Copyright International Business Times
Artificial intelligence is quickly establishing its presence in the U.S. health insurance industry, bringing faster claim reviews, quicker authorizations, and lower administrative costs to a system known for being complex and cumbersome. But a new survey shows that what Americans really want from their insurers isn't more algorithms, it's more honesty. A national poll commissioned by health technology firm Zyter|TruCare found that most Americans are wary of how insurers are using AI in their decision-making. Sixty-seven percent of respondents said they worry AI could unfairly deny care, while about half said they would value the technology if it sped up authorizations and reduced delays. In other words, consumers are not rejecting the technology itself, they are lamenting how little they know about it. Two-thirds of respondents said they want insurers to disclose, in plain language, whenever AI is used to review their claims or prior-authorization requests. It's clear that transparency and human oversight matter more to consumers than automation alone. "Consumers aren't rejecting AI, they're asking for confidence and clarity," said Sundar Subramanian, CEO of Zyter|TruCare. "They want assurance that the technology is being used to make their lives easier, without adding more risk, and that a human is always making the final call." The Trust Gap at the Heart of Health AI The findings come at a pivotal moment for the insurance industry. Health plans across the country are ramping up investments in AI tools to streamline medical reviews and accelerate claims processing. Machine learning models can sift through hundreds of pages of clinical documentation in seconds, flag relevant data, and even recommend whether a claim should be approved or denied. For insurers, that level of efficiency can save millions of dollars. But for consumers, it can feel like losing control. The same efficiency that makes AI appealing to insurers can make it intimidating for patients. Most Americans have never been told that an algorithm might have played a role in deciding whether their MRI was covered, or whether their physical therapy was medically necessary. And that lack of disclosure is breeding skepticism. Zyter|TruCare's data show that 51% of consumers still trust a human claims analyst more than an AI system, but they are open to change if transparency improves. That openness is critical because health insurers are entering an era where automation will no longer be optional. When Explainability Drives Adoption Zyter|TruCare's research also highlights a crucial lesson from the clinical side of the equation. In a separate study, the company found that when doctors and nurses understood how AI generated its recommendations, acceptance of those systems jumped from 13% to 67%. Once users can see how an algorithm reaches its conclusions, the resistance fades. That principle applies equally to consumers. If people understand how AI helps speed up approvals or reduces paperwork for clinicians, they are more likely to view it as a benefit rather than a threat. The problem is that few insurers are communicating that story directly to members. Many health plans have spent years focusing on internal efficiency or provider relationships, Subramanian pointed out, while neglecting consumer engagement. "It's time to engage consumers directly," he said, "showing them how AI can lead to faster, fairer, and more personalized care decisions." The Policy Pressure Is Mounting This trust gap is not just a public-relations challenge. It could soon become a regulatory issue. Federal and state officials have already signaled plans to scrutinize how AI is used in health insurance coverage decisions. Lawmakers are asking whether automated reviews could violate patient rights, and regulators are pushing for clearer accountability when algorithms influence medical determinations. That growing attention means transparency is likely to become a legal requirement, not just a branding opportunity. Health insurers that adopt clear disclosure policies early could find themselves ahead of the curve, while those that resist may face backlash from both regulators and consumers. A Competitive Advantage in Clarity For the industry, the takeaway is that transparency is not a compliance issue, it's a competitive advantage. Consumers are signaling that they will reward insurers who treat them as partners in the process rather than as data points. Health plans that can explain, in plain English, how AI helps them make faster, fairer decisions will build loyalty in an environment where trust is already thin. AI can make healthcare administration faster, but only human communication can make it trusted. If insurers hope to realize the full promise of automation, they will have to pair every algorithm with a clear explanation, and every decision with a human face. In the end, it won't be software programs that earn consumers' trust, it will be transparency.
