Artificial Intelligence - Cigna - Litigation over alleged use of AI to wrongfully avoid paying for treatment (US)

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Cigna is facing a US complaint accusing it of developing and relying on an algorithm to enable its doctors to automatically deny payments for treatments that do not match certain pre-set criteria, thereby evading the legally required individual physician review process. According to the complaint, Cigna’s doctors use the PXDC system to instantly reject claims on medical grounds without ever opening patient files, leaving thousands of patients effectively without coverage and with unexpected bills.

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