AI Incident Database: Cigna Algorithm PXDX Allegedly Rejected Thousands of Patient Claims En Masse in Breach of California Law
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.
AI Incident Database · Incident 591Operator lens (high): inspect D2 (output validation), D6 (autonomy oversight), D7 (tool permissions).
Event summary
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.
Linked entities
Related graph edges
| Edge | Type | Confidence |
|---|---|---|
| ent-aiid-cigna to ent-psf-d2 | maps to | 60% |
| ent-aiid-cigna to ent-psf-d2 | maps to | 60% |
| ent-aiid-cigna to ent-psf-d2 | maps to | 60% |
| ent-aiid-cigna to ent-psf-d6 | maps to | 60% |
| ent-aiid-cigna to ent-psf-d6 | maps to | 60% |
| ent-aiid-cigna to ent-psf-d6 | maps to | 60% |
| ent-aiid-cigna to ent-psf-d7 | maps to | 60% |
| ent-aiid-cigna to ent-psf-d7 | maps to | 60% |
| ent-aiid-cigna to ent-psf-d7 | maps to | 60% |