CMS warns insurers against using AI to deny Medicare Advantage care
The Centers for Medicare & Medicaid Services (CMS) clarified that health insurers cannot use algorithms or AI to deny care to Medicare Advantage members. This follows lawsuits alleging UnitedHealth and Humana used an AI tool, nH Predict, to wrongfully deny post-acute care to elderly patients. The tool reportedly produced rigid estimates ignoring individual patient needs, leading to premature denials. CMS warned that non-compliance could result in penalties and increased audits.
- Company involved
- UnitedHealth, Humana
- AI system involved
- nH Predict
10 source articles · read the reporting →
Estée Lauder settles with make-up artists sacked by algorithm
Three MAC make-up artists were dismissed after failing a video interview that was scored by HireVue's algorithm. They appealed but received no clear explanation of how the system assessed them. Estée Lauder Companies settled the resulting legal challenge out of court. HireVue later discontinued the visual analysis component of its video interview platform.
- Company involved
- Estée Lauder Companies
- AI system involved
- HireVue
2 source articles · read the reporting →
Jordan's National Aid Fund Algorithm Denies Cash Assistance to Vulnerable Households
Human Rights Watch reported that Jordan’s Takaful cash transfer programme, run by the National Aid Fund and financed by the World Bank, uses an algorithm to rank households by estimated economic vulnerability and select recipients. The report found that the algorithm relies on inaccurate self-reported income and questionable indicators such as car ownership and utility use, causing eligible poor families to be denied benefits or receive reduced payments. The World Bank and NAF defended the programme and its targeting approach.
- Company involved
- National Aid Fund (NAF)
- AI system involved
- Takaful (Unified Cash Transfer Program)
3 source articles · read the reporting →
Hong Kong tycoon sues Tyndaris over AI hedge fund losses
Hong Kong tycoon Samathur Li Kin-kan is suing Tyndaris Investments after its AI-powered hedge fund, K1, lost over $20 million in a single day. Li alleges that the system was not as sophisticated as claimed. The trial is set to begin in London in April 2020.
- Company involved
- Tyndaris Investments
- AI system involved
- K1
10 source articles · read the reporting →
Nippon Life Sues OpenAI Alleging ChatGPT Engaged in Unauthorized Practice of Law
Nippon Life Insurance Company of America filed a lawsuit against OpenAI, alleging that ChatGPT acted as an unlicensed attorney by advising a former disability claimant to reopen a settled case and drafting dozens of meritless motions. The insurer claims the AI's actions constitute unauthorized practice of law under Illinois statute and seeks $300,000 in compensatory damages. OpenAI has denied the allegations, calling the complaint meritless. The case is pending in federal court in Chicago.
- Company involved
- OpenAI
- AI system involved
- ChatGPT
2 source articles · read the reporting →
RealPage's YieldStar algorithm pushes rents higher for tenants
RealPage's YieldStar algorithm uses private competitor data to recommend rent increases for apartment units. Landlords adopt up to 90% of the suggestions, leading to higher rents for tenants. Critics allege the software may facilitate indirect price-fixing in violation of antitrust law. The company denies wrongdoing and says the software helps eliminate collusion.
- Company involved
- RealPage
- AI system involved
- YieldStar
10 source articles · read the reporting →
UDR Sued Over Alleged Use of RealPage Algorithm to Set Rents in San Diego
A class action lawsuit alleges that UDR, Inc. used RealPage's YieldStar algorithmic pricing software to set rental rates and occupancy levels for its San Diego properties, in violation of a local ordinance. The suit claims the software relied on nonpublic competitor data, contributing to inflated rents and making housing less affordable. The lawsuit, filed in July 2026, seeks to represent all affected tenants. UDR has previously acknowledged using YieldStar as one tool among others in its decision-making.
- Company involved
- UDR, Inc.
- AI system involved
- RealPage YieldStar
1 source article · read the reporting →
EEOC sues iTutorGroup for automated rejection of older tutor applicants
The US Equal Employment Opportunity Commission (EEOC) alleges that tutoring provider iTutorGroup programmed its recruitment software automatically to reject female applicants aged 55 or older and male applicants aged 60 or older. More than 200 qualified US-based applicants were denied work in 2020. The EEOC has filed a lawsuit in the Eastern District of New York seeking back pay and damages.
- Company involved
- iTutorGroup
10 source articles · read the reporting →
Cense exposed 2.5 million records of auto accident victims online
On July 7, 2020, a security researcher discovered 2.5 million records containing personal and medical data of auto accident victims exposed online. The records, belonging to New York-based AI company Cense, included names, insurance policy numbers, claim numbers, and medical diagnosis notes. The data was labeled as staging data, possibly intended for temporary storage before being loaded into an AI system. After the researcher sent a responsible disclosure notice, Cense restricted public access to the database.
- Company involved
- Cense
- AI system involved
- Cense
5 source articles · read the reporting →
DWP's Universal Credit algorithm causes underpayment and hardship for claimants
The Department for Work and Pensions (DWP) uses an automated means-testing algorithm in its Universal Credit system that miscalculates earnings due to a design flaw, leading to underpayments and fluctuating benefit amounts. Claimants such as Janet R. received payments hundreds of pounds short, forcing them into debt and foodbank use. A Court of Appeal ruling in June 2020 ordered the DWP to fix the flaw, but the department had not yet fully implemented the remedy at the time of writing.
- Company involved
- Department for Work and Pensions
- AI system involved
- Universal Credit
10 source articles · read the reporting →
Allstate's proposed retention model charged big spenders more in Maryland
Allstate proposed an auto insurance rate adjustment plan in Maryland using a retention model algorithm that varied premium changes based on existing premiums. The algorithm would have increased rates up to 20% for customers already paying the highest premiums while capping increases at 5% for others, and would have denied meaningful discounts to thousands owed reductions. The Maryland Insurance Administration rejected the plan as discriminatory, but Allstate claims it was withdrawn and has continued proposing similar models elsewhere. The proposal never took effect in Maryland.
- Company involved
- Allstate Corporation
- AI system involved
- retention model
9 source articles · read the reporting →
Study finds Italian car insurers charge more based on birthplace
A study by the Universities of Padua, Udine and Carnegie Mellon found that Italian car insurers, including Genertel, Mps, Quixa and Con.Te, use birthplace and citizenship in pricing algorithms, charging some drivers over €1,000 more. The practice was ruled against in a 2018 decree involving Linear, but the study says it continues. The companies contacted denied or explained the findings.
- Company involved
- Genertel, Mps, Quixa, Con.Te
8 source articles · read the reporting →
Uber algorithm reinforced gender pay gap in compensation offers to new hires
Uber used an algorithm to determine compensation offers for new hires, allegedly paying women less than men for similar roles. The algorithm was designed to protect existing shareholders and save money, but it reinforced existing gender pay gaps. The system is now being altered, according to The Information.
- Company involved
- Uber
7 source articles · read the reporting →
Lemonade backtracks on tweet claiming AI scans customer faces for fraud
Lemonade, an insurance firm, posted a tweet claiming it uses AI to detect non-verbal cues in customer videos to deny claims. After backlash comparing the practice to phrenology, the company deleted the tweet and denied using AI to deny claims based on facial characteristics. Lemonade stated it uses facial recognition only to flag claims submitted under different identities, which are then reviewed by human investigators.
- Company involved
- Lemonade
10 source articles · read the reporting →
University of Chicago report finds US healthcare algorithms rife with bias
A University of Chicago report alleges that algorithms used by hospitals, insurers and other businesses across the US are biased along racial and economic lines. The algorithms help triage patients, predict diabetes and flag those needing extra care, but the report says flawed products were introduced with little oversight. It says inequitable treatment has continued for more than a decade.
7 source articles · read the reporting →
Amazon sellers lose thousands after RepricerExpress pricing glitch
A software glitch in RepricerExpress's automated repricing system caused products sold by Amazon sellers to be priced at 1p, leading to significant financial losses for the sellers. RepricerExpress apologised but did not offer compensation, while Amazon said it had reached out to affected sellers but many reported no response. Some sellers have instructed lawyers to take legal action against RepricerExpress and Amazon.
- Company involved
- RepricerExpress
- AI system involved
- RepricerExpress
10 source articles · read the reporting →
Natural England biodiversity metric undervalues rewilding habitats
Natural England published a new biodiversity net gain metric in July 2021 that uses an algorithm to score habitat value. Ecologists and conservationists warned that the metric misclassifies scrubby and ruderal habitats as degraded, potentially undervaluing rewilding projects like Knepp estate and leading to inadequate compensation for habitat loss. The article claims the metric could blight hundreds of thousands of sites and penalise rewilding-style management.
- Company involved
- Natural England
- AI system involved
- Biodiversity Net Gain (BNG) metric
10 source articles · read the reporting →
Danish law enables algorithm to profile unemployed for long-term risk
The Danish parliament passed a law in April 2019 that allows an algorithm to analyse personal data of all unemployed individuals to identify those at risk of long-term unemployment. The system uses data on ethnicity, age, health, and education history to produce a risk score for social workers. Critics, including legal experts and unemployment insurance funds, argue the profiling is stigmatising, lacks transparency, and may violate GDPR. The Danish Data Protection Authority has reopened its review of the law.
- Company involved
- Danish Ministry of Employment
10 source articles · read the reporting →
LoanDepot algorithm denied mortgage to Black couple in Charlotte
In August 2019, Crystal Marie and Eskias McDaniels, a Black couple, were denied a mortgage for a house in Charlotte, North Carolina, by loanDepot's automated underwriting algorithm. The algorithm rejected the application because Crystal Marie was a contractor, not a full-time employee, despite her high credit score and income. After the couple enlisted their real estate agent and employer to intervene, the lender reversed the decision and cleared them to close. The couple alleged that race played a role in the denial, which loanDepot denied.
- Company involved
- loanDepot
- AI system involved
- Classic FICO and Fannie Mae/Freddie Mac automated underwriting software
10 source articles · read the reporting →
UnitedHealthcare sued for using AI to deny Medicare Advantage patients care
A class action complaint alleges that UnitedHealthcare and its subsidiary naviHealth deployed an artificial intelligence model to override treating physicians' determinations of medically necessary care for elderly Medicare Advantage patients. The complaint claims the AI model has a known 90% error rate and wrongfully denied patients care. The lawsuit, filed in the U.S. District Court for the District of Minnesota, seeks damages on behalf of the estates of two deceased patients and all others similarly situated.
- Company involved
- UnitedHealthcare, Inc.
10 source articles · read the reporting →
UnitedHealth used ALERT algorithm to limit mental health coverage, regulators found
ProPublica reports that UnitedHealth Group's Optum subsidiary used the ALERT algorithm to flag mental health patients and therapists as outliers, leading to therapy coverage denials. Regulators in California, Massachusetts and New York alleged this breached the federal Mental Health Parity and Addiction Equity Act, and UnitedHealth agreed to restrict the system in those jurisdictions. The company denies wrongdoing and says its programmes are compliant. Affected patients, including Medicaid enrollees, were left to pay out-of-pocket or go without care.
- Company involved
- UnitedHealth Group
- AI system involved
- ALERT
5 source articles · read the reporting →
EviCore denied heart catheterization for patient using algorithm
In fall 2021, Little John Cupp's doctor requested a left heart catheterization exam. EviCore, a company hired by UnitedHealthcare, denied the request twice using an algorithm called 'the dial' that adjusts thresholds for review. The algorithm flagged the request for review, and EviCore's doctors determined it was not medically necessary. Cupp did not receive the procedure and his symptoms continued.
- Company involved
- EviCore (a Cigna company)
- AI system involved
- the dial
6 source articles · read the reporting →
Humana sued for using AI to deny seniors rehabilitation care
Health insurer Humana is accused in a class-action lawsuit of using an AI algorithm to systematically deny rehabilitation care to Medicare Advantage patients, despite recommendations from their doctors. The lawsuit, filed on December 12, 2023, alleges that the AI tool restricted medically necessary care. This is the second major health insurer to face legal action over its use of AI to deny care.
- Company involved
- Humana
9 source articles · read the reporting →
Judge rules lawsuit over UnitedHealth’s AI care denials can move forward - STAT
The system denied necessary medical care to Medicare Advantage beneficiaries.
- Company involved
- UnitedHealth Group
1 source article · read the reporting →
