The debate around the positive and negative impacts of Artificial Intelligence has existed since the first shoots of progress in the field were seen, and in mid-2023 the first rumblings of disquiet about the potential impact that AI could have was sounded in the US. A class action lawsuit was launched against a major health insurer that had reportedly managed to reject 300,000 claims in the space of just 2 months by the use of AI, with an average time to consider the merits of a case of just 1.2 seconds. The lawyers in pursuit of the insurer asserted that this amounted to abuse of process, and broke both the implicit and explicit contract with policyholders regarding the proper consideration of submitted claims.

I have no idea exactly what the company did, whether they even used AI, or whether the case has any merit. But it did occur to me that the insurer would have been massively impressed and pleased with the decision-making power of the AI being used. At the same time, there was equally massive dissatisfaction amongst their policyholders at the way in which AI (supposedly) was being deployed and the decisions being taken.

From these humble beginnings grew the germ of an idea. That maybe the presence of a Code of Conduct for Claims would serve to guide both the actions of the insurer and any suppliers involved, and also to reassure the claimants that due consideration had been given to the proper use of AI in all its glory. The last 6 months have been a whirlwind of activity amongst many people and this Code of Conduct is the result.