COMPUTER SAYS NO: False expectations of computer based insurance claims processing

Many insurance companies are touting the idea of computer based insurance claims processing. Most recently Zurich insurance has announced a pilot project to have claims processed by computers based on Artificial Intelligence (AI).

Zurich Insurance Chairman Tom de Swaan told Reuters that Zurich would be able save tens if not hundreds of thousands of work hours, and claims could be processed in 5 seconds rather than the current average of 52 minutes.

It is claimed that this would be a huge benefit for customers as they would have really fast „resolutions“ to their claims. This also implies more unemployed insurance assessors.

Zurich insurance is not breaking new ground here. Other countries have experienced the negative repercussions and the huge problems that this kind of casino insurance brings with it.

SUISHARE collaborators know AI. An AI based claims processing system can be set up like a casino gambling machine to only approve a defined % of claims, and leave the majority of claimants with a rejection and purposefully designed complicated path to recourse.

A new report from the United Kingdom financial ombudsman finds that many lives have been wrecked because this new kind of inflexible IT „customer service“. The first line of abuse is against vulnerable customers. The „computer says no“ approach, instead of trying to personally resolve tricky financial problems are leaving those in serious difficulty worse off than before.

In long lists of abuses, the financial ombudsman found many worrying scenarios. The number of such complaints being made in the UK has rocketed over the past six months into the tens of thousands, a quantum rise on last year.

And in the majority of cases, the ombudsman is finding that the insurance company acted incorrectly in respect of their decision, and forced the insurer to reverse the decision in the customer's favour.

Thus in the brave new world of insurance the computer will be programmed to say no to a greater number of people in the expectation that many people will just give up after protracted challenges against recurring rejections, the elderly will just expire, and the insurance company will, after giving customers a protracted run around, outsource final decision making to the financial ombudsman?

The UK financial ombudsman warns of the human toll that this inflexibly designed 'computer says no' approach can end up causing even greater distress for customers.