In certain instances, we may earn revenue when a reader makes a purchase or completes a form through our pages or on a partner’s website. We adhere to a strict More insurance companies are now using artificial intelligence (AI) in health insurance to manage claims, support customers, and suggest care options. Some of these tools are seen as helpful, especially when they make things faster or easier. But others are raising concerns.
As insurance claims automation becomes more common, people are starting to pay closer attention to how these systems work and how much control they really have.
This article explores how these tools are being used, why some are trusted more than others, and what it means for the future of AI in health insurance.
Key Takeaways
- Many insurance companies now use automation and generative AI to handle claims faster, give plan suggestions, and improve customer support.
- People feel more comfortable when AI offers guidance instead of making final decisions about treatment or payments.
- Trust in claim-related tasks is still low – only 30% of people said they trust AI to approve claims, while most prefer a person to decide.
- Stories about rising health insurance denials and legal cases are making people more cautious about how these tools are used.
- While generative AI in insurance helps explain policies and simplify the process, most users still want a human involved when it matters most.
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How AI in Insurance Is Used Today
AI in insurance plays a bigger role than most people realize. It’s working in the background to make tasks quicker, smoother, and easier to manage for both providers and policyholders.
Here are some of the ways AI in insurance is being used right now:
- Fraud detection: AI systems go through claims to spot anything that looks unusual or out of place, helping companies catch fraud before it becomes a bigger issue.
- Plan suggestions: Tools can recommend coverage options based on someone’s budget, lifestyle, or medical needs. This saves time and makes it easier for people to choose the right plan.
- Customer support: Many companies use chat-based help services powered by AI for insurance to answer questions, guide users, and handle common requests.
On the admin side, AI helps with checking claims, making sure all the information is complete, and getting them ready for review. This helps insurance teams:
- Speed up everyday tasks
- Reduce paperwork and costs
- Make better use of customer data
Survey Results Reveal Low Trust in AI Insurance Claims
Most insured Americans don’t feel comfortable relying on AI when it comes to claims. According to recent YouGov data, trust drops sharply when AI has a say in how claims are handled.
Only 30% of respondents said they trust AI to evaluate or approve claims – in contrast, 55% said they don’t. That gap points to a real hesitation, especially around decision-making.
Confidence in other tasks isn’t much better. Many people still prefer a human touch, even for basic steps like submitting a claim or getting help with a question.
Out of all the areas tested, only preventive care guidance – such as fitness tips, screenings, or wellness programs – had more trust than doubt.
This shows that while people are open to AI in healthcare claims processing, they still want a person involved when it comes to the final say. AI can help with the process, but most prefer it to stay in a support role.
That’s why, for now, the public sees AI for claims processing as a tool; useful for speed and convenience, but not ready to stand on its own.
United Healthcare AI Lawsuit Sparks Concern Over Health Insurance Denials
Negative headlines are making people even more unsure about how AI is being used in health insurance. One case in particular has drawn a lot of attention: a lawsuit involving UnitedHealthcare’s AI tool called nH Predict. This system was used to help decide which claims to deny, including cases where elderly patients were recommended treatment by their doctors.
The lawsuit made some serious claims:
- The tool denied care even when doctors said it was necessary
- It reportedly had a 90% error rate, with most denials eventually reversed
- Patients were left waiting for care they should have received
United Healthcare said that the AI tool was only meant to support decisions, not make them. But many people are not convinced, especially those who were directly affected by the delays.
This case also highlights a wider trend. Reports of health insurance denials are becoming more common, even in situations where medical professionals push for treatment.
As more companies rely on automated tools, concerns are growing about how often those tools are used to reject claims.
The Trust Divide: What Makes People More Accepting of AI?
Some uses of AI in insurance are seen more positively than others. People seem more willing to accept AI when it gives suggestions rather than making the final call.
Survey results show that advisory tools (like those recommending wellness programs or health plans) are trusted more than tools used for claim decisions.
This could be because these features don’t decide what care someone receives; they simply offer advice, which still leaves the final choice in human hands.
In this context, AI for insurance plays a support role, helping users make informed decisions instead of replacing human input.
Younger adults are often more open to this approach. They tend to be more familiar with digital tools and are comfortable interacting with them.
Some reasons why younger users may be more accepting:
- They often use mobile apps and digital-first services
- They’re used to receiving personalized suggestions
- Chatbots and virtual assistants feel more natural to them
The real difference lies in how AI is used. Suggesting a plan feels like help. Denying a claim feels like control.
That’s why the level of trust in AI insurance tools depends more on the role they play than the task itself.
Why Insurers Still Rely on Automated Claims Processing Despite Doubts
Many insurers are still moving ahead with automated claims processing, even though some people feel unsure about it. For these companies, the benefits are clear: it helps them handle claims faster, reduce workload, and catch mistakes early.
Automation can:
- Speed up claims by handling simple checks and early steps
- Keep things consistent, so similar cases get similar outcomes
- Spot possible fraud using data patterns and past examples
Most providers still keep a person involved, especially near the end of the process. They use automation to manage the basics, then pass the claim to a human for the final review. This mix of tech and human input helps them save time without giving up control.
There’s also interest in new tools that go a step further. Some teams are testing:
- Predictive approvals, which may fast-track low-risk claims
- Personalized pricing, where costs change based on someone’s habits or past claims
That’s why insurance claims automation continues to grow. It helps companies stay efficient, even if public trust still needs work.
The Bottom Line
Public trust in AI in health insurance depends on how it’s used, because people are more comfortable with tools that offer guidance, not control. While insurers continue to invest in automation, most policyholders still want a human involved, especially when it comes to claims.
For now, AI works best as a support system, helping to speed things up without replacing personal judgment.
