Artificial intelligence is increasingly being used by insurers to approve or deny medical treatments. According to WETM, algorithms often decide whether care is “medically necessary” and how much treatment a patient can receive—sometimes without oversight or transparency.
Critics argue these systems may delay or deny needed care, particularly for people with chronic illnesses or from marginalized groups. Appeals are rare and slow, leaving many to pay out-of-pocket or forgo treatment altogether.
Though federal and state efforts to regulate insurance AI are growing, most systems still operate without independent review. Experts say FDA oversight may be necessary to ensure safety, fairness, and accountability.
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