Humana also using AI tool with 90% error rate to deny care, lawsuit claims

Humana, a major health insurance provider, is facing a lawsuit for allegedly utilizing an AI model with a 90 percent error rate to deny care to elderly people under their Medicare Advantage plans. The lawsuit claims that the use of this AI model constitutes a fraudulent scheme that results in financial gain for the company while leaving elderly beneficiaries with overwhelming medical debt or without necessary care. The plaintiffs argue that the AI model fails to consider the full circumstances of each patient and their doctors’ recommendations, leading to draconian and inflexible predictions. Despite the inaccuracy of the AI model, Humana and other insurers continue to use it to avoid paying for covered care and make more profit. The lawsuit seeks damages for financial losses and emotional distress and aims to prevent Humana from using the AI-based model to deny claims.