UnitedHealth allegedly used AI to deny coverage prior to its CEO’s murder

The fatal shooting of UnitedHealthcare CEO Brian Thompson in Manhattan has brought renewed attention to the company’s recent legal challenges and coverage controversies.

The incident: The shooting of UnitedHealthcare CEO Brian Thompson occurred in midtown Manhattan near the Hilton Hotel, where he was scheduled to speak at an investor presentation.

• Thompson, 50, was shot on December 4, 2024, at approximately 6:45 a.m. and was later pronounced dead at Mount Sinai Hospital
• Police described the attack as “brazen” and “targeted,” with the suspect reportedly waiting several minutes for Thompson
• A bullet found at the scene was marked with the words “deny, defend and depose”

Investigation status: The NYPD is pursuing a person of interest in what they describe as a premeditated attack.

• The suspect, who fled on an E-bike toward Central Park, remains at large
• NYPD Commissioner Jessica Tisch confirmed the suspect appeared to deliberately wait for Thompson
• Police have released surveillance images of the person of interest

Legal backdrop: A significant lawsuit filed in November 2023 alleged UnitedHealthcare’s improper use of artificial intelligence in coverage decisions.

• The lawsuit claims the company used AI to deny coverage to elderly Medicare Advantage patients despite a reported 90% error rate
• Two families of deceased patients brought the suit against UnitedHealth Group, UnitedHealthcare, and NaviHealth
• The complaint alleges the company continued using the AI system knowing that only 0.2% of policyholders would appeal denials

Technical details: The lawsuit describes an AI system that makes coverage decisions based on patient data comparisons.

• The system allegedly compares diagnosis, age, living situation, and physical function to predict care needs and discharge dates
• Critics say these AI-generated recommendations are generic and fail to account for individual patient circumstances
• More than 90% of appealed denials are ultimately reversed, according to the lawsuit

Company response: UnitedHealth Group has challenged the lawsuit’s validity while expressing shock at Thompson’s death.

• The company’s lawyers argued in May that the suit should be dismissed, citing plaintiffs’ failure to exhaust administrative appeals
• They contend the issues raised belong with the federal government, not UnitedHealth
• The company released a statement expressing deep sadness over Thompson’s death, describing him as “highly respected”

Public reaction: The shooting has sparked divided responses across social media and news platforms.

• Some critics cited the company’s coverage denials in their responses to Thompson’s death
• Others, including KARE anchor Julie Nelson, condemned insensitive reactions, emphasizing Thompson’s humanity
• The incident has intensified discussions about healthcare coverage practices and corporate accountability

Broader implications: This tragic incident highlights the growing tensions surrounding healthcare coverage decisions and the implementation of AI in medical care management.

• The investigation’s focus on the marked bullet suggests a possible connection to coverage disputes
• The ongoing lawsuit and subsequent shooting may prompt closer scrutiny of AI use in healthcare coverage decisions
• The incident raises questions about the security of healthcare executives and the potential for violence stemming from coverage disputes