𝟏.𝟐 𝐒𝐞𝐜𝐨𝐧𝐝𝐬 𝐏𝐞𝐫 𝐂𝐥𝐚𝐢𝐦: 𝐈𝐧𝐬𝐢𝐝𝐞 𝐭𝐡𝐞 𝐋𝐚𝐰𝐬𝐮𝐢𝐭𝐬 𝐓𝐞𝐬𝐭𝐢𝐧𝐠 𝐀𝐈'𝐬 𝐑𝐨𝐥𝐞 𝐢𝐧 𝐈𝐧𝐬𝐮𝐫𝐚𝐧𝐜𝐞
An AI decided whether to pay a claim. A judge is now deciding whether that was even allowed.
That’s the fight playing out right now in cases like Lokken v. UnitedHealth, Barrows v. Humana, and Kisting-Leung v. Cigna, where plaintiffs claim generative AI stepped into a decision that was supposed to belong to a person. In Kisting-Leung, doctors are alleged to have spent an average of 𝟏.𝟐 𝐬𝐞𝐜𝐨𝐧𝐝𝐬 reviewing each algorithmic recommendation before signing off. All three cases have survived a motion to dismiss.
I’m speaking next week on a CLE panel digging into exactly this, and I’m covering the two bookends of the conversation:
→ 𝐖𝐡𝐞𝐫𝐞 𝐭𝐡𝐞 𝐭𝐞𝐜𝐡𝐧𝐨𝐥𝐨𝐠𝐲 𝐬𝐭𝐚𝐧𝐝𝐬 𝐭𝐨𝐝𝐚𝐲 — what it can and can’t actually do in a claims decision → 𝐖𝐡𝐞𝐫𝐞 𝐭𝐡𝐢𝐬 𝐢𝐬 𝐡𝐞𝐚𝐝𝐢𝐧𝐠 — what insurers should be building into their AI programs now, before a lawsuit forces the question
In between, 𝐊𝐞𝐥𝐥𝐲 𝐊𝐨𝐬𝐬 (Barnes & Thornburg) and 𝐉𝐨𝐬𝐡𝐮𝐚 𝐏𝐨𝐥𝐬𝐭𝐞𝐫 (Simpson Thacher & Bartlett) take you through the policyholder theories, the discovery requests insurers are already fielding, and the privilege fights over AI communications and chat logs.
𝟗𝟎 𝐦𝐢𝐧𝐮𝐭𝐞𝐬. 𝐓𝐡𝐫𝐞𝐞 𝐚𝐧𝐠𝐥𝐞𝐬. 𝐎𝐧𝐞 𝐪𝐮𝐞𝐬𝐭𝐢𝐨𝐧 𝐞𝐯𝐞𝐫𝐲 𝐢𝐧𝐬𝐮𝐫𝐞𝐫 𝐮𝐬𝐢𝐧𝐠 𝐀𝐈 𝐧𝐞𝐞𝐝𝐬 𝐚𝐧 𝐚𝐧𝐬𝐰𝐞𝐫 𝐭𝐨: can you prove a human was actually in charge of the decision?
𝐈𝐧𝐬𝐮𝐫𝐚𝐧𝐜𝐞 𝐋𝐢𝐭𝐢𝐠𝐚𝐭𝐢𝐨𝐧: 𝐃𝐢𝐬𝐜𝐨𝐯𝐞𝐫𝐲 𝐨𝐟 𝐀𝐈 𝐏𝐫𝐨𝐝𝐮𝐜𝐭 𝐃𝐞𝐯𝐞𝐥𝐨𝐩𝐦𝐞𝐧𝐭 𝐢𝐧 𝐂𝐚𝐬𝐞𝐬 𝐀𝐥𝐥𝐞𝐠𝐢𝐧𝐠 𝐀𝐈-𝐃𝐫𝐢𝐯𝐞𝐧 𝐂𝐨𝐯𝐞𝐫𝐚𝐠𝐞 𝐃𝐞𝐧𝐢𝐚𝐥𝐬 Strafford/BARBRI CLE Webinar 𝐒𝐞𝐩𝐭𝐞𝐦𝐛𝐞𝐫 𝟏𝟕, 𝟐𝟎𝟐𝟔, 𝟏:𝟎𝟎 𝐏𝐌 𝐄𝐓
About the Author
John Tredennick (jt@merlin.tech) is CEO and Founder of Merlin Search Technologies, a company pioneering AI-powered document intelligence for legal professionals. A former trial lawyer and founder of Catalyst Repository Systems, he is recognized by the American Lawyer as a top six ediscovery pioneer and has been involved in legal technology and document review for more than 30 years.