Six in 10 Patients and Caregivers Facing Prior Authorization Delays or Denials Have Given Up on Care, Penguin Ai Survey Finds

Résumé détaillé

87% would support AI that speeds approvals, most of them on the condition of human oversight 62% of respondents who faced a prior authorization delay, denial, or medication…

87% would support AI that speeds approvals, most of them on the condition of human oversight

PALO ALTO, Calif., Nov. 12, 2026 /PRNewswire/ -- Patients and caregivers are giving up on care rather than fight their insurer over prior authorization. In a national survey of 500 U.S. adults commissioned by Penguin Ai, 62% of those who faced a delay, denial, or medication restriction say they have given up on care because fighting their insurer wasn't worth it. Across the full sample, 48% say the same.

Every respondent needed at least one prior authorization for themselves or a family member in the past two years. More details on the findings can be found here.

"Six in 10 people who faced a delay or denial gave up on care. Among the people who appealed, nearly half got the decision reversed," said Fawad Butt, co-founder and CEO of Penguin Ai. "Patients are leaving a process that often rules in their favor. Health plans and providers can keep more patients from giving up by putting complete clinical information in front of reviewers on the first submission."

Most wait four days or longer (62%). Only 14% of respondents received a same-day decision. The most common wait was four to seven days (29%), and about one in three respondents waited a week or longer or were still waiting when they took the survey.

Respondents also lost time to phone calls and paperwork with their insurer, including appeals. Seventy percent spent at least an hour, and 16% spent more than five hours. Nearly half (49%) rated their stress a 4 or 5 out of 5.

Patients who appeal win nearly half the time. Of the 44% of respondents who appealed, 47% had the decision overturned and 24% saw it upheld. Another 20% were still waiting for an outcome, and 8% gave up partway through.

Most don't know whether AI played a role. Only 8% of respondents were told AI or automated software was involved in their decision. Another 32% suspect it was, and 32% have no idea.

Most say AI involvement would make a denial worse.

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