AI incident #501 ·

Length of Stay False Diagnosis Cut Off Insurer's Payment for Treatment of Elderly Woman

Open on the AI Incident Database 1 news report Synced from the AIID API · record last edited 3 Sep 2026

What happened

An elderly Wisconsin woman was algorithmically determined to have a rapid recovery, an output which the insurer based on to cut off payment for her treatment despite medical notes showing her still experiencing debilitating pain.

Only the incident metadata is stored here. The underlying news reports are on the AI Incident Database (CC BY-SA 4.0); use the links above to read them.

News reports (1)

Coverage catalogued by the AI Incident Database. Titles link to the original publisher; the text is not reproduced here.

Who was involved

Alleged developer
NaviHealth
On AIID: NaviHealth
Alleged harmed party
Frances Walter Elderly patients
On AIID: Frances Walter, Elderly patients

AI systems implicated

AI-enabled decision support systems

Classification (MIT AI Risk Repository taxonomy)

Causal entity
AI
Intent
Intentional
Timing
Post-deployment
Harm level
AI tangible harm event
Sectors
human health and social work activities
Countries
US

Risk entries describing this failure mode

Entries from the MIT AI Risk Repository coded to subdomain 7.3.

  • Reliability issues

    "Relying on general-purpose AI products that fail to fulfil their intended function can lead to harm. For example, general- purpose AI systems can make up facts (‘hallucination’), generate erroneous computer code, or pro...

    International AI Safety Report 2025 (Bengio2025)

  • Type 2: Bigger than expected

    Harm can result from AI that was not expected to have a large impact at all, such as a lab leak, a surprisingly addictive open-source product, or an unexpected repurposing of a research prototype.

    TASRA: a Taxonomy and Analysis of Societal-Scale Risks from AI (Critch2023)

  • Type 3: Worse than expected

    AI intended to have a large societal impact can turn out harmful by mistake, such as a popular product that creates problems and partially solves them only for its users.

    TASRA: a Taxonomy and Analysis of Societal-Scale Risks from AI (Critch2023)

  • Ethics and Morality Issues

    LMs need to pay more attention to universally accepted societal values at the level of ethics and morality, including the judgement of right and wrong, and its relationship with social norms and laws.

    Towards Safer Generative Language Models: A Survey on Safety Risks, Evaluations, and Improvements (Deng2023)

  • Safe learning

    "AGIs should avoid making fatal mistakes during the learning phase. Subproblems include safe exploration and distributional shift (DeepMind, OpenAI), and continual learning (Berkeley)."

    AGI Safety Literature Review (Everitt2018 )

  • Malign belief distributions

    "Christiano (2016) argues that the universal distribution M (Hutter, 2005; Solomonoff, 1964a,b, 1978) is malign. The argument is somewhat intricate, and is based on the idea that a hypothesis about the world often includ...

    AGI Safety Literature Review (Everitt2018 )

  • Meta-cognition

    "Agents that reason about their own computational resources and logically uncertain events can encounter strange paradoxes due to Godelian limitations (Fallenstein and Soares, 2015; Soares and Fallenstein, 2014, 2017) an...

    AGI Safety Literature Review (Everitt2018 )

  • Misaligned consequentialist reasoning

    "As we think about even more intelligent and advanced AI assistants, perhaps outperforming humans on many cognitive tasks, the question of how humans can successfully control such an assistant looms large. To achieve the...

    The Ethics of Advanced AI Assistants (Gabriel2024)

Linked by AIID editors or by its text-similarity model.

Incidents in the same risk subdomain

All incidents in this subdomain