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A Disturbing, Viral Twitter Thread Reveals How AI-Powered Insurance Can Go Wrong (vox.com) 49

An anonymous reader quotes a report from Vox: Lemonade, the fast-growing, machine learning-powered insurance app, put out a real lemon of a Twitter thread on Monday with a proud declaration that its AI analyzes videos of customers when determining if their claims are fraudulent. The company has been trying to explain itself and its business model -- and fend off serious accusations of bias, discrimination, and general creepiness -- ever since. [...] Over a series of seven tweets, Lemonade claimed that it gathers more than 1,600 "data points" about its users -- "100X more data than traditional insurance carriers," the company claimed. The thread didn't say what those data points are or how and when they're collected, simply that they produce "nuanced profiles" and "remarkably predictive insights" which help Lemonade determine, in apparently granular detail, its customers' "level of risk." Lemonade then provided an example of how its AI "carefully analyzes" videos that it asks customers making claims to send in "for signs of fraud," including "non-verbal cues." Traditional insurers are unable to use video this way, Lemonade said, crediting its AI for helping it improve its loss ratios: that is, taking in more in premiums than it had to pay out in claims. Lemonade used to pay out a lot more than it took in, which the company said was "friggin terrible." Now, the thread said, it takes in more than it pays out.

The Twitter thread made the rounds to a horrified and growing audience, drawing the requisite comparisons to the dystopian tech television series Black Mirror and prompting people to ask if their claims would be denied because of the color of their skin, or if Lemonade's claims bot, "AI Jim," decided that they looked like they were lying. What, many wondered, did Lemonade mean by "non-verbal cues?" Threats to cancel policies (and screenshot evidence from people who did cancel) mounted. By Wednesday, the company walked back its claims, deleting the thread and replacing it with a new Twitter thread and blog post. You know you've really messed up when your company's apology Twitter thread includes the word "phrenology." "The Twitter thread was poorly worded, and as you note, it alarmed people on Twitter and sparked a debate spreading falsehoods," a spokesperson for Lemonade told Recode. "Our users aren't treated differently based on their appearance, disability, or any other personal characteristic, and AI has not been and will not be used to auto-reject claims."

The company also maintains that it doesn't profit from denying claims and that it takes a flat fee from customer premiums and uses the rest to pay claims. Anything left over goes to charity (the company says it donated $1.13 million in 2020). But this model assumes that the customer is paying more in premiums than what they're asking for in claims. So, what's really going on here? According to Lemonade, the claim videos customers have to send are merely to let them explain their claims in their own words, and the "non-verbal cues" are facial recognition technology used to make sure one person isn't making claims under multiple identities. Any potential fraud, the company says, is flagged for a human to review and make the decision to accept or deny the claim. AI Jim doesn't deny claims. The blog post also didn't address -- nor did the company answer Recode's questions about -- how Lemonade's AI and its many data points are used in other parts of the insurance process, like determining premiums or if someone is too risky to insure at all.

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A Disturbing, Viral Twitter Thread Reveals How AI-Powered Insurance Can Go Wrong

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  • by Krishnoid ( 984597 ) on Thursday May 27, 2021 @04:34PM (#61429362) Journal

    which help Lemonade determine, in apparently granular detail, its customers' "level of risk."

    So the detail is large enough to see the grains, or small enough that it's grain-sized, i.e., coarse-grained or fine-grained? That's the part that really grinds my gears.

  • by dmitch33 ( 6254132 ) on Thursday May 27, 2021 @04:40PM (#61429378)
    I've worked for a major insurance carrier programming rates and what they are claiming is 100% bull! You have to be Generation Zero to believe this claim, "The company also maintains that it doesn't profit from denying claims and that it takes a flat fee from customer premiums and uses the rest to pay claims. ". Gee. Let me think. If they deny a claim they don't pay for the claim. How simple can you get??? And where does this money go if they don't pay for a claim? Oh I forgot. Denied claims are paid out in bonuses to the CEO and those who do the best at denying claims in their yearly bonus.
    • by reanjr ( 588767 ) on Thursday May 27, 2021 @04:53PM (#61429416) Homepage

      "Anything left over goes to charity"

      Literally the next sentence in the summary after the one that made you angry.

      • "Anything left over goes to charity"

        That's BS. Charity funds are fungible. If you want to donate to a charity, donate to a specific one you know and trust.

        There are too many charities, with questionable records, led by the girlfriends or wives or relatives of CEOs. Then the charity's funds just become a slush fund for the CEO's every whim.

        • by Anubis IV ( 1279820 ) on Thursday May 27, 2021 @06:11PM (#61429652)

          "Anything left over goes to charity"

          That's BS.

          It's not. Lemonade is a registered Public Benefit Corporation, so they are legally obligated to operate in a way that's somewhat akin to a charity, even though they're still a for-profit company. They keep a flat 25% on any premium payment and use the other 75% to cover claims/reinsurance. Anything left from that 75% gets donated to charity once a year.

          Read about their Giveback program [lemonade.com] for yourself. It's the key thing that differentiates them from other insurance companies, and the fact that it aligns their incentives with my own is why I actually switched to them about a year ago. I just had to make my first claim last month (for a brand new roof after a hailstorm), and the process couldn't have been simpler. They're half the cost of my previous insurance company and were WAY easier to deal with than the previous insurer was when someone ran a car into my house.

      • by AmiMoJo ( 196126 )

        Left over (after the CEO bonus)

        • by Anubis IV ( 1279820 ) on Thursday May 27, 2021 @06:06PM (#61429642)

          Left over (after the CEO bonus)

          Not so. The funds are pulled from a separate pool.

          You can read up on Lemonade's business model and Giveback program [lemonade.com] here, but the gist of it is that they aren't a typical insurance company. Rather, they are a registered Public Benefit Corporation, and as such are legally obligated to operate for a social benefit. A flat 25% of its customers' premium payments go to their own costs, which is where they'd pay out any bonuses from, while the other 75% of the payments are used to pay out claims and purchase their own reinsurance. Anything left of that 75% at the end of the year gets paid out to charities that their customers select. So whether they pay out a claim or not doesn't matter: they aren't keeping that money, nor will it be available to pay their CEO a bonus.

          Read up for yourself. Here's where they announced the switch to being a Public Benefit Corporation: https://www.lemonade.com/blog/... [lemonade.com]
          Here's their FAQ: https://www.lemonade.com/faq [lemonade.com]

          I've been using Lemonade for the last year or so and love them. They're half the cost of my previous homeowner's insurance, and I had no hassle at all when I made a claim a few weeks ago for a full roof replacement. The money to pay the roofers was even in my bank account before I saw the notification for the email where they told me they approved my claim.

    • by Anubis IV ( 1279820 ) on Thursday May 27, 2021 @05:57PM (#61429618)

      I've worked for a major insurance carrier programming rates and what they are claiming is 100% bull! [...] And where does this money go if they don't pay for a claim? Oh I forgot. Denied claims are paid out in bonuses to the CEO and those who do the best at denying claims in their yearly bonus.

      No, Lemonade doesn't use denied claims that way. Lemonade isn't a typical for-profit company: they're a registered Public Benefit Corporation [wikipedia.org] with a B-Corp certification, and as such are legally obligated to operate in a way that's somewhat more akin to what we might expect of a registered charity, even though they are still a for-profit corporation.

      The way they do that is by "giving back" [lemonade.com] (check the Giveback section at the end) any premium payments they collect that aren't spent during the year. And to keep themselves from having an incentive to deny claims, the way that works is that they take a flat 25% from each premium payment (this is where bonuses would come from), then use the other 75% to cover the costs of paying out claims or purchasing their own reinsurance (i.e. insurance with Lloyd's of London for if they don't have enough to pay out claims). If there's anything left of that 75% at the end of the year, it gets paid out to charities selected by their customers.

      So, whether it's paid out in a claim or paid out to charity, Lemonade never keeps any of the money related to denied claims. They keep the flat 25%, but claims aren't paid out of that portion, so they really don't have much reason to deny a claim, and if you check the reviews online, you'll find that the claims processes and approvals are simple and easy for the vast majority of their customers.

      Including me.

      I actually switched to Lemonade about a year ago after doing some research and loving that they had a business model that didn't incentivize denying claims. They were less than half the price of my previous homeowner's + VPP insurance and the process for signing up couldn't have been simpler, since it was nearly entirely automated. I had to make my first claim a few weeks ago after a hailstorm came through. Roofers suggested I needed a whole new roof, so I hit up the Lemonade app, clicked the button to make a claim, answered some quick prompts in a chatbot, recorded a 20-ish second video of me basically saying, "we had a hailstorm and this roofer next to me says I need a new roof", they sent out an adjuster a few days later, and my claim was approved the next day to the tune of $14K, with the first payment hitting my bank account even before I saw the email that said the claim was approved.

      Couldn't have been simpler.

      As for this current stuff, I'm not pleased to hear any of it, but it sounds like they're using the AI to flag suspicious videos for review while letting deemed-valid ones through without a human review. I'm fine with that. It's the converse with which I'd have an issue. Otherwise, I've frankly been so impressed by their operation and how smartly they've automated things to keep their costs low (while still making humans available when you need them) that I honestly just don't care about a Twitter tempest in a teapot or people on Slashdot who spout off without knowing relevant details about how the company operates.

      • Four people take out an insurance, then all four have an accident.
        For their business model to work, they simply have to deny one person regardless of validity of their claim.
        And that's at "stuffing money under mattress" payout level - dollar in, dollar out, disregarding inflation.

        I.e. For them to be both making money AND giving to charity they'd have to be either a) denying claims like crazy, b) making money in other ways (i.e. lying about flat 25% off the top source of income), c) charging their customers

        • Many companies including insurance companies make charitable contributions, pay expenses, and make money at the same time. These are not mutually exclusive or unique to Lemonade. You can even do this with a lemonaid company.
          • Such companies don't make claims that they're only taking 25% "off the top" flat fee, being a "public-benefit corporation" or that they are "keep[ing] themselves from having an incentive to deny claims incentive to deny claims" - while actively investing in algorithmic black boxes which were clearly trained to maximize "taking in more in premiums than it had to pay out in claims".

            I.e. They are not practicing this particular form of bullshitting their customers - a psychological, feel-good, scheme for gullib

            • I think you would agree that most companies practice some sort of BS/marketing to get customers to pay more for their product than the actual cost to produce it, i.e. earn a profit. Even charities have to take in more in donations than they give back. It sounds like the concept of social charity corporations is not to your liking or you just don't like this particular one, so thanks for sharing your opinion. In a perfect world customers wouldn't submit BS claims and insurance companies would never deny a cl
        • Four people take out an insurance, then all four have an accident [...]

          Where to even start on how wrong your analysis is...?

          - You're treating outliers as the norm
          - You overlooked that premiums are sized to the risk involved
          - You're ignoring the role of geography and scale in mitigating risk
          - You've disregarded the reinsurance that has already been talked about in this thread
          - You're acting as if you didn't just hear me say that they were half the price of my previous insurer
          - You clearly missed them saying this is facial recognition tech being used to flag fraud based on ident

      • the way that works is that they take a flat 25% from each premium payment (this is where bonuses would come from), then use the other 75% to cover the costs of paying out claims or purchasing their own reinsurance (i.e. insurance with Lloyd's of London for if they don't have enough to pay out claims). If there's anything left of that 75% at the end of the year, it gets paid out to charities selected by their customers.

        Interesting. My concern would be that they are incentivized to overcharge customers on the following basis: Their operating budget (salaries, offices, perks, etc.) is fixed at 25% of premiums charged, ergo the greater the premiums they charge, the more operating budget they have to pay themselves with.

        If they consistently have money left from the 75% after paying out claims, then that would serve as evidence they are overcharging. This is something that would have to be analyzed on an ongoing basis -ther

        • Completely agreed. While all insurance companies are incentivized to increase prices so that they can pocket more, the fact that Lemonade only pockets 25% for itself means that if they want to bring in $X more, they need to raise cumulative rates by 4x that amount, whereas a traditional insurer would only need to raise cumulative rates by $X, since they get to pocket 100% of any excess.

          For my part, they've been significantly cheaper than my previous insurance company, and 25% seems like a healthy amount to

  • the "non-verbal cues" are facial recognition technology used to make sure one person isn't making claims under multiple identities

    That... does not match the common/garden meaning of the phrase "non-verbal cues". That sounds like something you come up with to distract attention while you're furiously back-pedalling because people are correct that you have an algorithm trying to play lie detector, and potentially picking up human biases from its training data in the process.

  • by phalse phace ( 454635 ) on Thursday May 27, 2021 @05:11PM (#61429478)

    The company also maintains that it doesn't profit from denying claims and that it takes a flat fee from customer premiums and uses the rest to pay claims. Anything left over goes to charity (the company says it donated $1.13 million in 2020).

    Why isn't the excess insurance payments being returned to the customers?

    I would think that lower premiums would bring in more customers.

  • Yeah, Lemonade sounds like the scummiest of scummy insurance companies. Even if I couldn't get USAA, literally any company that advertises on TV would be a better choice. And even then, right now the only product Lemonade has that I'd use is renter's insurance, and at like $15 a month from USAA I can't imagine how they could beat that.
  • by Whateverthisis ( 7004192 ) on Thursday May 27, 2021 @05:27PM (#61429526)
    Tyrell: "So how many questions does it take to reject an insurance claim?"

    Decker: "20, 30 maybe, cross-referenced."

  • by ceoyoyo ( 59147 ) on Thursday May 27, 2021 @05:37PM (#61429556)

    I was involved with a startup incubator thing once. Bunch of MBA types and some aspiring AI company founders. We were chatting in the pub one evening and one of the MBA types was going on about AI-powered insurance. His idea was that you'd have an app that would monitor your driving, and give you a rate that varied in realtime based on AI assessment of your background, location, accelerometer input, etc.

    I sipped my beer, laughed, and commented that people would absolutely hate that, and at some point your AI would commit PR suicide for you.

  • by King_TJ ( 85913 ) on Thursday May 27, 2021 @05:43PM (#61429580) Journal

    They promised a cheaper, better way to do car insurance, etc. etc.

    I'm always happy to find a lower rate so I researched them a bit.

    A buddy of mine in the industry said to watch out for them, because essentially, they just put customer money in a savings "pot" that starts over annually. This might work fine as long as things remain "business as usual". But the real risk is when you get into big disaster scenarios. Say there's an earthquake or hurricane damage along a swath of cities with a lot of people insured with them. The "pot" is going to get drained instantly and they're going to default on paying the remainder of the claims.

    • by Anubis IV ( 1279820 ) on Thursday May 27, 2021 @07:54PM (#61429878)

      A buddy of mine in the industry said to watch out for them, because essentially, they just put customer money in a savings "pot" that starts over annually. This might work fine as long as things remain "business as usual". But the real risk is when you get into big disaster scenarios. Say there's an earthquake or hurricane damage along a swath of cities with a lot of people insured with them. The "pot" is going to get drained instantly and they're going to default on paying the remainder of the claims.

      This is FUD. Like any small insurance company that doesn’t want to go bankrupt within a decade, they’re reinsured (in their case, through Lloyd’s of London) to deal with exactly that sort of scenario.

      The way they operate is simple:
      - They keep a flat 25% of premium payments.
      - The remaining 75% is used to pay out claims and to purchase reinsurance. Anything left over at the end of the year from this pot gets paid out to charities that their customers select.

      Thus, if a major disaster hits, they have reinsurance to cover it, the same as every other decent insurance company. And if a major disaster doesn’t hit, they pay out the leftover claims money to charity. Because they don’t keep the funds either way, they have no incentive to deny valid claims, so if you look through reviews online, you’ll find loads of people saying they’re really easy to work with.

      That’s certainly been my experience with them. I switched to them a year ago for homeowner’s and VPP. They’re half the cost of what I was paying, provide better coverage, and I had zero hassle when I filed my first claim with them, just last month for hail damage. They approved a full roof replacement a day after the adjuster did his inspection, and the up front part of the $14K claim was in my bank account even before I saw the email saying they had approved the claim.

      I had my doubts, but I did my research, have probably saved over $1000 in premiums from what I would’ve paid otherwise at this point, and had a great claims experience, so at least in my anecdotal, firsthand experience, they check out.

      • This is FUD. Like any small insurance company that doesn’t want to go bankrupt within a decade, they’re reinsured (in their case, through Lloyd’s of London) to deal with exactly that sort of scenario.

        The way they operate is simple: - They keep a flat 25% of premium payments. - The remaining 75% is used to pay out claims and to purchase reinsurance. Anything left over at the end of the year from this pot gets paid out to charities that their customers select.

        My insurer pays out a dividend if there is anything leftover in that "pot" at the end of the year. Nice to get a discount.

        • My previous one did as well. Their premiums were also twice as expensive after a few years of jumps for no apparent reason and the dividend amounted to a few bucks a month on a premium that was approaching $200 each month, but still, it was nice.

    • by jbengt ( 874751 )

      A buddy of mine in the industry said to watch out for them, because essentially, they just put customer money in a savings "pot" that starts over annually. This might work fine as long as things remain "business as usual". But the real risk is when you get into big disaster scenarios

      Aren't insurance companies insured against things like that?

  • They failed to assess the relative risk of posting this crap on Twitter.
  • I for one welcome our new, summer beverage named AI overlords.

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