A message left at the scene of an insurance executive’s fatal shooting — “deny,” “defend” and “depose” — echoes a phrase commonly used to describe insurer tactics to avoid paying claims.
The three words were written on the ammunition a masked gunman used to kill UnitedHealthcare CEO Brian Thompson, according to two law enforcement officials who spoke to The Associated Press on condition of anonymity Thursday. They're similar to the phrase “delay, deny, defend” — the way some attorneys describe how insurers deny services and payment, and the title of a 2010 book that was highly critical of the industry.
Police haven't officially commented on the wording or any connection between them and the common phrase. But Thompson's shooting and the messages on the ammunition have sparked outrage on social media and elsewhere, reflecting a deepening frustration Americans have over the cost and complexity of getting care.
What does the phrase mean?
“Delay, deny, defend” has become something of a rallying cry for insurance critics. The terms refer to insurers delaying payment on healthcare claims, denying claims and defending their actions.
“Delay, deny, defend” is also the title of a 2010 book by Jay Feinman that delves into how insurers handle claims.
How does the phrase relate to UnitedHealthcare?
UnitedHealthcare provides coverage for more than 49 million Americans and brought in 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 for denying claims or complicating access to care.
Critics say insurers are increasingly interfering with even routine care, causing delays that can, in some cases, hurt a patient's chances for recovery or even survival.
What is the criticism of insurers?
Doctors and patients have become particularly frustrated with prior authorizations, which are requirements that an insurer approve surgery or care before it happens.
UnitedHealthcare was named in an October report detailing how the insurer’s prior authorization denial rate for some Medicare Advantage patients has surged in recent years. The report from the U.S. Senate Permanent Subcommittee on Investigations also named rivals Humana and CVS.
Insurers say tactics like prior authorization are needed to limit unnecessary care and help control spiraling medical costs.
Frustrations extend beyond the coverage of care. Expensive breakthrough medications to slow Alzheimer’s disease or help with obesity are frequently not covered or have coverage limits.
How do Americans feel about insurers?
In the U.S. health care system, patients get coverage through a mix of private insurers such as UnitedHealthcare and government-funded programs such as Medicaid and Medicare. That can prove particularly frustrating for doctors and patients because coverage often varies by insurer.
Polls reflect those frustrations with the U.S. health care system in general and insurance companies in particular.
About two-thirds of Americans said health insurance companies deserve “a lot of blame” for high health care costs, according to a KFF poll 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 experienced a problem using their insurance in the previous year. That included denied claims, provider network problems and pre-authorization problems. Nearly half of insured adults with insurance problems said they were unable to resolve them satisfactorily.
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AP polling editor Amelia Thomson-DeVeaux in Washington contributed to this report.
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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.
