Who was Brian Thompson, healthcare CEO gunned down in New York?

Brian Thompson, the US health care insurance CEO who was gunned down in an apparent targeted attack in Manhattan on Wednesday, had been receiving threats related to medical "coverage", according to his widow.

"There had been some threats," Paulette Thompson told NBC. "Basically, I don’t know, a lack of [medical] coverage? I don’t know details."

"I just know that he said there were some people that had been threatening him."

Mr Thompson, who worked at UnitedHealth for several decades before rising to chief executive, was shot in the back by an unknown assailant who is now the target of a police manhunt.

Two law enforcement sources told CBS News, the BBC's US news partner, that the words "deny, defend, depose" were written on shell casings found at the scene.

Investigators believe this could be a reference to the "three D's of insurance" - a known reference made by opponents of the industry.

The terms refer to alleged tactics used by insurance companies to refuse payment claims by patients in America's complicated and mostly privately run health care system.

The suspect used a silencer attached to a pistol as he arrived at a hotel in Midtown Manhattan to speak at an insurance conference.

Police have not identified the killer or announced any suspected motive. The killer fled into Central Park following the attack and is still at large.

Authorities are focusing on a surveillance image taken in a branch of Starbucks just before the shooting.

Although a mask covers most of his face, enough is visible in the image that investigators are using facial recognition software to try to find a match.

Police are also testing bullet casings live rounds found at the scene for DNA.

Mr Thompson's death was mourned by family and colleagues.

“We are shattered to hear about the senseless killing of our beloved Brian," his sister-in-law said in a statement issued on behalf of the family.

"Brian was an incredibly loving, generous, talented man who truly lived life to the fullest and touched so many lives," she said.

She also added that he was "an incredibly loving father" to the couple's two sons.

UnitedHealth Group said it was "deeply saddened and shocked" by his death.

"Brian was a highly respected colleague and friend to all who worked with him," the company said in statement.

"We are working closely with the New York Police Department and ask for your patience and understanding during this difficult time. Our hearts go out to Brian's family and all who were close to him."

Mr Thompson, who lived in a suburb of Minneapolis, Minnesota, was named chief executive of UnitedHealth in April 2021.

He made $10.2m (£8m) from the company last year. In 2022, he made $9.8m and in 2021 he made $9.6m.

He started at the health insurance provider in 2004, and has held multiple leadership roles, including CEO of the company’s government programmes division.

UnitedHealth is the largest private insurer in the US.

Prior to starting at UnitedHealth, Mr Thompson was a manager at PwC for a number of years, according to his LinkedIn account.

He graduated from the University of Iowa in 1997 with a bachelor's in business administration, it adds.

Mr Thompson had been facing insider trading allegations.

A class-action lawsuit filed by a pension fund in May 2024 alleged that Mr Thompson sold $15m of his UnitedHealth shares when he knew that the company was under investigation by the US Department of Justice.

Officials were looking into whether the company violated US antitrust law, according to an investigation made public by a report in the Wall Street Journal in February.

The BBC has contacted UnitedHealth for comment.

UnitedHealth is a huge company with interests in insurance, health care providers, pharmacy services and health data. In 2023 it had more than $371bn in revenues.

According to court documents, the company has purchased more than 35 healthcare companies over the last 10 years. Justice department investigators have been looking into whether it used its market power to reduce competition, hurting customers and employees.

The Wall Street Journal reported that officials interviewed healthcare industry representatives, and were asking questions about “possible effects of the company’s doctor-group acquisitions on rivals and consumers”.

The City of Hollywood Firefighters’ Pension Fund initiated a complaint against Mr Thompson and other executives, accusing them of failing to tell investors about the investigation before selling a total of more than $117m in company stock.

As long-term investors who buy large amounts of stock, pension funds often take action on behalf of shareholders, and proposed a class-action lawsuit against UnitedHealth.

The lawsuit remains active.

The company is also facing legal action over its proposed takeover of a rival healthcare company.

UnitedHealth offered to buy Amedisys, a provider of home healthcare and hospice services, for $3.3bn (£2.6bn).

But on 12 November, the justice department sued to stop the merger, alleging it would eliminate competition and “harm patients who receive home health and hospice services, insurers who contract for home health services, and nurses who provide home health and hospice services”.

UnitedHealth responded that the merger would be "pro-competitive and further innovation, leading to improved patient outcomes and greater access to quality care". It described the justice department suit as an "overreaching interpretation of the antitrust laws".

Under President Joe Biden's administration, the justice department has stepped up its enforcement of US antitrust laws, which aim to prevent industrial monopolies and encourage competition between companies.