A client's roof was totaled but the insurance algorithm called it fine

Using algorithms to handle insurance claims without a real check is unfair and lazy. In my work, I see roofs that are clearly damaged get denied because some computer uses old data. This kind of system hurts people who actually need help.

4 comments

4 Comments

claire_grant341mo ago

Something that gets missed is how these algorithms might actually break the contract law part of an insurance policy. Most policies say they'll pay for "direct physical loss," but if the system is designed to look for cheap repairs instead of real damage, that's a breach of good faith. A lawyer friend said fighting a denial on those grounds can sometimes scare them into a real inspection faster than anything else.

rowan_wells301mo ago

Totally agree about algorithms using old data. Had a client get denied until we brought in a public adjuster who forced a real inspection. Have you tried getting a second look from one?

holly_bell981mo ago

That's such a good point from @rowan_wells30. It feels like we're all running into more systems that rely on old or lazy automation, not just in insurance. I see similar things with automated grading programs at school that can't understand a kid's real progress. Having a real human review makes all the difference.

the_piper4d ago

My roof claim last year got a lowball offer from their system. Hired a public adjuster who found hidden water damage in the attic. The final settlement was almost double their first number. What did your client's adjuster find that the algorithm missed?