United Healthcare CEO Shooting Highlights Deny and Defend Crisis

Words on ammo in CEO shooting echo common phrase on insurer tactics: Delay, deny, defend

In the AP article titled “Words on ammo in CEO shooting echo common phrase on insurer tactics” reports on the fatal shooting of UnitedHealthcare CEO Brian Thompson.

At the crime scene, authorities discovered ammunition inscribed with the words “deny,” “defend,” and “depose,” mirroring the phrase “delay, deny, defend,” commonly used to criticize insurance companies’ strategies to avoid paying claims.

Luigi Mangione’s manifesto:

To the Feds, I’ll keep this short, because I do respect what you do for our country. To save you a lengthy investigation, I state plainly that I wasn’t working with anyone. This was fairly trivial: some elementary social engineering, basic CAD, a lot of patience. The spiral notebook, if present, has some straggling notes and To Do lists that illuminate the gist of it. My tech is pretty locked down because I work in engineering so probably not much info there. I do apologize for any strife of traumas but it had to be done. Frankly, these parasites simply had it coming. A reminder: the US has the #1 most expensive healthcare system in the world, yet we rank roughly #42 in life expectancy. United is the largest company in the US by market cap, behind only Apple, Google, Walmart. It has grown and grown, but as our life expectancy? No the reality is, these have simply gotten too powerful, and they continue to abuse our country for immense profit because the American public has allowed them to get away with it. Obviously the problem is more complex, but I do not have space, and frankly I do not pretend to be the most qualified person to lay out the full argument. But many have illuminated the corruption and greed, decades ago and the problems simply remain. It is not an issue of awareness at this point, but clearly power games at play. Evidently I am the first to face it with such brutal honesty.

This incident has intensified public scrutiny of insurer practices and misplaced healthcare priorities  – highlighting widespread frustration with tactics perceived as prioritizing personal interests over patient care.


Experiencing a “deny and defend” response from healthcare providers can be profoundly devastating, especially when medical errors occur. Patients often feel abandoned by the very system entrusted with their care, leading to a profound sense of betrayal and loss of trust.

  • This abandonment not only hampers immediate recovery but also complicates future healthcare interactions, as patients may become hesitant to seek care or disclose information, fearing further neglect or denial.
  • The psychological impact is significant, compounding the physical harm and leading to what is termed “double harm.” This term refers to the initial injury caused by the medical error and the subsequent emotional trauma inflicted by the institution’s defensive and dismissive response.

In my personal experience, detailed at Enemy Held Territory, I encountered such challenges within the VA Community Care system. After a surgical complication, I faced a bureaucratic maze where both the VA and community providers deflected responsibility, prioritizing institutional protection over patient care. This systemic failure transformed a potentially correctable issue into a permanent disability, underscoring the urgent need for accountability and patient-centered approaches in healthcare.

The “deny and defend” culture not only undermines individual patient outcomes but also erodes public trust in the healthcare system. Addressing this issue requires systemic changes that prioritize transparency, accountability, and, most importantly, the well-being of patients.

 
The three words echo a common phrase—“delay, deny, defend”—describing allegations leveled at insurers who avoid paying claims, the Associated Press reported Thursday. The phrase, adopted by critics of the healthcare industry, refers to the ways insurance companies “delay paying claims, deny valid claims in whole or part, and defend their actions by forcing claimants to enter litigation,” according to “Delay Deny Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It,” a book on the topic published in 2010. The book claims to be “an expose of insurance injustice and a plan for consumers and lawmakers to fight back.” It was written by Jay Feinman, an expert in insurance law and professor emeritus at Rutgers University who set out to show companies denying valid claims was “the result of an increasing and systematic focus on maximizing profits by major companies such as Allstate and State Farm.” Though police haven’t publicly said the motive for Thompson’s killing was related to his work, UnitedHealth Group—which oversees UnitedHealthcare—is one of the nation’s largest healthcare insurers, was ranked 19th on Forbes’ list of the world’s biggest companies this year and has a market capitalization of more than $560 billion. The New York Times reported last year that UnitedHealthcare had plans with denial rates ranging from 7% to 27% in 2019, and the AP reported UnitedHealthcare, along with other for-profit insurers, “have become frequent targets of criticism” for denying claims and making it harder to get care.