The murder of Brian Thompson, CEO of UnitedHealthcare, has sent shockwaves across the nation. Thompson, 50, was fatally shot outside a Hilton hotel in Midtown Manhattan in what police are calling a “brazen” and “targeted” attack. While the killer remains at large, speculation is growing that this tragedy might be linked to a controversial AI system used by UnitedHealthcare to deny health insurance claims.
UnitedHealthcare, one of America’s largest health insurers, has faced growing criticism for its use of artificial intelligence (AI) in decision-making. The company implemented the nH Predict AI Model in 2019, a system designed to assess patient data and predict medical outcomes. However, a 2023 lawsuit alleges the AI unfairly denied 90% of claims, leaving many elderly patients without the care they needed.
The lawsuit brought by the families of two elderly patients, Gene Lokken and Dale Tetzloff, paints a troubling picture. Both men were covered under UnitedHealthcare’s Medicare Advantage Plan, yet their claims for necessary medical care were denied by the AI system. Lokken, 92, suffered a fall and required extended post-acute care. While his doctor recommended continued treatment, UnitedHealthcare stopped coverage, claiming it was “not medically necessary.” Lokken’s family was left with massive out-of-pocket expenses, and he passed away in July 2023.
Similarly, Tetzloff, 76, struggled to recover after a stroke. His insurance denied coverage for the care his doctor prescribed, leaving his family burdened with over $70,000 in medical bills. He passed away in October 2023. The lawsuit describes the AI system as a “fraudulent scheme,” alleging it “banks on the patients’ impaired conditions, lack of knowledge, and lack of resources to appeal the erroneous AI-powered decisions.” It further states that the model “fails to adjust for a patient’s individual circumstances,” with 90% of appealed denials being overturned, exposing serious flaws in the system.
Stay up-to-date with the latest news!
Subscribe and start recieving our daily emails.
Investigators found a cryptic message at the murder scene: the words “deny,” “defend,” and “depose” were etched on the shell casings. These terms allegedly reflect tactics used by insurance companies to avoid paying claims. While the motive for Thompson’s murder remains unclear, some speculate it could be tied to anger over denied health coverage. A former FBI agent told Newsweek that the shooter “may have been denied health coverage.” However, police have not confirmed any connection between the lawsuit and the murder.
The nH Predict AI model was developed by NaviHealth Inc., a company acquired by UnitedHealth in 2020 for $2.5 billion. While AI has the potential to revolutionize healthcare by improving efficiency, it raises ethical concerns when it comes to patient care. Critics argue that AI decisions lack the nuance and compassion of human judgment.
This tragic event has reignited debates about the role of AI in healthcare. Can technology truly make life-and-death decisions? And who should be held accountable when it fails? For now, the public waits for justice for Brian Thompson and answers for the families who have suffered under the weight of a flawed system.
Featured image via Political Tribune Gallery
