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UnitedHealthcare sued for denying Medicare advantage claims with faulty AI

Allegations of a 90% error rate and pressure to cut costs fuel class action lawsuit

15-Nov-2023

Key points from article :

UnitedHealthcare is being sued for using an algorithm to deny Medicare Advantage claims.

The algorithm, naviHealth, is said to have a 90% error rate.

UnitedHealth continued to use the algorithm because few people appeal denied claims.

The lawsuit alleges that UnitedHealth used the algorithm to cut costs.

UnitedHealth says that the algorithm is not used to make coverage decisions.

The lawsuit is part of a trend of increased scrutiny of insurers' use of AI to deny claims.

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UnitedHealthcare sued for denying Medicare advantage claims with faulty AI