Description: 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.
Entities
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Risk Subdomain
A further 23 subdomains create an accessible and understandable classification of hazards and harms associated with AI
7.3. Lack of capability or robustness
Risk Domain
The Domain Taxonomy of AI Risks classifies risks into seven AI risk domains: (1) Discrimination & toxicity, (2) Privacy & security, (3) Misinformation, (4) Malicious actors & misuse, (5) Human-computer interaction, (6) Socioeconomic & environmental harms, and (7) AI system safety, failures & limitations.
- AI system safety, failures, and limitations
Entity
Which, if any, entity is presented as the main cause of the risk
AI
Timing
The stage in the AI lifecycle at which the risk is presented as occurring
Post-deployment
Intent
Whether the risk is presented as occurring as an expected or unexpected outcome from pursuing a goal
Intentional
Incident Reports
Reports Timeline
Cigna, the healthcare and insurance giant, was hit with a lawsuit on Monday that alleges the company systematically rejects claims in a matter of seconds, thanks to an algorithmic system put in place to help automate the process—further rai…
SACRAMENTO, Calif. (AP) — A federal lawsuit alleges that health insurance giant Cigna used a computer algorithm to automatically reject hundreds of thousands of patient claims without examining them individually as required by California la…
Variants
A "variant" is an incident that shares the same causative factors, produces similar harms, and involves the same intelligent systems as a known AI incident. Rather than index variants as entirely separate incidents, we list variations of incidents under the first similar incident submitted to the database. Unlike other submission types to the incident database, variants are not required to have reporting in evidence external to the Incident Database. Learn more from the research paper.
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