Health insurers
Health insurer lawsuits, over how claims get denied.
Three federal class actions allege that UnitedHealth, Humana and Cigna used algorithms to deny or cut off care. Here is what each complaint claims, what the courts have allowed to proceed, and which of your denial records matter.
We verify each case against the court docket and the regulators involved, and we show our sources. We don't decide whether you are part of a case or match you with a lawyer. We help you get the records that matter.
Verified cases
3 cases, each fully sourced
- 0:23-cv-03514-JRT-SGEActiveUnitedHealth nH Predict Medicare Advantage denial lawsuitThe class action over UnitedHealth's use of the nH Predict model for Medicare Advantage post-acute care: what survived dismissal, where it stands, and the denial records that matter.District of Minnesota · checked October 12, 2026
- 3:23-cv-00654-RGJ-CHLActiveHumana nH Predict Medicare Advantage denial lawsuitThe class action over Humana's alleged use of nH Predict for Medicare Advantage post-acute care denials: the 2025 ruling, current posture, and the records that matter.Western District of Kentucky, Louisville Division · checked October 12, 2026
- 2:23-cv-01477-DAD-CSKActiveCigna PxDx algorithm claim denial lawsuitThe class action over Cigna's PxDx claim-review system: what is alleged, which claims proceed, where the case stands, and the denial records that matter.Eastern District of California (Sacramento) · checked October 12, 2026
Worth knowing
Before you do anything else
These are allegations about process
The complaints claim that software outputs, not clinicians, drove coverage decisions. The insurers dispute that. The case pages quote the court's rulings on which claims were allowed to continue and which were dismissed.
Your appeal rights exist regardless
Medicare Advantage and commercial plans have appeal processes with deadlines that run from the denial letter. Nothing about a lawsuit pauses those clocks. Appealing and keeping records of the appeal protects you either way.
The denial letter is evidence
The letter's date, denial code and stated reason, together with the treating clinician's orders, are what show whether a decision matched the medical facts.
If this involves you
The records that matter, and who has them.
Insurer cases turn on the paper trail: what was ordered, what was denied, when, and why. These are the documents that show it.
Every denial letter, with denial codes and stated reasons
The exact basis the plan gave for denying or ending coverage.
Held by: your health plan; you
Prior-authorization requests and the clinician's orders
What was requested, by whom, and on what clinical basis.
Held by: treating provider; facility
Explanations of Benefits and itemized bills
What was billed, paid and denied, by date.
Held by: your health plan; provider billing office
Appeal correspondence and plan documents (Evidence of Coverage)
Shows the appeal timeline and the coverage rules the plan agreed to.
Held by: your health plan; you
We send the request, follow up with the provider, and deliver the records to you. We don't take case details here and we never share your records with a law firm unless you tell us to.
Questions people ask
Straight answers, with sources
Does a lawsuit against my insurer change my own denial?
No. A pending class action does not reverse individual denials. Your plan's appeal process, and for Medicare Advantage the federal appeals levels, are how an individual denial gets reviewed. Keep every letter.source: ecfr.gov
How do I know a lawsuit is real?
Look for it on the court's own docket. Federal cases are on PACER, and multidistrict litigation is listed in the Judicial Panel on Multidistrict Litigation's monthly report with the court, judge and number of pending actions. Each case page here links to those documents.source: pacer.uscourts.gov
If a case is real, am I part of it?
Not automatically. In a class action, a court decides whether to certify a class and approves how members are notified; in an MDL, each person has their own filed case. Only a court-approved notice, a settlement administrator, or a lawyer you have retained can tell you where you stand. We don't make that call.source: law.cornell.edu
Which records should I get first?
The records from the providers who diagnosed or treated the injury at issue, plus pharmacy fill history for a drug case or the operative report and implant identification for a device case. Each case page lists the specific documents and who holds them.source: hhs.gov
How long does it take to get my records?
Under HIPAA, a provider generally has 30 days to act on your written request, and may take one 30-day extension if it tells you why in writing. Some state laws set shorter deadlines. We follow up with the provider and post every verified update to you.source: hhs.gov
Can my records go straight to my lawyer?
Yes. HIPAA lets you direct a copy of your records to a third party you name in a signed, written request. If you'd rather hold them yourself first, that works too.source: hhs.gov
Sources
Where this page comes from
- 42 CFR 422.101 Requirements relating to basic benefits
eCFR (U.S. Government Publishing Office) · ecfr.gov
Medicare Advantage plans must cover basic benefits and follow Medicare coverage rules when making medical-necessity determinations.
- Find a Case (PACER)
Administrative Office of the U.S. Courts · pacer.uscourts.gov
Federal court dockets and filings are public; PACER is the official system for finding and reading them.
- Individuals' Right under HIPAA to Access their Health Information
HHS Office for Civil Rights · hhs.gov
Covered entities generally must act on an access request within 30 days, with one 30-day extension if they explain the delay in writing; individuals may direct a copy to a third party and may be charged only a reasonable, cost-based fee.
- Federal Rule of Civil Procedure 23: Class Actions
Cornell Legal Information Institute · law.cornell.edu
Sets out how a class is certified, how class members are notified, and how a court reviews and approves a class settlement.