lawsuitFiled
U.S. District Court, Eastern District of California v. Cigna (PxDx algorithm)
March 31, 2025 · United States
In Kisting-Leung v. Cigna, the court in March 2025 allowed part of a class action to proceed, alleging Cigna used its 'PxDx' algorithm to batch-deny hundreds of thousands of claims without physician review (reportedly ~1.2 seconds per claim), in breach of plan terms and California law.
Key takeaway — how to prevent this
AI that denies insurance claims or benefits must preserve meaningful human review of medical necessity; automated mass denials draw bad-faith, breach-of-contract and class-action liability.
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