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.
44 incidents closest to “Pega for Integrated Eligibility and Benefits Management” · matched on meaning · public reporting
Job applicants were automatically screened out by AI, allegedly discriminating against older, minority, and disabled applicants.
1 source article · read the reporting →
Selected employees for layoff, disproportionately affecting those with disabilities or on medical leave
1 source article · read the reporting →
Cigna, one of the largest health insurers, used an algorithm called PXDX to automatically deny medical claims. The system flagged mismatches between diagnoses and procedures, and company doctors signed off on denials in batches without reviewing patient files. One patient, Nick van Terheyden, was denied coverage for a $350 vitamin D test that his doctor had ordered. Former employees said the system saved Cigna billions of dollars but left patients with unexpected bills.
10 source articles · read the reporting →
Workday Gains an Edge in AI Hiring Bias Fight: California Brief - Bloomberg Law News
1 source article · read the reporting →
The system screened and ranked job applicants, leading to rejections for individuals over 40.
1 source article · read the reporting →
Daniel Swanson, a 24-year IBM manager in Austin, sued IBM in federal court, saying he was fired at 48 and then rejected for other roles because IBM's AI-driven HR screening software was programmed to favour younger workers. IBM denies the claims.
1 source article · read the reporting →
米連邦地裁がWorkdayの主張を退け、AI採用訴訟の継続を認める - Межа. Новини України.
A federal court in San Francisco declined Workday's request to dismiss a lawsuit alleging its AI-powered hiring software discriminates against applicants with disabilities and other protected groups. Judge Rita Lin ruled that California anti-discrimination law may apply and allowed claims that the software screens candidates using proxy indicators such as employment gaps to move forward. Workday maintains its tools evaluate only qualifications and do not make hiring decisions.
1 source article · read the reporting →
Foxglove, supporting the Greater Manchester Coalition of Disabled People, sent a formal pre-action letter to the Department for Work and Pensions over its secret benefit investigations algorithm, demanding the department explain how it works and show evidence it does not discriminate. Campaigners say the algorithm targets disabled people disproportionately and unfairly. Rick Burgess of the GMCDP described how people targeted by the algorithm have sometimes been found dead, starved and dehydrated, having written letters of despair on the same brown envelope the DWP sent them.
1 source article · read the reporting →
Верховный апелляционный суд ЮАР рассмотрел дело об алгоритмах Sassa - UA.NEWS
The Supreme Court of Appeal heard an appeal on 25 August about Sassa's digital application system for the SRD grant. The system only accepts online applications and uses automated bank account checks that may deny grants to people whose accounts receive deposits that are not regular income. The Global Center on AI Governance submitted that automated decisions must uphold constitutional rights and be fair, non-discriminatory, and suited to South Africa's informal economy.
1 source article · read the reporting →
Michigan's Unemployment Insurance Agency (UIA) deployed the Michigan Integrated Data Automated System (MiDAS) to automate fraud detection. The system algorithmically adjudicated over 40,000 fraud cases between October 2013 and September 2015, with 85 percent of those resulting in incorrect fraud determinations. The false accusations led to severe financial penalties, ruined credit, and homelessness for many victims. A class-action lawsuit was filed, and while the state has apologised and returned fines, it has fought against compensation claims, though legislators have promised to seek at least $30 million for those affected.
10 source articles · read the reporting →
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.
10 source articles · read the reporting →
The Council of Europe Human Rights Commissioner reported that Estonia's social security system used AI to establish incapacity levels and remove benefits from elderly people without human involvement. The system allegedly made decisions automatically, leading to complaints from NGOs.
8 source articles · read the reporting →
The UK government is reportedly using artificial intelligence to make decisions on welfare benefits and immigration applications. The system automates decisions previously made by human caseworkers. Concerns have been raised about the fairness and transparency of such automated decisions.
10 source articles · read the reporting →
The Idaho Department of Health and Welfare used a secret formula to drastically cut Medicaid assistance for adults with developmental disabilities, claiming the formula was a trade secret. The ACLU of Idaho filed a class action lawsuit, K.W. v. Armstrong, in 2012, alleging the cuts violated due process. A federal court struck down the formula in 2016 and ordered a new system, but as of 2024, a fair system has not yet been implemented.
10 source articles · read the reporting →
A rural worker in Brazil, Josélia de Brito, had her pension application through the Meu INSS app automatically denied after the AI system misidentified her as a man. The INSS deployed the system to speed up benefit decisions, but experts say it struggles with complex rural cases. The case is cited as evidence that automation may exclude vulnerable people with limited digital access.
4 source articles · read the reporting →
The Texas Attorney General investigated Pieces Technologies, a Dallas-based healthcare AI company, for making false and misleading statements about the accuracy of its generative AI product used in hospitals. The company claimed an error rate of less than 1 per 100,000, but the investigation found these metrics were likely inaccurate. As part of the settlement, Pieces agreed to accurately disclose its product's accuracy and ensure hospital staff understand the appropriate reliance on its AI. The case marks the first-of-its-kind healthcare generative AI investigation by the AG.
4 source articles · read the reporting →
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.
10 source articles · read the reporting →
The Indian government has made its Aarogya Setu COVID-19 contact tracing app mandatory for gig workers and government employees, despite widespread privacy and algorithmic accountability concerns. The app lacks transparency and data protection safeguards, and could misidentify individuals as at risk, leading to forced isolation and loss of income. A coalition of 37 organisations and 75 individuals sent a joint representation to the Prime Minister's Office urging that the app not be made mandatory and calling for financial relief and healthcare for workers.
10 source articles · read the reporting →
Dozens of hospitals across the US are using Epic's deterioration index AI system to predict which Covid-19 patients will become critically ill, despite the tool not being validated for the new disease. The rapid deployment during the pandemic bypassed normal testing and validation processes.
9 source articles · read the reporting →
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.
10 source articles · read the reporting →
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.
9 source articles · read the reporting →
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.
10 source articles · read the reporting →
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.
5 source articles · read the reporting →
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.
6 source articles · read the reporting →
