Murdered health insurance boss Brian Thompson backed 'malicious' AI that denied 90% of patient coverage
UnitedHealthcare became the largest denier of insurance plans in 2023, dismissing one in every three claims.
by Ellyn Lapointe For Dailymail.Com
A controversial AI program used to deny elderly people health coverage is now at the center of questions about the shooting of the UnitedHealthcare CEO.
Brian Thompson, 50 was gunned down Wednesday outside a Hilton in Midtown Manhattan in what police have described as a 'brazen' and 'targeted' attack.
The killer is still on the loose and the motive is not yet known - but a former-FBI agent told Newsweek that he may have been denied health coverage.
UnitedHealthcare became the largest denier of insurance plans in 2023, dismissing one in every three claims.
It has now emerged that during the years before that, the company implemented AI software that had a 90 percent denial rate.
A lawsuit has claimed the software led to the deaths of at least two men who were elderly patients denied post care following a stroke and fall.
UnitedHealthcare is said to have launched the nH Predict AI Model in 2019, with Thompson taking over as CEO in April 2021 - years before the lawsuit was filed.
Thompson's shooter, who has yet to be identified, wrote the words 'deny,' 'defend' and 'depose' on the shell casing recovered at the murder scene, which refers to alleged tactics insurance companies are accused of using to avoid paying claims.
The lawsuit claimed that UnitedHealthcare 'banks on the patients' impaired conditions, lack of knowledge, and lack of resources to appeal the erroneous AI-powered decisions.'
The document continued to blast the use of AI as a 'fraudulent scheme' that allows the company a clear financial windfall in the form of policy premiums without having to pay for promised care.'
The nH Predict model was developed by NaviHealth Inc, a Tennessee company acquired by UnitedHealth in 2020 for $2.5 billion, the lawsuit states.
The software analyzes large datasets of patient health records, comparing a patient's data to similar cases within the database to predict future needs and potential outcomes, providing information to health insurance companies.
The model allegedly provided 'generic recommendations' that failed to 'adjust for a patient's individual circumstances and conflict with basic rules on what Medicare Advantage plans must cove,' the lawsuit claims.
The plaintiffs are the families of Gene B. Lokken and Dale Henry Tetzloff, both now-deceased patients who were covered by a Medicare Advantage Plan policy provided by UnitedHealthcare. from at least November 2019 to 2023.
Lokken fell at home and fractured his leg and ankle.
He was admitted to the hospital and before being discharged, he recommended he be admitted to hospice care because his health began to deteriorate.
UnitedHealthcare covered the cost of Lokken's post-acute care at Thorne Crest Senior Living Community in Albert Lea, Minnesota from July 1, 2022 to July 20, 2022.
When coverage was terminated, the insurance company explained: 'More inpatient days at the skilled nursing facility are not medically necessary. A safe discharge plan has been recommended.'
The lawsuit claims that 'medical records submitted to UnitedHealthcare for review indicated that Mr. Lokken was not ready to go home.'
Lokken's out-of-pocket expenses during his stay at the skilled nursing facility amounted to $12,000 to $14,000 per month from July 2022 until July 15 2023 when he passed away at the age of 92.
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I doubt this dude was just outed by some random angry geriatric over health care denial. It’s a great cover up though, he was probably going to something honest for a change, that seems to be the way things go in this evil world.
Good riddance. one less sociopath piece of shit greedy criminal CEO in the business world lining his and the wallstreet banksters pockets with blood money stolen from people thru denial of care.