Insurance murder suspect an Ivy League grad with health issues

26-year-old said to have suffered from chronic back pain that limited his daily life

ALTOONA, Pennsylvania - Luigi Mangione, the suspect charged with gunning down UnitedHealth executive Brian Thompson, briefly struggled with officers and angrily shouted while being escorted into a Pennsylvania courthouse on Dec. 10, as a clearer picture of his motives began to emerge a day after his arrest ended a massive manhunt.

Mangione, 26, turned towards a group of reporters and yelled in part, "...completely out of touch and an insult to the intelligence of the American people!" before deputies pushed him away. It was not clear what he was referring to.

At the court hearing, his defense lawyer told a judge that Mangione would oppose extradition to New York, where he is charged with murder and other crimes. That decision could delay the process by weeks but is unlikely to block his eventual transfer.

For now, Mangione will remain in jail in Pennsylvania, where he faces gun and forgery charges.

His attorney Tom Dickey said at a news conference that Mangione planned to plead not guilty to the charges.

Mr. Brian Thompson was the CEO of UnitedHealth's insurance arm, UnitedHealthcare, one of the largest health insurers in the U.S. He was shot dead on the morning of Dec. 4 outside a hotel in Manhattan in what police said was a targeted attack, sparking a manhunt that led to Mangione's arrest.

More clues about Mangione's possible motivation came to light on Dec. 10. When arrested, he was in possession of a handwritten manifesto that offered insight into his mindset, according to police.