Judge trims claims against Aetna in cancer coverage lawsuit

Aetna again got a partial win in a proposed class-action lawsuit that claims the health insurer wrongfully denied coverage for a cancer treatment called proton beam radiation therapy, according to court documents.

A judge in the U.S. District Court for the Southern District of Florida said March 19 that Sharon Prolow's simultaneous Employee Retirement Income Security Act claims can't proceed. 

Ms. Prolow's lawsuit, filed in March 2020, claimed Aetna violated its fiduciary obligations and wrongfully denied coverage of proton beam radiation therapy for breast cancer as an experimental or investigational treatment. Both the improper denial of benefit and breach of fiduciary duty claims were made under ERISA.

On Jan. 4, a court dismissed Ms. Prolow's breach of fiduciary duty claim, saying it was duplicative, but allowed her to amend the claim.

In a March 19 order, U.S. District Judge Kenneth Marra agreed with Aetna that Ms. Prolow's amended claim failed to correct the pleading deficiency in the court's initial dismissal. It also didn't successfully allege separate losses under the claims, Mr. Marra said.

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