Cigna Algorithm PXDX Allegedly Rejected Thousands of Patient Claims En Masse in Breach of California Law
July 24, 2023
Cigna health insurer faces a class-action lawsuit for allegedly using the PXDX ("procedure-to-diagnosis") algorithm to automatically reject over 300,000 patient claims in violation of California law, prompting two members to file the lawsuit seeking damages and a jury trial. Cigna disputes the allegations, claiming the process expedites physician reimbursement and does not result in care denials.
- Alleged deployer
- cigna
- Alleged developer
- cigna
- Alleged harmed parties
- patients
Source
Data from the AI Incident Database (AIID). Cite this incident: https://incidentdatabase.ai/cite/591
Data source
Incident data is from the AI Incident Database (AIID).
When citing the database as a whole, please use:
McGregor, S. (2021) Preventing Repeated Real World AI Failures by Cataloging Incidents: The AI Incident Database. In Proceedings of the Thirty-Third Annual Conference on Innovative Applications of Artificial Intelligence (IAAI-21). Virtual Conference.
Pre-print on arXiv · Database snapshots & citation guide
We use weekly snapshots of the AIID for stable reference. For the official suggested citation of a specific incident, use the “Cite this incident” link on each incident page.