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AI incident

Algorithm auto-denied insurance claims at scale

Health insurer · 2023

Organisation
Health insurer
Year
2023
Failure mode
Automation harm / over-reliance
Severity
critical
Domain
Insurance pricing / risk
Agentic
Yes — an AI system acting, not just advising
Source
Investigative reports, 2023

What happened

Claims were reportedly denied in bulk with little individual clinician review.

What would have prevented it

Human review of adverse decisions + audit trail

Requirements this maps to

Editorial cross-reference from our prevention note — it is not a finding that any law was breached.