New York City police are investigating the mysterious words found carved into shell casings at the scene of a brazen attack that killed UnitedHealthcare CEO Brian Thompson.
Thompson, 50, was gunned down outside the New York Hilton Midtown hotel at approximately 6:40AM on Wednesday, December 4.
The attack occurred just hours before the start of a UnitedHealthcare investors conference in Manhattan, where Thompson was scheduled to appear.
Authorities believe the shooting was premeditated, with the suspect reportedly waiting for Thompson near the hotel. NYPD Commissioner Jessica Tisch said: “People passed the suspect, but he appeared to wait for his intended target.”
Additionally, Chief of Detectives Joe Kenny confirmed that the attack “does not appear to be a random act of violence,” though the motive remains unclear.
After the attack, the shooter fled the scene, escaping through an alley and then biking into Central Park.
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Detectives are now examining the possible significance of the three words etched into the shell casings: "deny", "defend", and "depose".
These terms bear a striking resemblance to the title of the 2010 book Delay, Deny, Defend by Jay Feinman, which critiques the insurance industry’s tactics in handling claims.
The book and its titular phrase highlight alleged practices by insurers to delay payments, deny claims, and vigorously defend decisions to avoid payouts, per AP. The phrase has since become a rallying cry for critics of the insurance industry, including those targeting auto, property, and health insurers.
“Delay, deny, defend” reflects broader frustrations with the health insurance system, with critics alleging that insurers frequently complicate access to care, leading to delays that can harm patient outcomes.
Feinman has not commented on the matter. However, police are reportedly exploring possible links between the words, the health insurance industry, and the attack on Thompson.
UnitedHealthcare - one of the largest health insurers in the United States - covers more than 49 million Americans and generated $281 billion in revenue last year. Alongside its rivals, the company has faced scrutiny from lawmakers, doctors, and patients for claim denials and pre-authorization requirements that critics say delay care.
A February KFF poll found that two-thirds of Americans blame health insurance companies for high healthcare costs, and a majority of insured adults reported experiencing problems with their coverage, including denied claims and unresolved disputes.
Mario Macis - a Johns Hopkins economist who studies trust in the health care system - said that "many" US citizens feel healthcare insurance companies are driven more by profits than supporting the public.
Thompson’s estranged wife, Paulette Thompson, revealed that the CEO had previously received threats, though she did not know specific details. "I just know that he said there were some people that had been threatening him," she told NBC News.
Paulette described her husband’s death as “senseless", saying: “Brian was an incredibly loving, generous, talented man who truly lived life to the fullest and touched so many lives. Most importantly, Brian was an incredibly loving father to our two sons and will be greatly missed.”
As the investigation continues, police are focused on uncovering the motive behind the attack. The words etched into the bullets remain a key piece of the puzzle, and detectives are probing whether they reflect a specific grievance tied to the health insurance industry or a broader ideological statement.
Meanwhile authorities have also revealed that a backpack they believe belonged to the gunman has been found in Central Park.
Additionally, NYPD Chief of Detectives Joseph Kenny has revealed on Friday that detectives are investigating whether the weapon used to kill Thompson was a “veterinary” gun - often used to euthanize animals.
Per the New York Post, Kenny said that the weapon used in the assassination "appears to be a larger handgun", adding that, "It’s a weapon commonly used on farms and ranches. If an animal has to get put down, the animal can be shot without causing a loud noise."
Authorities have urged the public to come forward with any information that could help identify the shooter. Anyone with information is being urged to contact Crime Stoppers at 1-800-577-TIPS.
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