We often assume that an insurance adjuster has our best interests at heart. In reality, many carriers deploy advanced artificial intelligence tools to reduce the amounts they pay out on claims. Our Raleigh, NC personal injury lawyer knows that by understanding how these systems work, we can level the playing field and protect your rights after an accident. We have a 5-star rating with over 70 reviews on Google, so come to us when you need help with your claim.
What AI Looks For In Your Claim
Insurance companies feed AI models with vast amounts of claim data, including photos, damage estimates and medical records. These systems learn to spot patterns tied to higher payouts—like certain injury treatments or parts replacements—and flag claims that deviate from low‐cost benchmarks. When your claim hits these flags, an automated report recommends a lower settlement amount before any human adjuster even reviews it.
How Damage Estimates Are Adjusted By Algorithms
Once an AI tool identifies potential overcharges, it compares the initial estimates against its internal database of “typical” repair costs. If your repair shop’s quote is higher than the AI’s calculated average for your vehicle make and model, the system automatically suggests cutting those line items. There have been cases where AI reduced repair labor by 20% simply because it relied on generic labor rates rather than the rates charged by a client’s local shop.
The Impact Of Predictive Analytics On Injury Claims
Predictive analytics examine past claims and litigation outcomes to assign a risk score to each new claim. High‐risk claims are often those involving multiple injuries or extensive treatment plans. An elevated risk score can lead to an insurance carrier arguing that certain therapies—like ongoing physical therapy or home health care—are unnecessary. We’ve noticed insurers citing AI reports to deny coverage for services that medical professionals prescribed.
Why Carriers Prefer AI Over Human Judgment
Automated decision systems allow insurers to process claims faster and with lower staffing costs. With AI handling the initial review, carriers can minimize settlement offers without expending human resources. This saves them money in the short term, but it can leave claimants undercompensated for real losses. We’ve learned that when a human adjuster does intervene, they often lean on the AI’s analysis rather than challenging its conclusions.
How We Counter AI‐Driven Reductions
At Burton Law Firm, we know how these AI tools work and where they fall short. We gather comprehensive evidence—detailed medical records, expert testimonies, and accurate repair estimates—to demonstrate the full scope of our clients’ losses. By presenting clear documentation, we force insurers to rely on facts instead of pre‐programmed assumptions. When necessary, we challenge AI reports in deposition and expert review, showing courts and juries that an algorithm’s “average” doesn’t reflect our clients’ real experiences.
What You Should Do After An Insurer’s Lowball Offer
If your settlement offer feels unreasonably low, don’t accept it without question. We recommend requesting a copy of the AI‐generated analysis and comparing it against your actual expenses. Collect all invoices, receipts, and medical provider statements, then seek legal help before signing any release. We find that even a short letter from our office can prompt carriers to reexamine their AI‐driven conclusions.
When insurers use AI to undervalue your claim, we’ll stand with you to secure a fair outcome and walk you through the legal process. Contact Burton Law Firm today for a free consultation. Let us handle the tech and tactics so you can focus on your recovery.