Ai Letterhead AI & Injury Law Canada Issue #1

The landscape of personal injury law is shifting — and artificial intelligence is accelerating the change. Each week, this newsletter explores the critical intersection of injury claims, insurance practices, and emerging AI technologies, with a sharp focus on what Canadian lawyers need to know.

The realm of personal injury litigation is currently undergoing a significant transformation, influenced by the emergence of AI-driven claim denials and the incorporation of algorithmic decision-making within the healthcare and insurance sectors. As these sophisticated technologies continue to gain traction, it is crucial for legal professionals and stakeholders to comprehend the extensive implications these systems have on the complexities inherent in personal injury cases.

This paradigm shift not only highlights the importance of understanding the multifaceted mechanisms that govern access to medical care, fair compensation, and the pursuit of justice but also calls for a critical examination of the ways in which algorithms and artificial intelligence influence decision-making. While traditional components like detailed medical reports and thorough accident reconstructions continue to hold their ground, they are now augmented by the pressing need to investigate the impact of technological frameworks on outcomes for individuals seeking redress.

The interplay between human factors and machine-driven analytics has never been more significant. As this field progresses, remaining vigilant and informed about technological advancements will be essential for successfully navigating the complexities of personal injury claims and effectively advocating for clients in a landscape that is increasingly characterized by innovation and technological prowess

This issue unpacks the headline-making UHC class action in the U.S., offers fresh legal insights through a Canadian lens, and spotlights key cases, expert voices, and actionable takeaways. Whether you’re in the courtroom or the boardroom, staying ahead of AI’s legal impact isn’t optional — it’s essential.

Let’s dive in.

🧠 When AI Denies Care: What PI Lawyers Can Learn from the UHC Class Action

In late 2023, a major class action lawsuit was filed in the United States against United Healthcare (UHC), alleging that the insurer systematically denied extended care benefits based on an artificial intelligence model — without proper physician oversight. At the center of the case is an algorithm known as nH Predict, which reportedly assessed elderly or injured patients and determined — often inaccurately — that care should end, regardless of doctors' actual recommendations.

 While this case is unfolding south of the border, the implications for personal injury (PI) law in Canada and beyond are hard to ignore.

🧩 Why This Matters for PI Law

Extended care — such as rehabilitation, long-term physiotherapy, or skilled nursing — often forms a core component of damages in personal injury cases, especially those involving:

 · Catastrophic injuries (e.g., spinal cord, traumatic brain injury)

 · Long-term disability or loss of function

 · Elderly plaintiffs with complex recovery needs

 If an AI model can deny or limit access to care, that:

 · Directly reduces the amount recoverable in damages

 · Undermines a treating physician’s opinion, which is typically central to claim valuation

 · Disrupts continuity of care, which may worsen health outcomes and complicate causation arguments

 · Furthermore, automated denials may delay essential treatments, increasing harm and extending recovery time — potentially giving rise to additional heads of damage.

🧑‍💻 Expert Witnesses Are Evolving

Just like we call medical experts to speak to injuries, we’ll need technical experts to:

 · Explain how an algorithm works (or fails to)

 · Analyze data inputs and outputs

 · Comment on industry standards for automation

 For high-value claims, retaining an AI ethics or data science expert could become essential — especially when fighting back against opaque or proprietary decision tools.

 Think of this like the evolution of accident reconstruction experts — except now it’s algorithm reconstruction.

⚖️ Key Legal Takeaways for PI Lawyers

1. AI Bias and Opaqueness are Litigable Issues

Many AI models, including those used in insurance, are proprietary and unexplainable (“black box” systems). When an insurer uses such a model to deny care:

 Demand disclosure of the algorithm’s logic and decision-making criteria

Raise procedural fairness concerns, especially if the model overrode clinical expertise

2. Bad Faith Denial Risks Are Heightened

If insurers knowingly use flawed or unreliable AI to automate denials, this can strengthen arguments for bad faith and punitive damages, especially in jurisdictions with strong consumer protection laws.

3. Expert Evidence Will Evolve

Future PI litigation may require AI ethics experts, data scientists, or forensic analysts to:

 Challenge the scientific basis of impairment or care denial scores

 Reconstruct how a decision was made in the absence of transparency

 4. Settlement Calculations Could Be Impacted

In the context of pre-litigation processes, there is a concern that AI tools may inadvertently lead to reduced claim values, evidenced by lower impairment scores or estimated recovery times. It is essential for plaintiff attorneys to meticulously assess the automated reports generated by these tools. By doing so, they can effectively advocate for a thorough human reassessment to ensure that their clients receive equitable treatment and appropriate compensation.

 A Canadian Lens:

While no parallel case has yet emerged in Canada involving AI denial of care in personal injury claims, the UHC class action offers a cautionary tale. Canada’s legal and regulatory framework has historically demanded greater transparency and human accountability — but with the rapid digitization of the insurance sector, similar disputes may not be far behind.

As insurers integrate machine learning into their workflows, PI lawyers must:

 · Stay informed about how AI is used in claim adjudication

 · Assert their clients' right to fair, human-reviewed decisions

 · Push for clearer audit trails and model explainability in litigation

📢 Bottom Line

AI has arrived in the courtroom, whether we're ready or not. For personal injury lawyers, this means evolving your strategy to ensure that your clients’ care, compensation, and dignity aren’t left to the whims of an algorithm. 

⚖️ Canadian Case Watch

Thiessen v. Kepfer, 2025 BCSC 127 -- BC Supreme Court

A decision by the British Columbia Supreme Court (BCSC) regarding the costs awarded after a personal injury trial.

📌 Key insight: Thiessen won a large amount of money in their car accident case. This specific court decision was about who pays the legal bills. Because Thiessen had tried to settle the case for a lower amount before trial, and they ended up winning even more money at trial, the court said that Kepfer has to pay double the usual legal costs from a certain point. However, the court didn't think Kepfer's behavior was bad enough to warrant even more extra costs.  

So, while Thiessen got a significant damage award, this particular ruling focused on making Kepfer pay more for the legal process because they didn't take a reasonable chance to settle earlier.

→ Read Summary

📈 Quick Bytes

1. Ontario’s Deductible Jump

As of Jan 1, 2025, the statutory deductible for pain and suffering in MVA claims rose to $46,790.05, making it even harder for soft tissue injury victims to recover non-pecuniary damages.

→ PI Tip: Carefully screen cases for threshold viability early.

2. AI Ethics Enters the Courtroom

The Canadian Judicial Council issued draft guidance on AI in judicial decision-making, urging transparency and human oversight.

→ PI Tip: Start asking whether insurer decisions were assisted by automation.

3. Latifi v. The TDL Group Corp. (2025)

The B.C. Court of Appeal clarified the standard for conspiracy claims in injury cases, emphasizing that harm must stem from the primary goal of the agreement, not just incidental effects.

→ PI Tip: Use this as a framework for challenging multi-party conspiracy claims.

 🎙️  Expert Voices

Interview: “How will AI impact the legal profession?”

With: [Hannah Smith and Bennett Borden]

Topics: Case evaluation, Data Protection and Confidentiality, traditional billing models

Quote: “If you think about every practice area that a lawyer could work in we fundamentally are dealers in information we gather it we analyze it we add our legal acumen to it and then we deliver it and so any kind of tools that make any of those steps easier is going to have an impact on how we practice law what's interesting to us is that it's not that AI is going to replace lawyers it's that lawyers who use AI are going to replace lawyers who don't So what we need to think about is how do we take advantage of this technology without it disrupting how we do business.”

Interpretation: This quote speaks volumes about the transformative power of AI in the legal profession. At its core, it reframes law not just as a matter of precedent or procedure—but as a sophisticated process of information handling. Lawyers are, essentially, information strategists: they gather facts, analyze them, apply legal reasoning, and communicate insight. This quote captures how AI supercharges each of these steps.

AI accelerates information gathering through tools like legal research assistants and document review platforms. It enhances analysis by uncovering patterns or risks that a human might overlook. And it even supports delivery—through drafting tools, chatbots for client interaction, or AI-enhanced case prediction. In short, AI doesn’t change what lawyers do—it amplifies how well they do it.

The most powerful line in the quote is this: “It’s not that AI is going to replace lawyers—it’s that lawyers who use AI are going to replace lawyers who don’t.” This is a wake-up call. AI is not a threat; it’s a lever of competitive advantage. Lawyers who integrate AI into their workflows will be faster, more accurate, and more client-responsive than those who don’t. It’s a future where legal expertise is augmented, not replaced.

So, the challenge isn’t resisting disruption—it’s embracing transformation without compromising core legal values. The legal profession must now focus on how to integrate AI tools ethically, effectively, and strategically. Those who do will define the future of legal practice.

 📩 Stay Smart, Stay Ahead

If you found this valuable, please forward it to a friend or colleague in PI law, legal ops, or insurance.

 💬 Got a story tip, tool to test, or want to collaborate? Email me at [email protected]