Aetna Life Insurance $3.42M Proton Beam Therapy Settlement

Were you or a covered family member denied proton beam therapy (PBT) to treat localized prostate cancer under an Aetna ERISA health plan between 2015 and 2024? You could receive $12,000 to $48,000 from a $3.42 million class action settlement. Submit your claim by October 3, 2025 to secure your payment.

Who Is Eligible?

You may qualify if all of the following apply:

• You were a member, participant, or beneficiary of an ERISA-governed employee welfare benefit plan administered or insured by Aetna Life Insurance Co.
• You (or a covered beneficiary) were diagnosed with localized prostate cancer and had an intact prostate.
• A precertification request for proton beam therapy was denied between Jan. 1 2015 and Mar. 31 2024 because the treatment was labeled “experimental,” “investigational,” “unproven,” or similar language not in the plan’s definition of medical necessity.
• You ultimately received PBT for the same diagnosis code and did not have allowed claims for another recognized treatment.

Those whose post-service PBT claims were later denied under the same criteria are also included. Individuals who obtained PBT coverage from another insurer or received a denial for administrative reasons are excluded.

Potential Payout

• Minimum payment: $12,000 per valid claim.
• Maximum payment: Up to $48,000 with proof of PBT expenses or debt above $12,000.

The settlement sets aside $3,408,000 for an estimated 71 class members. If fewer claims are filed, unclaimed funds may be donated to court-approved charities or revert to Aetna.

Required Documentation

To receive more than the $12,000 minimum, provide any of the following that show out-of-pocket PBT costs:

• Provider receipts for proton beam therapy
• Cancelled checks or credit-card statements
• Notarized affidavits or sworn statements from the payer
• Loan documents, collection notices, or self-pay agreements

How to File a Claim

1. Gather your claimant ID (found on the mailed notice, if any) and last name.
2. Complete the online claim form, or download and mail the paper form.
3. Upload or attach supporting documents if you seek more than $12,000.
4. Submit online, email, or ensure your mailed form is postmarked by Oct. 3, 2025.

Key Deadlines

• Claim & Exclusion Deadline: Oct. 3 2025
• Final Approval Hearing: Nov. 18 2025

If the court grants final approval and no appeals are filed, checks are expected about 65 days after the settlement becomes final.

Settlement at a Glance

• Total Fund: $3,420,000
• Lead Plaintiff Service Award: $15,000
• Attorney Fees & Costs: Up to $1,675,000 (separate from class payments)
• Case: Sharon Prolow and Mark Lemmerman v. Aetna Life Insurance Co., No. 9:20-cv-80545
• Court: U.S. District Court (S.D. Fla.)
• Settlement Website: aetnapbtsettlement.com
• Administrator: Atticus Administration, PO Box 64053, St. Paul, MN 55164 – 1-800-757-8121 – AetnaPBTSettlement@atticusadmin.com

Why the Lawsuit Settled

Plaintiffs alleged Aetna wrongfully labeled proton beam therapy for localized prostate cancer as “experimental” or “not medically necessary,” violating ERISA plan terms. Aetna denies liability but agreed to settle to avoid the expense, delay, and uncertainty of further litigation.