After UnitedHeathcare CEO Brian Thomspon was gunned down on a New York City street on Wednesday, investigators found “bizarre” engravings on the bullet casings left on the scene — the words “deny,” “depose” and “defend,” according to law enforcement sources.

Thompson ran the company’s insurance arm, and the words on the ammunition may have been a reference to strategies insurance companies use to try to avoid paying claims.

Officers give chest compressions after Thompson was shot

Here’s what we know:

The Three D’s of the insurance industry

The apparent messages found on the bullets could be a reference to tactics that legal experts say the insurance industry uses to avoid paying claims.

Insurance critics call these the Three D’s – delay, deny and defend – referring to insurers delaying payment on healthcare claims, denying claims and defending their actions.

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A person of interest in the ambush killing of UnitedHealthcare CEO Brian Thompson 

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.

The distinguished Rutgers Law School professor Jay Feinman published a 2010 book on the practice titled “Delay Deny Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It.”

“The denial of valid insurance claims is not occasional or accidental or the fault of a few bad employees. It’s the result of an increasing and systematic focus on maximizing profits by major companies such as Allstate and State Farm,” the book’s description reads.

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Brian Thompson was the CEO of UnitedHealthcare’s insurance arm

The New York Times also reports that this “absurd process has infiltrated American health care.”

“It’s called prior authorization. Here’s how it works, before your doctor provides a treatment, your insurance requires them to prove it’s necessary. This is often a time-consuming process that can cause dangerous delays,” journalist Alexander Stockton writes in a video op-ed.

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

Police officers investigate the scene where UnitedHealthcare CEO Brian Thompson was fatally shot in Midtown Manhattan near a hotel on 54th Street between 6th and 7th Avenues on Dec. 4, 2024, in New York, United States. (Photo by Kyle Mazza/Anadolu vi

According to sources, the words “deny” and “defend” were written on the live rounds and casings left behind by the assassin, but the casings also included the word “depose” instead of “delay.”

One source described these markings to FOX 5 NY as “bizarre and scary.”

Despite this correlation, the motive behind the attack is unknown, and it is even unclear if the engravings are supposed to send a specific message.

The suspected gunman in the killing of Brian Thompson

Police haven’t officially commented on the wording or any connection between them and the common phrase.

A manhunt continues for the gunman a day after the ambush-style attack. Law enforcement sources confirm with FOX 5 NY that they have received a number of tips, and in one of those tips, there is a name police are looking at.

What happened?

Police said Thompson was heading to the company’s annual investor conference at the New York Hilton Midtown around 6:45 a.m. when a person walked up behind him and shot him multiple times.

Thompson was alone at the time and did not have a security detail, police said.

Officers found Thompson on the ground outside the hotel with gunshot wounds to his back and right calf, according to Joseph Kenny, the police department’s chief of detectives. He was pronounced dead at a nearby hospital at 7:12 a.m.

What do we know about the shooter?

Kenny said the shooter appeared to be a man who was wearing a black face mask, black and white sneakers and a “very distinctive” gray backpack.

He arrived outside the hotel about five minutes before Thompson got there, waiting near the building and ignoring others before he approached Thompson from behind.

A surveillance image released by the NYPD shows the suspect in the shooting death of United Healthcare CEO, Brian Thompson on Wednesday, December 4, 2024. (NYPD Crimestoppers)

After the assailant began to fire at Thompson, the gun malfunctioned, but he was able to quickly fix the issue and continue firing, Kenny said.

“From watching the video, it does seem that he’s proficient in the use of firearms as he was able to clear the malfunctions pretty quickly,” Kenny said.

The shooter ran into an alleyway near the hotel and later got on the e-bike that he took into Central Park.

Kenny said police found a cellphone in the alleyway, but it was unclear if it belonged to the shooter.

This article uses reporting from the Associated Press.



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