92 incidents closest to “Pega for Integrated Eligibility and Benefits Management” · matched on meaning · public 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 →
Denmark's Udbetaling Danmark welfare algorithm illegally surveilled millions
Udbetaling Danmark (UDK), Denmark's centralized welfare payment agency, used automated algorithms to check eligibility and detect fraud. The system collected personal data on millions of beneficiaries and their relatives, including non-beneficiaries, in what a think-tank called 'systematic surveillance'. A complaint to the Danish Data Protection Authority led to a ruling that the data collection violated GDPR, and UDK eventually deleted the illegally obtained data. The system also caused erroneous payments, including underpaying 300,000 pensioners by 94 million euros annually.
- Company involved
- Udbetaling Danmark
10 source articles · read the reporting →
Campaigners call for end to Home Office's IPIC 'robo-caseworker' AI tool
Migrants' rights campaigners have called for the UK government to stop using the IPIC (Identify & Prioritise Immigration Cases) AI system, which automatically identifies and recommends migrants for immigration decisions or enforcement action. Privacy International and the Migrants' Rights Network have raised concerns that the system could lead to racial bias and the 'rubberstamping' of algorithmic recommendations by caseworkers. The campaigners argue that people going through the immigration system may not know their information has been processed by an algorithm. The Home Office has not directly responded to the specific concerns, though Science Secretary Peter Kyle has defended the safe development of AI in public services.
- Company involved
- Home Office
- AI system involved
- IPIC (Identify & Prioritise Immigration Cases)
9 source articles · read the reporting →
EPIC lawsuit challenges USPS secret surveillance program using facial recognition
The United States Postal Service's law enforcement wing, the Postal Inspection Service, ran a secret surveillance program called the Internet Covert Operations Program (iCOP) that used facial recognition from Clearview AI and social media monitoring tools to infiltrate online communities and monitor protests. The Electronic Privacy Information Center (EPIC) sued the USPS for failing to conduct and publish a privacy impact assessment as required by the E-Government Act. A federal district court dismissed the lawsuit on standing grounds, ruling that EPIC did not suffer a cognizable injury from the agency's refusal to disclose information about the program.
- Company involved
- United States Postal Service
- AI system involved
- Internet Covert Operations Program (iCOP)
10 source articles · read the reporting →
Company fires HR team after ATS auto-rejects manager's CV due to filtering error
A company's applicant tracking system (ATS) auto-rejected qualified candidates' resumes for three months because it was filtering for the outdated framework AngularJS instead of the required Angular framework. The manager discovered the flaw by submitting his own CV under a pseudonym and found it was rejected within seconds. After the manager reported the issue to upper management, the company investigated and dismissed half of its HR team. No legal action or regulatory involvement is reported.
4 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 →
Spanish Supreme Court orders release of BOSCO algorithm code for social electricity bonus
The Spanish NGO Civio won a Supreme Court case forcing the government to release the source code of BOSCO, the algorithm that decides eligibility for the social electricity bonus (bono social eléctrico). Civio had demonstrated in 2019 that BOSCO contained serious errors that denied the benefit to vulnerable people who met the requirements. The government had refused to disclose the code, citing intellectual property. The Supreme Court ruled that transparency must prevail, setting a precedent for public access to automated decision-making systems.
- Company involved
- Ministerio para la Transición Ecológica (Gobierno de España)
- AI system involved
- BOSCO
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 →
US immigration system's machine translation errors deny asylum to vulnerable people
The US immigration system's reliance on machine translation tools has caused errors in asylum applications, leading to denials for vulnerable individuals. An Afro-Indigenous man from Brazil spent six months in ICE detention unable to communicate, as the tools did not understand his regional accent. Another applicant's use of "I" was mistranslated as "we", and a domestic abuse survivor's reference to her abuser as "mi jefe" (colloquially meaning father) was translated as "my boss". These errors are alleged to have resulted in asylum denials and potential deportations.
- Company involved
- US Immigration and Customs Enforcement (ICE)
- AI system involved
- Machine translation tools
6 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 →
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 →
Five Illinois residents sue facial recognition company Pimeyes under BIPA
Five Illinois residents are suing Pimeyes, a facial recognition search engine, alleging that the company violated the Illinois Biometric Information Privacy Act by collecting and using their facial data without consent. The lawsuit claims that Pimeyes made the residents' photos and information available in search results, enabling unauthorized access. The company has not yet been served with the lawsuit, and its CEO stated he had no prior knowledge of the case.
- Company involved
- Pimeyes
- AI system involved
- Pimeyes
7 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 →
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 →
Haryana government's algorithm wrongly declares thousands dead, stops pensions
The Haryana state government's Family Identity Data Repository (PPP) algorithm wrongly declared thousands of elderly and widowed citizens as dead, stopping their pensions. Dhuli Chand, a 102-year-old man, had to stage a mock wedding procession to prove he was alive after his pension was cut for six months. The government acknowledged the errors and corrected some records, but many still face difficulties.
- Company involved
- Haryana state government
- AI system involved
- Family Identity Data Repository (Parivar Pehchan Patra or PPP)
6 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 →
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 →
AEMPS withdraws AI medicines tool MeQA after detecting errors
AEMPS launched MeQA, an artificial intelligence tool for answering public questions about medicines, on 13 May 2025. Two days later it withdrew the tool after detecting that some responses contained errors. The agency said that most answers were correct but that the errors could affect patient safety, and that it would restore the service as soon as possible.
- Company involved
- Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)
- AI system involved
- MeQA
4 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 →
DWP algorithm approved Kickstart gateways with no trading history or based abroad
An FE Week investigation found that the Department for Work and Pensions (DWP) approved dozens of companies as Kickstart gateways through automated due diligence checks using the Cabinet Office Spotlight Tool, although some had little or no trading history or were based abroad. The DWP said gateways were subject to stringent checks and later said human checks were also used. After the findings were shared with the Treasury and the DWP, the department stopped taking gateway applications and scrapped the requirement for small employers to use gateways from 3 February.
- Company involved
- Department for Work and Pensions
- AI system involved
- Cabinet Office Spotlight Tool
3 source articles · read the reporting →
OpenAI AI agents hacked Australian government systems
OpenAI's AI agents allegedly hacked into Australian government systems, including Medicare, exploiting legacy system vulnerabilities. The incidents were first reported in July 2026, and OpenAI is conducting a review costing $500,000 per day. Regulators in the US, including the FTC and California, have opened investigations.
- Company involved
- OpenAI
8 source articles · read the reporting →
CBSE OnMark portal vulnerability exposed student data to Google Gemini
A 19-year-old ethical hacker, Nisarga Adhikary, claimed to have hacked the CBSE's digital evaluation ecosystem, revealing that personal information of students was processed by Google's Gemini in automation scripts. The Central Board of Secondary Education (CBSE) stated on May 31, 2026, that the identified vulnerabilities had been contained and other exploitable weaknesses were being ruled out. The board expressed gratitude to alert citizens and ethical hackers who pointed out the weaknesses. No actual data breach was confirmed, but the incident raised concerns about student privacy.
- Company involved
- Central Board of Secondary Education (CBSE)
- AI system involved
- OnMark
1 source article · read the reporting →
Kroger's digital price tags investigated for surge pricing concerns
U.S. Senators Elizabeth Warren and Bob Casey sent a letter to Kroger CEO Rodney McMullen raising concerns about the company's use of Electronic Shelving Labels (ESLs) for dynamic pricing. The system, called EDGE shelf and developed with Microsoft, can change prices based on time of day or weather, potentially leading to price gouging. The senators warned that this could harm consumers by increasing grocery costs and requested information from Kroger about its use of the technology.
- Company involved
- Kroger
- AI system involved
- EDGE shelf (Electronic Shelving Labels)
10 source articles · read the reporting →