Hunton Insurance Recovery Blog

In the case The Estate of Gene B. Lokken v. UnitedHealth Group, Inc., No. 23-CV-3514 (JRT/SGE) (D. Minn.), the plaintiffs alleged that the defendant insurer had denied claims using an artificial intelligence program without human review. They sought discovery into the insurer’s use of AI. When the insurer refused, they moved to compel and the Minnesota federal court granted the motion. Although this case deals with health insurance, its principles are widely applicable to all other types of insurance. Insurers are increasingly using AI to evaluate or even deny claims without human review. They also use it to challenge policyholders’ expenses as too high. Courts are beginning to allow discovery into how AI was used in the claim process. Accordingly, requests for AI chat files, use policies, and documents concerning oversight of AI should now be a standard part of every policyholder’s discovery requests in coverage litigation.

A Michigan federal court in Wolverine World Wide Inc. v. The American Insurance Co. et al., No. 1:19-cv-00010 (W.D. Mich.), recently confirmed what should go without saying – a claim handler is a claim handler, even if they may also be a lawyer.  Recognizing that it’s the nature of the work that drives the analysis, the court ordered an in-house Travelers’ attorney to sit for a deposition in a PFAS coverage suit because the attorney was performing ordinary claim-handling activity.  In rejecting the insurer’s arguments, the court reiterated that “an insurer cannot create a ‘shroud of secrecy’ by simply designating an attorney to conduct an otherwise ordinary claim investigation.”