Defendant: Aetna Life Insurance Company | Category: Insurance | Added: 2026-07-12
Alleged Issue
The suit alleges Aetna denied precertification and post-service claims for single-level lumbar artificial disc replacement surgery by deeming it experimental or investigational under ERISA-governed plans.
Eligibility
Members of ERISA-governed plans insured or administered by Aetna who were denied coverage for single-level L-ADR surgery between August 7, 2016 (Hendricks) or March 4, 2019 (Howard) and February 8, 2023.
Estimated Payout
up to $55,000 reimbursement for out-of-pocket single-level L-ADR costs
Claim Deadline
2026-09-29
Background
The consolidated action Hendricks and Sagalongos v. Aetna Life Insurance Company (No. 2:19-cv-6840-AB) and Howard v. Aetna Life Insurance Company (No. 2:22-cv-01505-AB) proceeded in the U.S. District Court for the Central District of California and received final approval on June 5, 2026. The settlement provides three forms of relief for members whose single-level L-ADR surgery was denied as experimental or investigational, including reimbursement of up to $55,000 for out-of-pocket costs and a pathway to new coverage requests, and a claim form is the only way to obtain relief. Administered by Atticus Administration, it sets staggered deadlines depending on the class member's situation.