Insurance Company Used AI to Deny Cancer Care

Added: 2026-05-24

[00:00:00]An algorithm decided that a woman who survived stage four cancer didn't need cancer treatment. Yeah, I'm looking at the denial letter now. It says not medically necessary the patient had So this patient had stage four cancer and she was given four months. She got the treatment and she's alive. So walk me through the not medically necessary part. Okay, I'm sorry. Your reviewer determined that treatment wasn't necessary because she survived. Say that say that again.

[00:00:30]So the proof that she didn't need the treatment is that the treatment worked.

[00:00:34]Ma'am, okay.

[00:00:36]Let me ask you something hypothetically.

[00:00:38]If she had died, would you have paid the claim? I'll wait. Yeah, so if she dies, it's covered. If she lives, it's denied.

[00:00:46]I'm not putting words in your mouth. I'm reading them back to you in English. No, your your reviewer, who I'm assuming is a doctor, is your Is your reviewer a doctor? I'm sorry. An algorithm? And the algorithm's name is what? Brad? I'm not I'm not being hostile, ma'am. I'm being accurate.

[00:01:04]Okay. So let me make sure that I have this straight because your company sold a woman a policy.

[00:01:10]She paid her premiums for 19 years. She got sick. She got the only treatment that would save her life. It saved her life because of the treatment and now you're refusing to pay because it actually worked. So you're saying it wasn't medically necessary.

[00:01:26]How Make that make Make that make sense. Cuz the math is not mathing on this.