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Case tracker · AI benefit & claim denials

Kisting-Leung v. Cigna Corporation

AI benefit & claim denials
Ongoing
Filed Jul 24, 2023; class advanced Mar 2025
AI system / company
Cigna "PxDx" automated claims-review algorithm
Jurisdiction
United States (California)
Court / regulator
U.S. District Court, E.D. Cal.
Status
Ongoing

What happened

Following a ProPublica investigation, plaintiffs filed a class action alleging Cigna's PxDx algorithm enabled mass denial of claims, with reviewing doctors allegedly spending an average of about 1.2 seconds per case, contrary to California law requiring thorough, fair review. In March 2025 the court allowed the class action over the AI-based algorithm to proceed.

About ai benefit & claim denials cases

Algorithmic tools used by insurers or health plans to deny medically necessary care or benefits at scale, overriding clinician judgment.

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