Source: PBS

PBS explores a growing trend where patients are utilizing artificial intelligence tools to contest health insurance claim denials. As insurance companies increasingly rely on algorithms to bulk-process and often deny claims—sometimes with little human oversight—patients are fighting back by using generative AI to draft complex appeal letters. These tools help individuals navigate the dense bureaucratic and legal terminology required to overturn coverage decisions, effectively "lawyering up" with software .

The report raises significant legal and ethical questions regarding the "arms race" of algorithms in the healthcare sector. While AI empowers consumers to enforce their contractual rights, it also highlights the lack of regulation surrounding automated decision-making in insurance. Legal experts note that this dynamic could force a re-evaluation of administrative laws and the standard of care, as the battle for coverage shifts from human negotiation to adversarial algorithmic interaction, potentially clogging appeals processes or, conversely, exposing systemic bad faith practices by insurers.