When you're injured in an accident, one of the first things you rely on is insurance. You assume your medical bills, lost wages, and other damages will be fairly evaluated and covered. But behind the scenes, the system that determines what your claim is worth is changing fast—and not necessarily in your favor.

Insurance companies have been using artificial intelligence (AI) for years to streamline claim processing. Lately, that use has expanded to decision-making roles, from evaluating injury claims to calculating settlement offers. While AI can improve efficiency, there's growing concern that these technologies may also be leading to faster—but smaller—payouts for injured people.

How AI is being used by insurers, the potential impact on personal injury claims, and what you can do if you suspect your claim was unfairly evaluated is covered in the article below.

How Insurance Companies Are Using AI

AI systems are increasingly being deployed to manage and review claims. Rather than relying entirely on human adjusters, companies are feeding injury data, medical records, accident reports, and historical claim outcomes into machine learning models.

Common AI Applications in Insurance:

• Claim triage: Prioritizing which claims need urgent attention
• Damage estimation: Using photos or repair data to calculate repair costs
• Injury assessment: Estimating medical costs or recovery time
• Settlement recommendations: Suggesting payout amounts based on prior similar cases

These tools can help process claims more quickly, but speed doesn’t always mean fairness. The concern arises when AI is used not just for assistance, but as the final word.

The Risk of Lower Payouts

AI’s biggest advantage to insurers is efficiency. But from a claimant's perspective, it may result in:

1. Over-Reliance on Historical Data

AI systems often base decisions on past claim outcomes. If insurance companies have historically paid less for certain injuries or undervalued certain claims, that pattern may be baked into the algorithm.

2. Lack of Human Context

AI doesn’t understand nuance. Two people may suffer the same injury but have very different recoveries or personal impacts. AI might treat them the same—and undervalue the one who was more severely affected.

3. Opaque Decision-Making

Unlike a human adjuster, an AI model doesn’t explain why it valued a claim the way it did. This lack of transparency can make it hard to dispute an unfair offer.

4. Pressure to Settle Quickly

Injured people may be presented with a fast offer and encouraged to take it—especially if it comes from a system that appears impartial or data-driven. But a fast settlement isn't always a fair one.

Legal and Ethical Concerns

As of now, there are few regulations specifically governing how insurance companies use AI in claims handling. This has raised alarms among consumer advocates and legal professionals alike.

Several states, including California and Colorado, are beginning to explore rules around the use of AI in consumer decision-making. Meanwhile, the National Association of Insurance Commissioners (NAIC) has published principles for AI use that emphasize fairness, accountability, and transparency—but these are not legally binding.

If AI is being used to determine your settlement and you're not told how, it becomes difficult to challenge decisions or understand your rights.

What You Can Do if You Suspect AI Affected Your Claim

If you’ve received a settlement offer that feels low—or if your claim was denied with little explanation—there are steps you can take:

1. Request an Explanation

Ask the insurance company how your claim was evaluated. Was AI used? If so, what factors were considered?

2. Compare With Similar Claims

A personal injury lawyer can help you compare your case to similar past claims and determine whether the offer is within a reasonable range.

3. Get Independent Medical Opinions

An outside medical evaluation may help challenge an insurer’s assumptions about your recovery time or treatment needs.

4. Hire a Personal Injury Attorney

Attorneys can negotiate with insurers, demand fair treatment, and, if needed, take your case to court. Unlike automated systems, lawyers advocate for your unique experience, not just your paperwork.

Call Brandon J. Broderick For Legal Help

The rise of AI in insurance is changing how claims are handled—but that doesn’t mean you have to accept an unfair outcome. If you believe your settlement was undervalued or rushed through an automated process, we can help.

At Brandon J. Broderick, Attorney at Law, we combine decades of experience with a deep understanding of how modern insurers operate. We’ll review your case, push back against lowball offers, and fight for the compensation you truly deserve.

Contact us today for a free consultation.