Keywords
AI; Artificial Intelligence; Health Insurance; Health Insurance Companies; Healthcare; Lawsuits
Abstract
In recent years, the healthcare system has been burdened by a multitude of obstacles that hinder the ability to provide effective, affordable, and timely care. Among these, one of the most significant challenges is the role that health insurance plays in shaping the quality of care. Health insurance companies are designed to decrease financial strain on patients, but they have introduced inefficiencies through delayed coverage approvals, increased denials, and administrative costs. Artificial intelligence (AI) has started to play an integral role in resolving these issues for the health insurance industry. Through its quick automated claim processing, fraud screening, and reduced cost, there are potential improvements in efficiency and patient satisfaction. However, the implementation of AI in health insurance raises some concerns. This literature review examines the ways AI has been used in health insurance practices, as well as the past and prospective repercussions of doing so. AI in health insurance has been the root cause of class action lawsuits due to technological error, placing a devastating financial burden on patients. AI additionally raises ethical concerns on its potential for violating privacy and committing demographic bias. Fortunately, state laws have been implemented to restrict AI’s potential to cause damage. If health insurance companies display untrustworthiness, placing AI into the wrong hands will only increase these consequences. It is important to regulate health insurance use of AI and understand the possible harm. In doing so, potential threats to healthcare will be eliminated. Hopefully, AI can one day reap its full potential in positively impacting the health insurance and healthcare industries.
Thesis Completion Year
2025
Thesis Completion Semester
Summer
Thesis Chair
Linville, Lisa
College
College of Nursing
Department
Nursing Systems
Thesis Discipline
Nursing
Language
English
Access Status
Open Access
Length of Campus Access
None
Campus Location
Orlando (Main) Campus
STARS Citation
Roberts, Alyssa N., "Consequences of Artificial Intelligence in Health Insurance: Lawsuits, Policy, and Ethics" (2025). Honors Undergraduate Theses. 381.
https://stars.library.ucf.edu/hut2024/381
Included in
Artificial Intelligence and Robotics Commons, Bioethics and Medical Ethics Commons, Civil Law Commons, Health Law and Policy Commons, Law and Politics Commons, Public Policy Commons
Rights Statement
