liability (CGL) insurance, errors and omissions (E&O) insurance, directors’ and officers’ (D&O) insurance and life insurance. Marshall has represented clients on numerous high-stakes, complex insurance claims arising out of prominent losses such as 9/11, Hurricane Katrina, Superstorm Sandy and the “Big Dig” in Boston. He also focuses extensively on assisting clients that own and manage captive insurance companies, especially with respect to resolving coverage disputes between the captive and its reinsurers.
Prior to joining Anderson Kill full time, Madison worked at the firm during her law school years as recipient of the Gene Anderson Clerkship and as a summer associate. She was also an Alexander Fellow to the Honorable Susan D. Wigenton at the United States District Court for the District of New Jersey, where she held a full time judicial internship during her Fall 2022 academic semester.
Protecting Policyholders as AI Is Developed for
Insurance Claims Handling:
Insurance Claims Handling:
Ensuring “Decency and Humanity” in the Digital Age
Adherence to “decency and humanity” in the claims-handling function must not be curtailed. In an age increasingly dominated by AI, it becomes even more crucial that these principles guide the integration of technology in insurance company operations.
Abstract:
The integration of artificial intelligence (AI) within the insurance industry raises concerns that insurance companies might use the technology to unfairly curtail or deny policyholders’ claims. Drawing on the historical example of the Colossus software, this article outlines the potential consequences of diminished human oversight in AI-driven claims handling. In the past, technology was used to boost insurance companies’ bottom lines while undervaluing policyholders’ claims. We may be seeing a similar situation unfold in real time with recent investigations into and lawsuits against certain health insurance companies for their alleged algorithm-driven claim denials. This article highlights the need for watchdogs and regulators to demand that AI tools under development afford “explainability” and protect policyholder rights. Insurance companies must stand by their fundamental duty of good faith to policyholders, and courts must maintain long-standing precedent that demands “decency and humanity” in insurance company claims operations.