Words about ammunition used in shooting the CEO Echo tactics used by insurers

A message left at the scene of the fatal shooting of an insurance executive — “deny,” “defend,” and “depose” — echoes a phrase often used to describe insurers’ tactics to avoid paying claims.

The three words were on the ammunition a masked gunman used to kill the CEO of UnitedHealthcare Brian Thompsona law enforcement official told the Associated Press on Thursday. They are similar to the phrase “delay, deny, defend” – the way some lawyers describe how insurers deny services and payments, and the title of a 2010 book that was highly critical of the industry.

Police have not yet officially commented on the wording or any connection between them and the common phrase. But Thompson’s shooting and reports of the ammunition have sparked outrage on social media and elsewhere, reflecting the growing frustration Americans have with the cost and complexity of obtaining care.

“Delay, deny, defend” has become something of a rallying cry for insurance critics. The terms refer to insurers delaying payment of healthcare claims, denying claims and defending their actions.

“Delay, deny, defense” is also the title of a 2010 book by Jay Feinman that examines the way insurers handle claims.

UnitedHealthcare provides coverage to more than 49 million Americans and generated more than $281 billion in revenue last year as one of the nation’s largest health insurers. UnitedHealthcare and its rivals have become frequent targets of criticism from doctors, patients and lawmakers in recent years denying claims or make access difficult to assure.

Critics say insurers are increasingly interfere even in routine care, causing delays that in some cases can harm a patient’s chances of recovery or even survival.

Doctors and patients have become especially frustrated with prior authorization, a requirement that requires an insurer to approve a surgery or care before it takes place.

UnitedHealthcare was cited in an October report detailing how the number of insurer prior authorization denials for some Medicare Advantage patients has skyrocketed in recent years. The report of the US Senate Permanent Subcommittee on Investigations also mentions rivals Humana and CVS.

Insurers say tactics like prior authorization are needed to limit unnecessary care and control rising medical costs.

The frustrations extend beyond healthcare coverage. Expensive breakthrough drugs to slow it down Alzheimer’s disease or help with obesity are often not covered or have coverage limits.

In the U.S. health care system, patients receive coverage through a mix of private insurers such as UnitedHealthcare and government-funded programs such as Medicaid and Medicare. This can be particularly frustrating for doctors and patients, because coverage often varies per insurer.

Opinion polls reflect these frustrations with the American health care system in general and insurance companies in particular.

About two-thirds of Americans believe that health insurers deserve “a lot of blame” for high health care costs a KFF survey conducted in February.

A 2023 KFF survey of insured adults found that most give their health insurance an overall rating of “excellent” or “good” – but a majority also said they had encountered a problem using their insurance in the past year. That included denied claims, provider network issues and pre-authorization issues. Nearly half of insured adults with insurance problems indicate that they cannot resolve them satisfactorily.

AP Polling Editor Amelia Thomson-DeVeaux in Washington contributed to this report.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.