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 →
NHS liver transplant algorithm causes longer waits for younger patients
An NHS computer algorithm that prioritises liver transplant patients most likely to die soon has led to younger patients waiting 156 days longer on average than those over 60. The algorithm, launched in 2018, gives a score based on 21 recipient and seven donor parameters. Patients like Sarah Meredith, 31, have been waiting two years for a transplant. NHS Blood and Transplant defends the system as saving lives but acknowledges the stress on younger patients.
- Company involved
- NHS Blood and Transplant
10 source articles · read the reporting →
Jessica Fuller v. Hyde School, et al. (D. Maine): AI-hallucinated content in court filing, CLE; Firm procedures and certification; Serve…
The AI generated fictitious legal citations that were submitted to the court in a legal filing.
- AI system involved
- ChatGPT or Claude
1 source article · 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 →
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 →
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 →
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 →
UNOS liver allocation policy reduces transplants in poorer states
The United Network for Organ Sharing (UNOS) implemented a new liver allocation policy in 2020 called the acuity circles system, which prioritizes the sickest patients regardless of location. An analysis by The Markup and The Washington Post found that the policy led to sharp declines in liver transplants in several Southern and Midwestern states and Puerto Rico, while increasing transplants in New York and California. Patients in affected states allege the system disadvantages poorer regions, and hospitals have sued to overturn the policy.
- Company involved
- United Network for Organ Sharing (UNOS)
- AI system involved
- Acuity circles liver allocation policy
10 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 →
Betfair algorithm failed to flag gambling addict before his suicide
Luke Ashton, a 40-year-old gambling addict from Leicester, died by suicide in April 2021 after building up huge debts betting online. An inquest found that Betfair's algorithm assessed him as low risk and did not intervene despite intensive betting activity. The coroner criticised Betfair for missed opportunities and said the company should have done more. Betfair denied wrongdoing but has since introduced additional safeguards.
- Company involved
- Betfair
10 source articles · read the reporting →
Andrea Bartz and others sue Anthropic PBC over copyright
In August 2024, Andrea Bartz, Kirk Wallace Johnson and Charles Graeber filed a lawsuit against Anthropic PBC in the US District Court for the Northern District of California. The complaint alleges copyright infringement under 17 U.S.C. § 501. Anthropic waived service, and the case was assigned to the court.
- Company involved
- Anthropic PBC
8 source articles · read the reporting →
Match Group kept Stephen Matthews on Hinge despite rape reports
A woman reported to Hinge that Stephen Matthews, a cardiologist she met on the app, drugged and sexually assaulted her in January 2023. Match Group, Hinge's parent company, had already received reports that Matthews had raped other women, but he remained on the platform until his arrest. He was later convicted of 35 counts and sentenced to 158 years to life. Lawyers for the women allege Match Group's failure to act allowed further abuse.
- Company involved
- Match Group
- AI system involved
- Hinge
4 source articles · read the reporting →
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 →
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 →
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 →
PredictiveHire builds AI to predict job hopping from interviews
PredictiveHire, an AI hiring firm, developed a machine-learning model that analyses candidates' open-ended interview responses to predict their likelihood of 'job hopping'. The company used data from 45,899 applicants to build the 'flight risk' assessment, which it advertises as coming soon. Scholars warn that such tools can suppress wages by screening out workers who might seek better pay or conditions, continuing a historical trend of using personality tests to identify potential labour organisers.
- Company involved
- PredictiveHire
- AI system involved
- Phai
1 source article · read the reporting →
Insurer drops California homeowner after aerial photo analysis
Cindy Picos was dropped by her home insurer after the company used aerial photos to assess her roof. The insurer refused to let her see the photos, and she believes her roof is in fine shape. The incident highlights the growing use of drones and aerial imagery by insurers to inspect properties without in-person visits.
2 source articles · read the reporting →
Brookdale Senior Living algorithm blamed for understaffing at assisted-living facilities
Managers at Brookdale Senior Living, the largest assisted-living chain in the US, allege that an algorithm called 'Service Alignment' set staffing levels so low that facilities were dangerously short-handed. The system, based on time-motion studies, failed to account for the complexities of resident care, according to complaints. Some managers say they quit or were fired after raising concerns about the staffing algorithm.
- Company involved
- Brookdale Senior Living
- AI system involved
- Service Alignment
1 source article · read the reporting →
VA's Suicide Prevention Algorithm Favours Men, Ignores Sexual Trauma
The Department of Veterans Affairs' REACH VET algorithm, designed to identify veterans at high risk of suicide, reportedly prioritises white men and excludes factors like military sexual trauma that disproportionately affect women. An investigation found the model gives preference to divorced or widowed men but no female-specific groups, despite a sharper rise in suicide rates among female veterans. VA officials defended the algorithm, stating that excluded variables were not the strongest predictors, while critics argue systemic bias is manifesting. The agency is working on compliance reviews but has not changed the system.
- Company involved
- Department of Veterans Affairs
- AI system involved
- REACH VET
2 source articles · read the reporting →
Perplexity AI Misdiagnosis Leads to Man's Death After He Avoids Cancer Treatment
Benjamin Riley's father, a former neuroscientist, used Perplexity AI to self-diagnose his chronic lymphocytic leukemia and was incorrectly told he had Richter's Transformation, leading him to refuse his oncologist's recommended Ven-Obi treatment for a year. Despite his son's efforts to correct the misinformation by contacting the study authors, the father's condition worsened, and he eventually started treatment but died weeks later. The incident highlights the dangers of relying on AI for medical advice.
- Company involved
- Perplexity AI
- AI system involved
- Perplexity AI
1 source article · read the reporting →
State Farm accused of algorithmic bias against Black homeowners
A class action lawsuit filed in Chicago alleges State Farm's automated claims processing system discriminates against Black policyholders. The suit claims Black customers are more likely to face additional paperwork and longer waits for claim approval than white customers, citing data from 800 homeowners. State Farm has stated it takes the filing seriously and is committed to fair treatment, while the plaintiffs seek to enjoin the current system and require audits.
- Company involved
- State Farm
- AI system involved
- automated claims processing system
2 source articles · read the reporting →
Moonwell loses $1.78M after AI-generated code from Claude Opus 4.6 causes oracle pricing error
DeFi lending protocol Moonwell lost $1.78 million after an oracle pricing error in smart contract code partially written by Anthropic's Claude Opus 4.6 model. The error valued cbETH at approximately $1.12 per token instead of its actual market price of nearly $2,200, triggering instant liquidations. Moonwell contained the issue by reducing the cbETH borrow cap, but users suffered catastrophic losses. The incident has sparked debate about the risks of AI-generated code in smart contracts.
- Company involved
- Moonwell
- AI system involved
- Claude Opus 4.6
4 source articles · read the reporting →
