CAN USING AI HURT MY LONG-TERM DISABILITY CASE?

This is a hard question to answer. As technology changes over time and offers us new tools that helps us communicate about matters that we normally wouldn’t be able to communicate about, there is risk in utilizing these tools for legal matters – including long-term disability claims and appeals. Artificial Intelligence (AI) is ubiquitous in today’s digital era. However, using AI to communicate in long-term disability claims governed by the Employee Retirement Income Security Act (ERISA) can pose certain dangers.

At Mehr Fairbanks Trial Lawyers, we understand the intricate nature of long-term disability claims and appeals. The appeal process in a long-term disability claim is vital as it provides a platform for claimants to challenge an unfavorable decision made by the insurance company. Often, depending on the insurance policy terms, the appeal process is even required before you can file a lawsuit challenging the insurance company’s decision. However, the sophistication needed in these cases requires more than just a basic understanding. And, importantly, the way you communicate with the insurance company may likely be used against you.

DOES AI REALLY HELP YOUR CLAIM?

Technology often lacks the human emotion that may be necessary to humanize you for purposes of the appeal – or later, for the Court.

Although technology advancement, particularly AI, has brought convenience to many aspects of our lives, it’s important to tread carefully when considering its use in the claim or appeal process for long-term disability claims. While AI assistance might seem inviting due to its speed and ease, it lacks the human touch necessary for these complex endeavors. AI, by nature, lacks the empathy and insight inherent in human interaction. For those who are going through the distress of dealing with a disability, it may be difficult expressing their concerns or articulating their situation to the insurance company. AI likely won’t capture the full extent of what a disabled claimant suffers on a day-to-day basis.

Insurance companies often use communication skills, detailed summaries, and information from claimants as evidence to prove the ability to work. Machine-generated appeals or summaries may lack the necessary nuances or fail to fully capture the claimant’s situation. AI also lacks the ability to understand and convey emotions, a significant factor considering the individualized nature of disability claims. In such sensitive cases, human involvement and understanding are indispensable.

Insurance companies will often seize any angle they can to minimize or deny the payout for a claim. One particular approach that these companies have been known to employ involves the exploitation of concise, well-written summaries, emails, or medical records provided by a claimant. Moreover, they might even leverage such articulated documents that were compiled with the assistance of AI. For instance, the company might argue that the claimant is not disabled or ill to the extent they claim if they are capable of putting together a lengthy medical history or appeal. By suggesting that the very ability to write a comprehensive, structured document contradicts the severity of the claimed disability or medical condition, the company may try to avoid its obligations and refuse to approve benefits.

The insurance company may not even acknowledge its view of your “detailed” appeal until you receive the final denial letter that alleges you were able to communicate and provide detailed information. If this happens, it is unlikely that you will be able to defend yourself by explaining that you utilized AI to assist you because once the insurance company issues a final denial of your benefits, you may not be able to submit any additional information in support of your claim.

PITFALLS OF AI

AI is not perfect. There is absolutely room for error in the information it generates based on the inquiries you input. There is a significant risk that – without careful review – you may even unknowingly provide information to the insurance company that is simply wrong. By failing to catch incorrect information that AI generated for you, you may be subject to the incorrect information being used against you unfavorably by the insurance company. If the appeal process finalizes without this information being corrected, you are at risk of being bound to that information without a way to dispute it if you file a lawsuit. This, combined with the lack of human emotion, the risk of the insurance company using detailed communications in opposition to you, and the privacy concerns related to your information, demonstrate the dangers of relying on AI to support your claim.

It is important to be up-to-date on the software you are relying on. Is that information protected? Are there privacy concerns? You may unknowingly put your own privacy at risk by inputting your confidential medical and personal information in AI software.

CONTACT US TODAY FOR A FREE CONSULTATION

Professional advice and representation in these matters carry more weight than any AI can provide. Mehr Fairbanks Trial Lawyers is ably equipped to navigate the complex terrain of disability claims and appeals. Our law firm provides personalized attention and drafts comprehensive appeals which articulate your story and situation compellingly. We keep abreast of the ever-evolving rules and regulations surrounding long-term disability claims, appeals, and ERISA to ensure we are always poised to fight for you.

Bear in mind, presenting well-articulated documentation is perfectly within your rights. If an insurance company tries to barter with such unscrupulous semantics, Mehr Fairbanks Trial Lawyers can help protect your rights and help you get the compensation you deserve. Reach out to us at (800) 249-3731 for a free consultation today.