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The at-large suspect who gunned down UnitedHealthcare CEO Brian Thompson outside a Midtown hotel may have left a message on the bullets he used to kill the executive Wednesday morning, according to police sources.

The NYPD is investigating the possible message — which appears to include the words “deny,” “depose” and “defend” — engraved on live rounds and shell casings left behind by the masked assassin after he shot Thompson, 50, several times at about 6:46 a.m. before fleeing, the sources said.

The words are possible attacks on the health insurance industry, in which Thompson is one of the most powerful leaders — and strikingly similar to a 2010 book condemning the business.

Surveillance footage outside the Midtown Hilton hotel shows a person of interest and the suspected shooter in the murder of UnitedHealthcare CEO Brian Thompson. Obtained by NY Post
Surveillance images released of the suspect show the gunman visiting a Starbucks at 6th Ave and 56th Street in Midtown just before the shooting. DCPI

“Delay, Deny, Defend” — two of the three words seemingly left — is sub-titled: “Why insurance companies don’t pay claims and what you can do about it.”

Police are looking at possible ties to the book, as well as more general references to the health industry, as a potential motive, sources told The Post.

The book’s author, Jay M. Feinman — a distinguished professor emeritus at Rutgers Law School — declined to comment Thursday morning. 

The words on the bullets are strikingly similar to this 2010 book condemning the insurance business. Amazon books
Brian Thompson, the CEO of UnitedHealthcare, was fatally shot Wednesday, Dec. 4, 2024, in New York. UnitedHealth Group

Cops had recovered three live 9-millimeter rounds and three discharged casings in front of the Hilton hotel on Sixth Avenue, where Thompson, of Minnesota, was set to host an investors’ conference that morning, police officials said.

Sources said several of the pieces of evidence each contained one word, indicating the killer may have been trying to leave a message as investigators try to piece together a motive.

Thompson’s estranged wife, Paulette “Pauley” Thompson, 51, told NBC News hours after the murder that the CEO had been getting “some threats.”

“Basically, I don’t know, a lack of coverage?” she said, suggesting it was tied to her husband’s job.

“I don’t know details. I just know that he said there were some people that had been threatening him.”

Members of the New York police crime scene unit pick up cups marking the spots where bullets lie as they investigate the scene outside the Hilton hotel in Midtown Manhattan. AP
Sources said several of the pieces of evidence each contained one word. AP

The masked gunman used a silencer and appeared to be an experienced shooter based on surveillance footage obtained by The Post. 

He was seen waiting outside the luxury hotel for his target — the CEO with a yearly salary of nearly $9.9 million — before he calmly fired off multiple shots at close range, causing Thompson to stumble and collapse. 

The gun had jammed but the calculated and methodical killer was able to clear it — showing he was a skilled gunman — and continue firing as his victim helplessly tried to crawl away, according to sources and the footage.

What we know about the shooting of UnitedHealthcare CEO Brian Thompson

  • Brian Thompson, the CEO of insurance giant UnitedHealthcare, was gunned down Wednesday outside a luxury Midtown hotel in a “brazen, targeted attack,” police said.
  • The methodical killer used a firearm with a silencer outside the Hilton hotel along Sixth Avenue.
  • The gunman fired at Thompson multiple times, striking his back and right calf before fleeing on foot.
  • The NYPD released a new photo of the hooded suspect standing in front of the counter at the Starbucks at West 56th Street and 6th Avenue, just minutes from the Hilton hotel where he gunned down Thompson, 50. 
  • Thompson was named CEO of UnitedHealth in April 2021. He joined the company in 2004. He was one of several senior executives at the company under investigation by the Department of Justice.
  • Thompson’s wife, Paulette, said her husband had been getting threats before he was killed.
  • The NYPD is investigating a possible message — which appears to include the words “deny,” “depose” and “defend” — engraved on live rounds and shell casings left behind by the masked assassin.

Follow along with The Post’s live updates on the news surrounding Brian Thompson’s murder.

He then ran into an alleyway and hopped on an e-bike, which he rode north along Sixth Avenue into Central Park, where surveillance camera coverage is spotty, police said. 

But the suspect may have made some major mistakes that could help investigators identify him.

He bought coffee, a water bottle and two PowerBars at a nearby Starbucks before the killing and tossed his bottle and coffee cup in a trash can — which cops dug out of the garbage and now have as evidence, according to sources.

And investigators also discovered a phone in an alleyway near the Hilton which they believe belongs to the killer, the sources said. Investigators have obtained a search warrant to comb through the contents of the phone. 

The lot of evidence could also help investigators to determine a motive for the execution-style hit. 

“Based on the evidence we have so far, it does appear that the victim was specifically targeted,” NYPD Chief of Detectives Joe Kenny said at an earlier conference. “But at this point, we do not know why. This does not appear to be a random act of violence.”

Thompson led the country’s largest private health insurer, which has a controversial history of rejecting customers’ claims and is facing a Department of Justice antitrust investigation. 

But he was well respected in his field and was a husband and dad of two sons in Minnesota. 

The CEO was rushed to Mount Sinai West Hospital after he was shot and he was pronounced dead at 7:12 a.m., police said.

A source confirmed to The Post that UnitedHealthcare informed investigators that Thompson had been the recipient of threats — though the source noted it’s not uncommon for someone in his position at a health care company.

A manhunt for the suspect is underway and the NYPD is offering a $10,000 reward for information.