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Detectives in New York are investigating inscriptions of “deny”, “defend” and “depose” on bullet casings left at the scene of the murder of the UnitedHealth Group executive Brian Thompson, according to a person familiar with the case.
As a sprawling manhunt to find the killer enters a second day, New York Police Department officials are searching for a motive behind what they called a “brazen, targeted attack”.
The person said that police believe the words inscribed on the bullet casings may be a nod to Jay M Feinman’s 2010 book on the insurance industry, Delay, Deny, Defend, which looks at how large health insurers avoid paying claims. Feinman, a professor at Rutgers Law School, declined to comment.
The shooting of Thompson, head of Minnesota-based UnitedHealthcare’s insurance unit, outside the Hilton hotel in Midtown Manhattan early on Wednesday morning stunned New York residents.
Three bullet casings were left at the scene alongside three live rounds, the person added.
A CCTV recording of the incident shows a masked man in a hooded jacket firing several shots from a 9mm pistol equipped with a silencer before fleeing the scene.
Detectives do not believe the individual was a professional hitman but they do think he was proficient with firearms since in the CCTV recording his gun jams and he manages to clear the malfunction quickly.
The use of a silencer, which is illegal to own in New York state, suggests the shooter may have travelled from out of state, the person added.
Police were called to the scene shortly before 7am on Wednesday, where they found Thompson unconscious. He was later declared dead at nearby Mount Sinai Hospital.
The shooter, who fled the scene on an e-bike towards Central Park, where he was last seen later on Wednesday morning, remains at large.
At a press conference on Wednesday, Joseph Kenny, chief of detectives at the NYPD, said the investigation would look at “everything” to ascertain the killer’s motive.
“We’re looking at his social media, we’re interviewing employees, we’re interviewing family members, we will be speaking to law enforcement in Minnesota,” said Kenny.
Thompson’s wife Paulette told NBC News in a phone interview on Wednesday that “there has been some threats” against him, adding that they may have related to “a lack of coverage” but she did not know the precise details.
“I just know that he said there were some people that had been threatening him,” she added.
UnitedHealth Group is the fourth-biggest listed company in the US by sales, and its UnitedHealthcare insurance arm, which Thompson ran, generated about three-quarters of its $371.6bn of sales in 2023.
The healthcare group has been the subject of a continuing Department of Justice antitrust probe.
Lawmakers called in April for the Securities and Exchange Commission to investigate UnitedHealth executives, including Thompson and group chief executive Andrew Witty, over share sales that came ahead of reports about the DoJ investigation, which hurt UnitedHealth’s share price.
A huge cyber attack also rattled UnitedHealth’s Change Healthcare division for months this year, costing $1.6bn and potentially exposing the data of one in three Americans.
Additional reporting by Josephine Cumbo
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