Cigna Algorithm PXDX Allegedly Rejected Thousands of Patient Claims En Masse in Breach of California Law
July 24, 2023
Cigna's health insurer faces a class-action lawsuit, accused of utilizing the PXDX algorithm to automatically reject over 300,000 patient claims in breach of California law. Two policyholders have filed this lawsuit, seeking damages and a jury trial.
The company counters that this process streamlines physician reimbursement and does not cause care denials, but concerns remain about the algorithm's impact on patients' access to healthcare services. This incident highlights the need for safe and secure AI practices in the health sector, especially when it comes to decisions affecting individuals' well-being.
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Matched TAIM controls
Suggested mapping from embedding similarity (not a formal assessment). Browse all TAIM controls
- MEASURE 2.6 — similarity 0.653, rank 1. TAIM detail and related incidents →
- GOVERN 6.1 — similarity 0.651, rank 2. TAIM detail and related incidents →
- MAP 4.1 — similarity 0.645, rank 3. TAIM detail and related incidents →
- 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.