The record

Where automated decisions went wrong

Incidents gathered from public reporting around the world. Each one links to the articles it came from. None of it is a finding that anyone broke the law.

Reports people file about their own experience are not shown here and never will be without their agreement. Tell us what happened to you.

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92 incidents closest to “FRISS Fraud Detection at Claims” · matched on meaning · public reporting

WF-VR6R0O1 Aug 2019

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 →

WF-J5IU7Z3 Dec 2024

FTC settles with IntelliVision over deceptive facial recognition claims

The Federal Trade Commission (FTC) took action against IntelliVision Technologies Corp. for making false, misleading, or unsubstantiated claims about its AI-powered facial recognition software. The company allegedly claimed its software had one of the highest accuracy rates on the market and was free of gender or racial bias, without supporting evidence. The FTC also alleged that IntelliVision did not train its software on millions of faces as claimed, but on images of approximately 100,000 individuals. Under a proposed consent order, IntelliVision is prohibited from making such misrepresentations without competent and reliable testing.

Company involved
IntelliVision Technologies Corp.
AI system involved
IntelliVision facial recognition software

9 source articles · read the reporting →

Face recognition bypass used to register shell companies for tax fraud in Shanghai

In a major tax fraud case in Shanghai, criminals used face recognition cracking techniques to register shell companies on government platforms. They purchased high-resolution photos and used apps to create fake videos, then used modified phones to bypass face recognition authentication. The scheme resulted in fraudulent invoices totaling over 500 million yuan. The case was prosecuted by the Shanghai procuratorate.

7 source articles · read the reporting →

WF-R2SNAZ1 Jan 2013

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 →

WF-DSAOTF14 May 2026

ООО «Точка опоры» v. ООО «ЦСС» (West Siberian District AC): AI-hallucinated content in court filing, Monetary Fine

The AI system generated fake legal citations that were submitted to the court, resulting in a fine for contempt.

Company involved
ООО «ЦСС»

1 source article · read the reporting →

WF-3333OU22 Sep 2021

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 →

IRCC uses AI triage for Temporary Resident Visa applications

Immigration, Refugees and Citizenship Canada (IRCC) uses an AI system called Advanced Analytics to triage Temporary Resident Visa applications from India and China. The system categorizes applications into tiers, with Tier 1 approved automatically and others sent to human officers. Critics allege the system lacks transparency and may introduce bias, leading to visa refusals without clear rationale. The author, a Canadian immigration lawyer, is filing Federal Court cases on behalf of clients affected by refusals.

Company involved
Immigration, Refugees and Citizenship Canada (IRCC)
AI system involved
Advanced Analytics Triage of Overseas Temporary Resident Visa Applications

10 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 →

WF-NFIWMI18 Nov 2023

Cigna StressWaves Test found unreliable and invalid in independent study

A study published in Scientific Reports evaluated the Cigna StressWaves Test (CSWT), an AI tool that claims to assess psychological stress from speech. The study found that the CSWT had poor test-retest reliability and poor validity compared to the Perceived Stress Scale. The authors warned that widespread availability of the tool could lead to misleading results and negative consequences for users making healthcare decisions. Cigna has not publicly responded to the findings.

Company involved
Cigna
AI system involved
Cigna StressWaves Test

4 source articles · read the reporting →

WF-LN1XAB1 Jan 2021

California EDD's automated fraud detection wrongly suspended 600,000 legitimate unemployment claims

In January 2021, the California Employment Development Department used Thompson Reuters automated batch review software to flag 1.1 million unemployment claims as potentially fraudulent. EDD stopped payments on those claims without prior notice. Later, over 600,000 were confirmed as legitimate after claimants used ID.me to verify their identity. The incident highlights the trade-off between fraud prevention and timely benefit access.

Company involved
California Employment Development Department (EDD)
AI system involved
Thompson Reuters Automated Batch Review

7 source articles · read the reporting →

WF-ROMQCH5 Feb 2024

OnlyFake site uses neural networks to generate fake IDs, bypasses OKX verification

An underground website called OnlyFake uses neural networks to generate realistic photos of fake IDs for $15. The journalist tested the service and obtained a convincing California driver's license. They then used another fake ID to successfully bypass the identity verification process on OKX, a cryptocurrency exchange. The article alleges that this technology could streamline bank fraud and money laundering, but reports no actual financial loss.

Company involved
OKX
AI system involved
OnlyFake

10 source articles · read the reporting →

EvenUp AI errors in personal injury demand letters lead to scrutiny

EvenUp, a legal tech startup valued at $1 billion, uses AI to draft personal injury demand letters. Former employees revealed that the AI system frequently makes errors, including missing injuries and fabricating medical conditions. The company defends its hybrid approach with human oversight, but critics allege overpromised AI capabilities.

Company involved
EvenUp

6 source articles · read the reporting →

WF-YDH39P1 Jan 2013

Swedish welfare agency's AI system flags marginalized groups for fraud investigations

Försäkringskassan, Sweden's Social Insurance Agency, uses an AI risk-scoring system to flag welfare applicants for fraud investigations. The system disproportionately targets women, individuals with foreign backgrounds, low-income earners, and those without university degrees, according to an investigation by Lighthouse Reports and Svenska Dagbladet. Amnesty International has called for the system to be discontinued, citing violations of the right to equality and non-discrimination.

Company involved
Försäkringskassan (Swedish Social Insurance Agency)

6 source articles · read the reporting →

Chicago class action challenges ShotSpotter's discriminatory stop-and-frisk deployments

ShotSpotter, a gunshot detection system used by the Chicago Police Department, generates alerts that lead to police deployments and stop-and-frisk stops. Analyses show over 90% of alerts are unfounded, and the system is deployed only in predominantly Black and Latinx districts. A class-action lawsuit against the City of Chicago alleges the system fuels unconstitutional and discriminatory policing, including false accusations against individuals like Michael Williams.

Company involved
City of Chicago
AI system involved
ShotSpotter

7 source articles · read the reporting →

WF-ID19SZ1 Jan 2012

Dutch government to refund over 10,000 students over discriminatory DUO fraud algorithm

The Dutch government has pledged to refund over 10,000 students who were unjustly flagged for student finance fraud by a discriminatory algorithm used by the Education Executive Agency (DUO). The algorithm, implemented in 2012, used criteria that disproportionately targeted students from immigrant backgrounds, particularly those of Turkish and Moroccan descent. Following investigations by the Dutch Data Protection Authority and an independent report by PwC, the algorithm was suspended in July 2023 and replaced with a random-sampling system. The government has allocated 61 million euro for refunds.

Company involved
Education Executive Agency (DUO)
AI system involved
DUO fraud detection system

9 source articles · read the reporting →

WF-0YQPL21 Jan 2019

iBorderCtrl lie detector falsely flagged honest reporter as liar

A journalist testing Europe's iBorderCtrl virtual policeman at the Serbian-Hungarian border gave honest answers but was deemed a liar by the system, scoring 48 out of 100 with four false answers flagged. The Hungarian policeman said the result suggested further checks, though none were carried out. The reporter only learned of the result after filing a data access request under European privacy laws. Experts and transparency activists have criticised the technology as pseudoscientific and potentially discriminatory.

Company involved
iBorderCtrl consortium
AI system involved
Silent Talker / iBorderCtrl virtual policeman

10 source articles · read the reporting →

DWP algorithm mistakenly flags 200,000 Housing Benefit claimants for fraud review

The UK Department for Work and Pensions (DWP) uses an algorithm to flag Housing Benefit claimants for possible fraud or error. According to a Big Brother Watch investigation, the algorithm has mistakenly flagged 200,000 innocent people, subjecting them to intrusive reviews. Only one in three flagged cases actually had errors, compared to two in three during the pilot. The DWP has spent £4.4 million on these pointless checks.

Company involved
Department for Work and Pensions (DWP)

6 source articles · read the reporting →

Audit of RisCanvi finds biases and reliability issues in criminal justice system

Eticas conducted an adversarial audit of RisCanvi, an AI risk assessment tool used in Catalonia's criminal justice system. The audit uncovered biases in risk classifications against specific demographics and significant reliability issues. The findings call for fairer practices in criminal justice AI.

Company involved
Catalonia's criminal justice system
AI system involved
RisCanvi

4 source articles · read the reporting →

WF-OP475C1 Jan 2018

Dutch probation service's OXREC algorithm flawed, leading to incorrect recidivism risk assessments

The Dutch Inspectorate of Justice and Security (Inspectie JenV) published a report finding that the probation service's (Reclassering) OXREC algorithm contains serious flaws, including swapped formulas and incorrect numbers, causing about a quarter of risk assessments to be wrong. The algorithm, used since 2018 for about 44,000 cases per year, also uses variables that can lead to discrimination, such as neighborhood score and income. The Inspectorate recommended immediate correction or temporary suspension. The probation service announced it would temporarily stop using OXREC.

Company involved
Reclassering Nederland
AI system involved
OXREC

4 source articles · read the reporting →

WF-Y1WBTU22 Mar 2022

Citizens Advice finds ethnicity penalty in car insurance pricing

Citizens Advice conducted exploratory research into car insurance pricing and found that people of colour may be paying £250 more per year than White people. The research suggests that areas with large communities of colour may be identified as more risky by algorithms, even when objective risk factors are controlled. Citizens Advice has called on the Financial Conduct Authority to investigate the issue.

9 source articles · read the reporting →

WF-UF6BMA1 Jan 2018

TransUnion AI tenant screening denied 75-year-old man apartment due to mistaken littering conviction

Chris Robinson, then 75, applied for a senior living apartment in California. The property manager used an AI screening program from TransUnion, which assigned him a low score based on a mistaken conviction for littering that belonged to a different person with the same name in Texas. Robinson lost the apartment and his application fee. A federal class-action lawsuit against TransUnion moved toward a $11.5 million settlement in 2023.

10 source articles · read the reporting →

WF-53EQUB1 Jun 2019

Security Health Plan used AI to cut off nursing home care for 85-year-old woman

Frances Walter, an 85-year-old woman with a shattered shoulder, had her nursing home care payment cut off by Security Health Plan after an algorithm predicted she would recover in 16.6 days. The algorithm, nH Predict from NaviHealth, did not account for her severe pain and allergy to pain medicine. She was forced to spend her life savings and enroll in Medicaid while fighting the denial. A federal judge later ruled the denial was speculative and she was owed thousands of dollars.

Company involved
Security Health Plan
AI system involved
nH Predict

1 source article · read the reporting →

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