News & Analysis as of

Artificial Intelligence Insurance Claims

Morgan Lewis

(AI)n’t Done Yet: States Continue to Craft Rules to Manage AI Tools in Healthcare

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As the regulation of artificial intelligence (AI) tools in healthcare settings rapidly evolves, state medical boards and related agencies are at the forefront of development and enforcement. While some states have taken...more

American Conference Institute (ACI)

[Event] 16th Annual Advanced Forum on Managed Care Disputes and Litigation - May 1st - 2nd, Chicago, IL

Join the industry’s top litigators and leading plan counsel at ACI’s 16th Annual Advanced Forum on Managed Care Disputes and Litigation, for two days of discussions designed to address emerging areas of concern for MCOs in...more

Arnall Golden Gregory LLP

UnitedHealthcare Must Face State Law Claims in Class Action Suit for AI Driven Coverage Denials of Medicare Advantage Claims

Daytime television inundates American seniors with advertisements for UnitedHealthcare’s (“UHC”) Medicare Advantage Plans. On its website, UHC claims its Medicare Advantage Plans “stand out from the rest,” providing...more

DLA Piper

Lawsuit Over AI Usage by Medicare Advantage Plans Allowed to Proceed

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The US District Court for the District of Minnesota has ruled that plaintiffs may proceed in a putative class action lawsuit brought against a Medicare Advantage organization (MAO) to challenge its alleged use of an...more

Fennemore

Lessons Learned from ERISA Health Plan Representation and Recommendations for Plan Design and Oversight

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ERISA Health Plan clients are engaged in nearly every industry in the United States. There are nearly 139 million Americans covered by ERISA Health Plans and 2.5 million Health Plans. Yet, operating a health plan has become...more

Fennemore

Regulatory Landscape of Insurance Claims Denial Practices and Suggestions for a Path Forward to a Sustainable Healthcare Future

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In the wake of the December 4, 2024 fatal shooting of UnitedHealthcare’s CEO Brian Thompson, questions were raised about insurance claim denial practices. Several news outlets noted that UnitedHealth Group’s profits have been...more

Zelle  LLP

The Zelle Lonestar Lowdown Issue 21 - January 2025

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Welcome to the first 2025 edition of the Zelle Lonestar Lowdown! Our theme this year is Collaboration. We recognize that we are not an island in this industry and our clients, and ultimately the property owners, best benefit...more

Zelle  LLP

The Zelle Lonestar Lowdown Issue 20 - December 2024

Zelle LLP on

Welcome to The Zelle Lonestar Lowdown, our monthly newsletter bringing you relevant and up-to-date news concerning Texas first-party property insurance law. Inside this Issue: - Todd Tippett’s Top Ten Consultants an...more

Lowenstein Sandler LLP

Weather, Drones, and AI … Oh My! How the Insurance Industry Changed in 2024

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In this episode of “Don’t Take No for An Answer,” Lynda A. Bennett, Chair of Lowenstein’s Insurance Recovery Group, joins Lowenstein’s Heather Weaver and Josh Weisberg, Chief Risk Officer at SterlingRisk to recap changes in...more

Dinsmore & Shohl LLP

[Hybrid Event] Credits & More – Continuing Legal Education Seminar - December 6th, Cincinnati, OH

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Sign Up Today! Registration is open for the 2024 Dinsmore & Shohl LLP Credits & More Continuing Legal Education (CLE) seminar, taking place on Friday, December 6. This hybrid event offers the flexibility of attending in...more

Cozen O'Connor

Claims Notes: August 2024

Cozen O'Connor on

The New York Department of Financial Services (DFS) previously circulated proposed guidance on using AI in underwriting and pricing to address discrimination. DFS requested public comment. Commenters expressed concern over: ...more

Robins Kaplan LLP

AI’s Impact on Property Insurance Coverage

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Artificial Intelligence (AI) is the simulation of human intelligence processes by machines, such as computer systems for assistance in quickly answering complicated questions, researching a specific topic, or creating an...more

Eversheds Sutherland (US) LLP

AI Litigation Insights - Jeremy Jong, individually and on behalf of similarly situated individuals v. Blue Shield of California

Plaintiff Jeremy Jong filed a putative class-action complaint against Blue Shield of California (Blue Shield), one of the largest medical insurance companies in the United States....more

Cozen O'Connor

Claims Notes: March 2024

Cozen O'Connor on

After a yacht ran aground, the owner filed a maritime insurance claim. Despite a New York choice of law provision in the insurance policy, the owner contended that Pennsylvania law applied. The Third Circuit had protected the...more

Patrick Malone & Associates P.C. | DC Injury...

Better Health Care Newsletter - March 2024

Is Medicare Advantage really a Disadvantage for seniors and taxpayers? Our nation is graying rapidly. Every day, 10,000 baby boomers, members of one of the largest generations in U.S. history, hit the traditional...more

Cozen O'Connor

Claims Notes

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New York Department of Financial Services (DFS) is concerned that AI’s self-learning behavior increases the risks of unlawful or unfair discrimination. DFS will audit insurers’ use of AI. Such insurers need to maintain...more

ArentFox Schiff

Health Insurers Sued Over Use of Artificial Intelligence to Deny Medical Claims

ArentFox Schiff on

With the surge of interest in artificial intelligence (AI), it should be no surprise that health insurers have come under scrutiny concerning their use of AI predictive tools to deny medical insurance claims. The question...more

Robins Kaplan LLP

Artificial Intelligence v. General Data Protection Regulation: Complex Risks in Changing Times

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Artificial Intelligence (“AI”) Is A Complicated Technology Developed With Data. This Saddles AI It With A Host Of Potential Privacy Regulations, Including Europe’s Data Protection Law, The General Data Protection Regulation...more

Bricker Graydon LLP

When life hands you lemons, a computer judges you

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“Instantaneous and delightful.” These words are not typically used in connection with the purchase of insurance, let alone with the filing of an insurance claim. But that is a mantra of Lemonade Insurance Company, a New York...more

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