The US health insurance company United Healthcare is on trial for discriminating against patients. A self-developed AI system is said to have unjustifiably reduced health insurance benefits.

Artificial intelligence is still on everyone’s lips. No matter whether Google, Microsoft or OpenAI: every company now offers its own AI solutions for end users. But digitalization also entails many risks in this area. It is still not fully clear to what extent prejudice and discrimination can be avoided within an algorithm.

After all, every algorithm is only as neutral as its developer. In the USA, a number of people recently experienced what a dystopian AI future could look like. An automated system at the country's largest insurer, United Healthcare, systematically rejected benefits for insured people.

AI cuts health insurance benefits and overrules doctors

For example, the system overruled doctors' diagnoses and sometimes withheld vital treatments from older patients. In this way, the insurer cut rehabilitation and nursing services for its customers. As a result, many households fell into debt in order to be able to maintain vital supplies. These allegations are the reason why proceedings are currently underway against the insurer.

Internal documents and conversation transcripts support the lawsuit against United Healthcare. A news portal also interviewed former employees of the subsidiary that developed the algorithm for the insurance. This was introduced in 2019 and has since taken over decisions regarding follow-up costs after a patient's accident. This includes, for example, care or therapy costs.

Discrimination by AI based on age and living situation

It is completely unclear how the algorithm makes its decisions. The AI ​​obtains the source data from an internal database with information on over six million patients. In addition, age, living situation and physical condition probably play a decisive role. However, the system does not take dynamic or individual characteristics into account.

As a result, patients who would normally be entitled to 100 days in a nursing home will have their benefits withdrawn after 14 days. United Healthcare also ignores the judgment of doctors. The company also categorically rejected requests as to whether customers could gain insight into the algorithm. The outcome of the lawsuit is therefore likely to be groundbreaking for AI in the medical sector.

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