Contradictory AI A program used to deny seniors access to health care is now at the center of questions surrounding the assassination of UnitedHealthcare’s CEO.
Brian Thompson, 50 was was shot on Wednesday outside of the Hilton in Midtown Manhattan in what police described as ‘senseless’ and ‘targeted’.
The killer is still at large and the motive is still unknown — but a former FBI agent told Newsweek that he may have been denied medical treatment.
UnitedHealthcare became the biggest opponent of insurance plans in 2023, rejecting one of every three conditions.
It is now known that years ago, the company launched an AI program that had a 90 percent rejection rate.
The lawsuit alleges the program led to the deaths of at least two elderly men who were denied treatment after suffering a stroke and a fall.
UnitedHealthcare reportedly launched the nH Predict AI Model in 2019, Thompson took over as CEO in April 2021 – years before the lawsuit was filed.
The shooter Thompson, who has not yet been identified, wrote the statement ‘deny’, ‘defend’ and ‘depose’ on the bullet recovered at the scene of the murder, which refers to the tactics that insurance companies are accused of using to avoid paying.
Police are still searching for the man who shot and killed UnitedHealthcare CEO Brian Thompson early Wednesday morning. Some speculate that the goal may be to build on the 2023 lawsuit that the insurance “malicious” AI rejected 90 percent of claims for elderly patients.
The lawsuit alleges that UnitedHealthcare ‘banks on poor patient attitudes, lack of information, and lack of resources to appeal poor AI-driven decisions.’
The document went on to blast the use of AI as ‘a fraudulent scheme ‘that allows the company to fall financially in the form of policy payments without paying the promised care.’
The nH Predict model was developed by NaviHealth Inc, a Tennessee company that was purchased by UnitedHealth in 2020 for $2.5 billion, the lawsuit said.
The software analyzes large datasets of patient health records, comparing the patient’s data to similar cases in the database to predict future and potential events, providing information to health insurance companies.
The brand allegedly offered ‘prescriptive statements’ that failed to ‘change the patient’s condition and conflicted with the basic rules for what Medicare Advantage plans must follow,’ the lawsuits said.
The plaintiffs are the families of Gene B. Lokken and Dale Henry Tetzloff, now deceased patients who were covered by the Medicare Advantage Plan offered by UnitedHealthcare. from at least November 2019 to 2023.
Lokken fell at home and broke his leg and leg.
He was admitted to the hospital and before being discharged, it was recommended that he be admitted to the hospital as his health began to deteriorate.
UnitedHealthcare covered the cost of Lokken’s post-hospital care at Thorne Crest Senior Living Community in Albert Lea, Minnesota from July 1, 2022 to July 20, 2022.
When treatment was terminated, the insurance company explained: ‘Many days spent in a skilled nursing facility do not require hospitalization. A successful evacuation plan has been issued.’
The lawsuit states that ‘medical records provided to UnitedHealthcare for review indicated that Mr. Lokken was not ready to go home.’
Lokken’s expenses during her stay in a skilled nursing facility totaled $12,000 to $14,000 a month from July 2022 to July 15, 2023 when she died at the age of 92.
Thompson’s shooter, who has not yet been identified, wrote the words ‘deny,’ ‘defend’ and ‘depose’ on a bullet found at the scene of his death, referring to tactics insurance companies are accused of using to avoid paying out.
Gene B. Lokken died on July 15, 2023 at the Thorne Crest Senior Living Community in Albert Lea, Minnesota at the age of 92, according to his obituary, which continues to say that he ‘never gave up on the funny or the heartfelt. a shared story’
He worked as an engineer throughout his career and is survived by his wife, brother, five children, 12 grandchildren and four great-grandchildren.
Tetzloff suffered a stroke in October 2022 and was admitted to the hospital where doctors advised him to stay on intensive care for at least 100 days.
‘Tetzloff contacted the Prosecutors to ask for a reason for denying his claim. The defendant refused to give any reason, saying it was confidential,’ the lawsuit says.
He was forced to pay more than $70,000 in alimony for nearly ten months until he was released in June 2023 to an assisted living facility, where he died on October 11, 2023.
He left behind a wife, three children and seven grandchildren.
And this was “all because the AI model” does not match the determination of their actual doctors,” the lawsuit says.
For those who do appeal, 90 percent of patient refusals are overturned, the lawsuit said, adding that ‘this demonstrates the obvious flaws of the nH Predict AI Model and the lack of human review involved in the denial of coverage.’
The shooter was caught on CCTV in several locations, but police have yet to identify him
The gunman shot Thompson at close range near the Hilton Hotel in Midtown, Manhattan before fleeing north on a bicycle to Central Park.
Ryan Clarkson, who founded the law firm representing the plaintiffs, previously said that the class could include thousands of people, and that the damages could reach billions of dollars.
In May, UnitedHealthcare’s attorneys argued that the plaintiffs ‘failed to defeat the pro-choice process established by the Medicare Act,’ and therefore the lawsuit should be dismissed, according to Number.
He believes the issues raised in the lawsuit belong to the government, not UnitedHealth or its affiliates.
The case has received renewed attention after Thompson’s murder, with the company under renewed scrutiny as people speculate about the shooter’s motive.
Some have criticized this as inconsiderate.
‘just a reminder that Brian Thompson, CEO of UnitedHealth was just was shot and killed in NYHe was a man with a family. Most of the comments on his execution are disgusting,” wrote Julie Nelson, anchor at Minnesota News station KARE, in a post on X.
UnitedHealth Group said in a statement that they were ‘heartbroken’ and ‘overwhelmed by the overwhelming outpouring of kindness and support.’
‘Many patients, consumers, healthcare workers, organizations, government officials and other concerned people have taken time to reach out. We are grateful, even saddened,’ the statement read.
‘Our priority is, first and foremost, to support Brian’s family; to ensure the safety of our employees; and working with the police to bring the perpetrator to justice.’
“We, at UnitedHealth Group, will continue to be there for those who rely on us for their health,” he said. ‘We ask that everyone respect the privacy of the family as they mourn the loss of their husband, father, brother and friend.’
UnitedHealthcare did not immediately respond to DailyMail.com’s request for comment.
