AMERICANS could get thousands of dollars in cash payouts after a major health insurer agreed to settle it wrongly denied cancer treatment.
The $3.42 million settlement comes after allegations that Aetna blocked coverage for proton beam therapy, a targeted radiation treatment for prostate cancer.
Aetna agreed to a $3.42 million settlement after wrongfully denying proton beam therapy for prostate cancer (stock)[/caption]
Aetna, one of the nation’s largest health insurance providers, agreed to pay without admitting liability (stock)[/caption]
The case was filed in the US District Court for the Southern District of Florida.
Court records show Aetna has not admitted wrongdoing but agreed to settle the class action to avoid further litigation costs.
Under the terms of the deal, eligible patients can receive a flat payment of $12,000.
Those who provide proof of payment or debt tied to the therapy may collect as much as $48,000.
Only members, participants or beneficiaries of employee benefit plans governed by the Employee Retirement Income Security Act qualify.
The claims must involve treatment between January 1, 2015, and March 31, 2024.
Patients needed a localized prostate cancer diagnosis and either a pre-certification request or a post-service claim denied by Aetna.
Denials citing terms like “experimental,” “investigational,” “unproven,” “superior,” “superiority,” or “more effective” are included.
The settlement also applies to patients who had pre-certification initially approved but later saw post-service claims denied under the same criteria.
Plaintiffs argued Aetna’s denials broke ERISA rules.
Aetna, one of the nation’s largest health insurance providers, agreed to pay without admitting liability.
The court has set an exclusion and objection deadline of October 3, 2025.
The same date applies for filing claim forms.
The final approval hearing is scheduled for November 18, 2025.
Aetna Proton Beam Therapy Settlement
Who’s Eligible:
- Members, participants, or beneficiaries of ERISA-governed Aetna plans.
- Diagnosed with localized prostate cancer between Jan. 1, 2015, and Mar. 31, 2024.
- Had precertification requests or post-service claims for proton beam therapy denied citing “experimental,” “investigational,” “unproven,” “superior,” “superiority,” or “more effective.”
Payout:
- Minimum: $12,000
- Up to: $48,000 with proof of payment or debt for treatment
Key Dates:
- Claim form deadline: Oct. 3, 2025
- Exclusion/objection deadline: Oct. 3, 2025
- Final approval hearing: Nov. 18, 2025
How to Claim:
- Submit online, by mail, or email to:
Atticus Administration
PO Box 64053, St. Paul, MN 55164
Email: AetnaPBTSettlement@atticusadmin.com
Payments are expected to be mailed about 65 days after the settlement becomes final, provided there are no appeals.
Roughly 71 people are eligible for payouts, with $3.4 million earmarked for class members.
If fewer than 71 claims are filed, leftover funds could be distributed to charities designated by the court.
Lead plaintiff David Prolow will receive a $15,000 service award under the agreement.
Aetna will also cover settlement administration expenses and up to $1.67 million in attorneys’ fees.
Claimants must file online or submit forms by mail or email through the settlement administrator, Atticus Administration, based in St. Paul, Minnesota.
Documentation such as receipts, cancelled checks, loan papers, or sworn statements is required for awards above the $12,000 minimum.
Those who qualify are urged to act before the October deadline to secure their payout.
