Court Rules in Aetna's Favor

Tuesday, August 15th 2000, 12:00 am
By: News On 6

PHILADELPHIA (AP) — A federal appeals court agreed Friday with a lower court judge that Aetna Inc.'s U.S. Healthcare unit doesn't violate racketeering laws in its advertising and membership materials.

The 3rd U.S. Circuit Court of Appeals said plaintiffs did not support their assertion that they paid too much for health care.

A federal court judge dismissed the lawsuit in October, saying the company's advertisements were not fraudulent.

The class-action lawsuit said Aetna promised quality medical care but encouraged widespread cost-cutting and penalized doctors who didn't increase their patient load. The lawsuit, filed in April 1999 on behalf of nearly 6 million Aetna customers, claimed the abuses were so widespread they constituted a pattern of fraud.

In fighting the case, Aetna Inc., the nation's largest health insurer, admitted that its advertising claims of being committed to ``maintaining and improving quality health care'' were ``mere puffery,'' but said that didn't amount to fraud.

The appeals court said Friday that the plaintiffs hadn't alleged or proved that they suffered medical injuries, received inadequate care or were denied care as a consequence of the structure of Aetna's HMO plan.

David Carter, a spokesman for Hartford, Conn.-based Aetna, said the ruling was significant because it showed that such claims would have to be alleged and proven on an individual basis.

Calls went unanswered Friday afternoon to the Foundation for Taxpayer and Consumer Rights, a Santa Monica, Calif., consumer group representing the plaintiffs.


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