One Year Before Fatal CEO Shooting, UnitedHealth Was Sued for Allegedly Using AI to Deny Coverage

Following the news that United Healthcare CEO Brian Thomspon was fatally shot outside of his hotel in New York City on Dec. 4, the company he once headed has received an unimaginable wave of backlash.

While many are mourning his death and slamming the use of violence against him, others are pointing their focus toward United Healthcare's business practices, bringing attention to the millions of people who have been denied coverage by the insurance provider.

Now, a lawsuit that the company faced just one year before Thompson's murder is resurfacing — one in which the company was accused of using AI to deny coverage claims to elderly patients using Medicare.

Here's what we know about the suit.

When health insurance providers deny coverage to patients, they are often shamed for their lack of human compassion — but what about when the decision is being made by a computer system?

United Healthcare was accused of doing exactly that in a 2023 lawsuit brought against them by the families of two now-deceased patients who were denied coverage.

The suit, which was filed on Nov. 14, 2023, alleged that United Healthcare had employed an AI model "known by the company to have a 90 percent error rate" to override decisions made by the patients' healthcare providers that deemed that medications, procedures, and other medical treatments were necessary, per CBS.

In the cases of the claimants' deceased family members, they were denied coverage for staying at nursing homes

"The elderly are prematurely kicked out of care facilities nationwide or forced to deplete family savings to continue receiving necessary medical care, all because [UnitedHealth's] AI model 'disagrees' with their real live doctors' determinations," the filing claimed.

It further accused the company of taking advantage of the patients' lack of knowledge and resources, as well as their vulnerability due to age and medical state, to ensure that they would not try to appeal the erroneously denied claims.

"UnitedHealth continues to systemically deny claims using their flawed AI model because they know that only a tiny minority of policyholders (roughly 0.2 percent) will appeal denied claims, and the vast majority will either pay out-of-pocket costs or forgo the remainder of their prescribed post-acute care," the lawsuit stated.

The lawsuit is ongoing and none of the claims have been proven in court.

It's unclear whether slain CEO Brian Thomspon had anything to do with the implementation of this technology, but in the wake of his murder, folks have been placing the blame on him.

"If you feel bad for Brian Thompson, I want you to know UHC made 22 billion dollars in profit in 2023. He did that by using a perfectly working AI model that denies 32 percent of its claims, after laying off many of their claims adjusters. He is directly at fault for thousands of deaths," one user on X (formerly Twitter) said.