An AI Said He Was Done Healing — His Family Is Fighting Back

0:04
Dean Lockan was 91 years old when he
0:06
fractured his leg. He needed rehab to
0:09
recover and his insurance was supposed
0:10
to cover it. United Healthcare paid for
0:13
19 days. Then an artificial intelligence
0:16
tool called NH Predict stepped in and
0:18
ended his coverage. It didn't matter
0:21
that his own doctor said he still needed
0:23
care. The algorithm decided he was done.
0:25
His family disputed it. They paid out of
0:28
pocket for nearly a year of care until
0:30
he passed away. Now, Jean's estate is
0:33
the lead plaintiff in a federal class
0:35
action lawsuit in Minnesota. And the
0:37
allegations are stunning. The lawsuit
0:40
claims NH Predict was used to
0:41
systematically cut off post-accute care
0:43
for Medicare Advantage members,
0:45
overriding the doctors who actually
0:47
treated them. Here's the part that
0:50
should make everyone pause. When
0:52
families pushed back and appealed,
0:54
roughly 90% of those denials were
0:56
reversed. But only about 0.2% of members
1:00
ever appealed at all. The suit alleges
1:02
the system counted on people not
1:03
fighting back. This isn't just one
1:06
lawsuit. A US Senate investigation found
1:09
that United Healthcare's denial rate for
1:11
this kind of care more than doubled
1:12
after the company started using the
1:14
algorithm. The case is now moving toward
1:17
class certification. If a judge grants
1:19
it, this could affect millions of
1:21
Medicare Advantage members across the
1:23
country. United Health denies all of it.
1:26
The company says NH Predict is only a
1:28
guide, not a decision maker, and that
1:31
coverage choices follow the plan and
1:32
federal rules. These are allegations. No
1:36
court has found the company liable yet.
1:38
But this story matters for anyone with
1:40
Medicare coverage. Read the full
1:42
breakdown at the link and tell us in the
1:44
comments. Have you ever had a claim
1:46
denied? Your story could help someone
1:48
else.

An AI Said He Was Done Healing — His Family Is Fighting Back

Insurance News

Donald Trump Is on His Last Legs | Steve Schmidt

How Erika Kirk and Bari Weiss Perpetuate Violence

The ethical dilemma of the assisted dying debate | James O’Brien - The Whole Show

'Very un-British': Is it acceptable to heckle politicians? | LBC debate

What happens at a longevity festival?

How AI emperors are breaking our democracy | The News Agents

US Economy 2024: Inflation, Saving Rates & the Federal Reserve

UNCAPTIONED: David Harbour responds to cheating allegations.

Five diabetes experts expelled from a conference?

Exclusive: The whistleblower silenced by Facebook hits back | The News Agents

UNCAPTIONED: Hugh Laurie responds to viral criticism of House.

ALLY OR SPY? Pentagon Lists Israel As Threat, White House Surveillance Claims Explode

Up next in 10

An AI Said He Was Done Healing — His Family Is Fighting Back

Insurance News