Court: UnitedHealth Must Answer for AI-Based Claim Denials

Lawsuit Alleges Insurer Used AI Tool in Denying Patients Medically Necessary Care Marianne Kolbasuk McGee (HealthInfoSec) • February 14, 2025

A proposed class action lawsuit against UnitedHealth Group that claims the company's insurance unit UnitedHealthCare used of artificial intelligence tools to deny Medicare Advantage claims for medically necessary care has the green light to proceed from a federal judge.

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In a ruling Thursday, a Minnesota federal judge dismissed some of the plaintiffs' allegations against UHG - including unjust enrichment, bad faith insurance, and various state statutory claims - saying those claims are preempted by the federal Medicare Act.

But the judge allowed the plaintiffs' claims of breach of contract and breach of the implied covenant of good faith and fair dealing to proceed because they are not preempted by federal law.

In the allegations that the judge allowed to move forward ...