Having worked with AI and AI products in my last job before I was let go I can say this:
Out of the box AI is very good at the following:
- Mundane very simple binary/boolean tasks. Is this a yes/no. Can I find a piece of information that I was told is here based on your statement? Etc
- Condensing very complex processes into very simplistic things - NOTE you will lose a lot of information based on this action unless you refine a statement.
- Making overarching summaries - kinda similar to 2 but also its own thing, think more creating a summary of a book.
Programmed AI - read machine learning, because you are still telling it how to interpret things - can be good at (depending how good you are at telling it what it should do):
- Interpreting meaning in a statement.
- Understanding if - then constructs.
- Deducing plausible outcomes.
ALL AI struggles at:
- Interpreting real vs fake (thats why you literally teach it how to understand what a spot light is with your captcha)
- Understanding complexity in speech and tonal differences - I am SO happy to be here /s
- Thinking on its own - using collected data to make an inference that it was not directly programmed to understand
The big craze over AI totally was misunderstood. AI is best to be thought of as Automated Intelligence and the word Artificial at its current state is a complete misnomer.
This is just one example of people having been mislead by the name to not fully understand what is up with AI.
Insurance is defined at its core as a transfer of risk. Its that simple. If insurance denies everything I send their way while I am paying them, its no longer a transfer of risk, I am simply paying someone to tell me 'no'.
That out of the way, the whole health insurance industry does not follow the concept of transfer of risk. The insurance companies rather follow the concept of transfer of action. Basically I am not going to spend all day negotiating with a hospital. That said, them denying is because they do not want to do the work still, so in other words, I am still paying someone to tell me 'no'.
In both concepts, the insurance companies are not doing what they ascribed to. Along with the laws that congress stripped away affordable care to its basics that we all are required to have it - read an extra tax but to corporations who give kick backs to their congressional lackeys - and the fact that insurance companies basically are price fixing all the rates and such, it becomes a lose (you)/lose (you)/lose (hospitals)/only ones who win are the companies.
Late stage capitalism hard at work.