Kazda v. Aetna Life Insurance Company

UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF CALIFORNIA
Case No. 3:19-cv-02512-WHO

If you had a pre-authorization request or post-service claim for lipedema surgery denied by Aetna, you could receive benefits from a class action settlement.

  • Aetna has changed its clinical policy bulletin regarding liposuction to treat lipedema (“Lipedema Surgery”).

  • Effective September 1, 2020, Aetna revised its “cosmetic” coverage position with respect to suction lipectomy. Aetna’s coverage position now explains when liposuction is medically necessary to treat lipedema, and when Aetna will cover Lipedema Surgery.

  • Persons who paid out-of-pocket for Lipedema Surgery after cosmetic, experimental or investigational denial between May 9, 2015, and September 1, 2020, are eligible for reimbursement under a settlement agreement with Aetna, for surgeries that took place prior to September 1, 2022.

  • Persons who were denied Lipedema Surgery by Aetna during the same time period, but have not yet undergone the surgery, and are Aetna members, are hereby notified that they can submit new coverage requests for Lipedema Surgery. Aetna will review those requests in accordance with criteria in the new coverage policy bulletin.

  • Court-appointed lawyers for the class of Aetna members will ask the Court for up to $675,000.00 in attorney’s fees and $46,162.84 in expenses to be paid separately by Aetna for investigating the facts, litigating the case, and negotiating the Settlement.

  • Your legal rights are affected whether you act or don’t act. Read the Notice carefully.

YOUR LEGAL RIGHTS AND OPTIONS IN THIS SETTLEMENT:

DO NOTHING

If you do nothing, you will remain a Class Member and you will be able to seek reimbursement for out-of-pocket expenses incurred for Lipedema Surgery

EXCLUDE YOURSELF

If you choose to exclude yourself, you will lose the ability to seek coverage for Lipedema Surgery under the terms of the Settlement, but you can bring your own lawsuit.

OBJECT

Write to the Court about why you don’t like the Settlement.

GO TO A HEARING

Ask to speak in Court about the fairness of the Settlement.

APPEAR THROUGH AN ATTORNEY

If you desire, you may enter an appearance in this case through an attorney at your own expense.

  • These rights and options—and the deadlines to exercise them—are explained in the Notice.

  • The Court in charge of this case still has to decide whether to approve the Settlement. Benefits under the Settlement will be provided if the Court approves the Settlement, if any appeals relating to the Settlement are resolved, and after claim forms and supporting documentation are provided. Please be patient.