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AI Denied Their Care, Now UnitedHealth Faces A Major Lawsuit
- Written by Kiara Fabbri Former Tech News Writer
- Fact-Checked by Justyn Newman Former Lead Cybersecurity Editor
A federal judge has ruled that a major lawsuit against UnitedHealth Group (UHG) can continue, despite dropping some of the claims.
In a Rush? Here are the Quick Facts!
- A judge allowed a class-action lawsuit against UnitedHealth Group to proceed.
- The lawsuit claims UHG used AI to deny elderly patients’ Medicare Advantage claims.
- Plaintiffs allege the AI system had a 90% error rate, leading to deaths.
The lawsuit accuses UHG and its partners, UnitedHealthcare and naviHealth, of using AI instead of doctors to decide whether elderly patients on Medicare Advantage plans should receive care, as first reported by Courthouse News Case (CNC).
The plaintiffs allege that UHG’s AI program, developed by its subsidiary naviHealth, has a 90% error rate. The automated decisions, according to the lawsuit, led to worsened health conditions for patients and, in some cases, even death.
The suit claims that despite the high error rate, the company continues to deny claims using the flawed system because only a small fraction of policyholders—around 0.2%—appeal these denials, with the rest either paying out of pocket or going without care.
UHG is the largest health insurance company in the U.S., covering nearly 53 million people. The company has already faced heavy criticism over claim denials, especially after the shocking murder of former UnitedHealthcare CEO Brian Thompson in New York last year, as reported in an earlier article by CNC .
Police found bullet casings at the scene with the words “deny,” “defend,” and “depose” written on them—terms allegedly tied to UHG’s claims practices. The suspect, Luigi Mangione, has pleaded not guilty and raised $300,000 in donations for his defense.
UHG tried to get the lawsuit dismissed, arguing that the patients didn’t fully go through the company’s appeals process. But Judge John Tunheim disagreed, saying UHG’s appeal system was so difficult that it was nearly impossible for patients to get a fair review.
He said the process was “futile” and could cause “irreparable harm,” as reported by CNC.
One example highlighted in the complaint involves a 74-year-old stroke patient who was denied post-acute care despite his doctor’s recommendation. The man was forced to pay over $70,000 in medical expenses out of pocket before he passed away in an assisted living facility.
Now, the lawsuit will focus on whether UHG broke its own contracts by refusing to pay for care it had promised. Lawyers for both sides have not yet commented on the case.
UCSF Adopts AI Scribes To Improve Doctor-Patient Interaction
- Written by Kiara Fabbri Former Tech News Writer
- Fact-Checked by Justyn Newman Former Lead Cybersecurity Editor
UC San Francisco (UCSF) is rolling out AI scribes to help doctors spend less time typing and more time engaging with patients.
In a Rush? Here are the Quick Facts!
- UCSF is using AI scribes to reduce doctors’ documentation workload.
- AI scribes record, transcribe, and draft notes for doctors to review.
- Physicians report lower cognitive burden and improved patient engagement.
These AI-powered tools record and transcribe clinical encounters, generating draft notes and patient instructions that physicians review before adding them to electronic health records, as reported by the university’s press release .
Dr. Sara Murray, UCSF’s Chief AI Officer, has been leading the implementation of AI scribes alongside other UCSF health leaders. “Clinicians have told us is that with AI scribes, they feel relieved of that cognitive burden because they can focus more deeply on talking to and thinking about their patients.” she explains.
With doctors often spending nights and weekends catching up on documentation, AI scribes aim to streamline the process and reduce burnout.
The impact is already visible. According to the press release, surveys show physicians who use AI scribes are more likely to complete their notes on the same day and report a more manageable workload.
Patients, too, appreciate the change. “My doctor was testing this new AI program which allowed him to speak directly to me: No typing, just eye-to-eye [contact] – simply spectacular.,” one patient shared, as reported by the UCSF.
While AI scribes enhance efficiency, privacy remains a top priority. Doctors must obtain verbal consent before recording, and all recordings are securely stored and later deleted in compliance with HIPAA regulations. Currently, 575 UCSF physicians have completed training to use AI scribes, with more expected to follow.
Looking ahead, AI’s role in health care is set to expand.
“As the technology evolves, AI scribes will become AI assistants, doing more and more to help clinicians with tasks that are needed to deliver safe and effective care to patients. For example, they may help by drafting orders for tests or to better summarize and incorporate past visit information into new documentation.” Dr. Murray predicts.
However, she emphasizes that these tools are designed to assist—not replace—doctors.
“Importantly, these tools are assistants and not replacements for your doctor. They are meant to make it easier for them to deliver high-quality care while always reviewing AI outputs. We call this “human-in-the-loop” and it is a critical part of ensuring these tools are trustworthy.”
