AI Legal Defensibility: How to Protect Yourself in Court, Audits, and Claims Reviews
AI Can Assist, But You’ll Be Cross-Examined:
Legal Defensibility for Legal, Medical, and Insurance Professionals
By Nikki Mehrpoo, The MedLegal Professor™
Founder, Immployment.AI | LegalTech Strategist | Former WC Judge
Your AI tool will not be on the witness stand. You will. Let us make sure your process holds up—ethically, legally, and under oath.
Let’s Be Clear: You Can Use AI, But You’ll Have to Defend It
I did not choose this title to be clever. I chose it because it is courtroom truth. AI can absolutely assist you, but you will be the one on the record, on the stand, or in the deposition when something goes sideways. You will be the one cross-examined. That is not fear, it is fact. Whether you are a lawyer submitting a motion, a physician signing a report, or an adjuster issuing a denial, your human judgment is what will be judged.
The good news? When AI is used intelligently, ethically, and transparently, it can enhance your credibility, not threaten it. That is the goal of this guide: not just to flag what can go wrong, but to model what it looks like when we get it right. Because this is not just about adapting to AI. It is about leading the transformation and shaping the very framework that others will follow.
To begin, let us define what is at stake when we talk about AI in regulated industries.
What Does “Legal Defensibility” Really Mean?
Legal defensibility means being able to show why a decision was made and how it was made, step by step. It is not just about being right. It is about proving you followed the rules, used good judgment, and can explain your process clearly. And now, in 2025, that includes how you used AI.
If you work in workers’ compensation, law, medicine, or insurance, you are likely already using AI tools, whether for writing letters, sorting records, reviewing claims, or more. That means you need to understand not only what the AI does, but also how to supervise it.
Your license, your reputation, and your client’s outcome depend on it.
If AI shaped the decision, your fingerprints better be on the process. You do not get to say, “The tool decided.” You say, “I decided, and here is how I used the tool.” Own the outcome. Lead the process. Defensibility is not just smart, it is your professional armor.
Once you understand your responsibilities, the next critical point is recognizing your authority.
AI Is a Tool, But You’re Still in Charge
Let me be very clear. AI cannot take the blame if something goes wrong. You are the professional. You are the one who must make sure AI is used safely, fairly, and legally.
Think of AI like a helpful assistant or witness. If the AI gave input into a decision, you need to know what it said, why it said it, and how it shaped your final call. If that decision gets challenged by a judge, a board, or a client, you need a clear record of everything that happened.
In court, in hearings, or under audit, there is one voice they want to hear. Yours. Not the chatbot. Not the software. Yours. Make sure your name stands for clarity, not confusion. Be the leader who used AI to enhance judgment, not replace it.
This leads us to a practical foundation. What exactly makes an AI decision defensible?
What Makes an AI Decision Legally Defensible?
You can explain it in plain English
You logged it and saved the prompt
You reviewed it before acting
You can name the person who signed off
You can trace the data back to trusted sources
If you cannot check all five boxes, you are flying without a seatbelt.
To help you check every box, you need rules that support structure, accountability, and alignment.
The 5 Rules of Defensible AI Use
To protect yourself and your organization, always follow these five rules:
Explainability
Auditability
Documentation
Data Integrity
Regulatory Alignment
If you cannot explain it, prove it, trace it, or trust it, do not use it.
You would not submit a report without signing it. You would not approve a claim without reviewing it. So why let AI into the process without structure? These five rules are not nice-to-haves. They are your legal seatbelt. Buckle up before you click “Run.”
And to bring those five rules to life, you need to track each decision, start to finish.
Build Your AI Decision Trail
Want to protect yourself in case of a dispute? Create what I call the AI Decision Trail. It is your record of how each AI-influenced decision was made.
AI Decision Trail: Input → Tool → Prompt → Output → Review → Decision → Archive
If you are missing one link in this chain, your decision may not survive the cross-exam.
If it is not written down, it did not happen. Think like a litigator. Think like a regulator. Think like a leader. Your AI trail is not extra paperwork. It is your protection plan. Build it once. Use it always.
What if that trail leads to a courtroom? Here is what you can expect.
What Happens When AI Goes to Court?
When challenged, the court will ask:
Can you prove what the tool did?
Was it tested and trustworthy?
Did a human review it?
Can you explain it clearly?
Mata v. Avianca. Loomis. Sanchez. Case law says it loud and clear. AI is not an excuse.
You do not need to fear the courtroom. You just need to be prepared for it. Use AI like it is already Exhibit A. The stronger your process, the stronger your defense.
Preparation means avoiding preventable errors that can undermine your credibility.
Common Mistakes to Avoid
Letting AI write something with no review
Failing to save prompts or logs
Using unapproved tools
Denying care or coverage with no human sign-off
Not disclosing AI use when required
These are not just workflow errors. They are legal liabilities. Stop them at the source with smart systems and real-time training.
Now that we know what to avoid, let’s outline what to do.
Your AI Use Checklist
Before you approve or submit anything AI-touched:
Prompt saved?
Data source verified?
Licensed reviewer signed off?
Tool approved for use?
Logs and rationale documented?
If you would not stand by it under oath, do not send it from your inbox. That is the new baseline.
To reinforce this guidance, here are examples that make it real.
Real Examples: Right vs. Wrong
Attorney:
Wrong: Files brief with fake citations
Right: Uses AI for draft, verifies, discloses use
Physician:
Wrong: Copies AI charting with no review
Right: Reviews, edits, signs, adds attestation
Claims Pro:
Wrong: Auto-denies claim from black-box tool
Right: Uses AI to flag, signs off with documentation
You know how to practice safely and ethically. Let AI amplify your expertise, not automate your mistakes.
And as the landscape changes, here is what to watch for next.
What’s Coming Next
Watch for:
State rules requiring explainability
AI disclosure mandates in court
Licensing board audits
New SOP requirements
Prompt logs as legal exhibits
You do not want to be catching up. You want to be setting the standard. When the rules come knocking, you will already be doing it right.
Final Word from The MedLegal Professor™
In 2025, legal defensibility is not about being perfect. It is about being prepared, principled, and precise.
If a tool helped shape a claim, a diagnosis, a chart, or a denial, then you must be able to explain and defend how that tool was used.
You do not have to be an AI expert. But you do have to lead like one.
I built this framework not just for compliance, but for confidence. Because if you are making decisions that affect lives, claims, or care, then I want you to walk into that deposition, hearing, or board review like the powerhouse you are. Trained. Prepared. Unshakable.
This is not just professional commentary. It is a blueprint. And it is how we make this system smarter, safer, and more credible for everyone who depends on it.
Call to Action
Attorneys: Add “AI Review” to your discovery prep
Physicians: Flag and sign off on AI-influenced charting
Insurers: Require documented human review on AI-denied claims
Want the TMP AI Defensibility Checklist? Need help training your staff or reviewing your AI systems?
Email me at [email protected] or visit MedLegalProfessor.AI. Let us future-proof your practice, together.
