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Judge: ERISA won't shield Aetna in negligence case
A federal judge ruled that a negligence lawsuit against Aetna, Hartford, Conn., will be tried in New Jersey
Superior Court under state medical malpractice laws instead of in federal court, where the insurer likely would have been
protected by the federal Employee Retirement and Income Security Act. Health plans traditionally have been shielded from malpractice
lawsuits by ERISA, which says administrators of employee benefit plans cannot be held liable for mistakes made by medical
providers. However, that protection increasingly is being eroded as more judges deem that health plans make medical -- not
just administrative -- decisions when they deny coverage.
In the Aetna case, a U.S. District Court judge in Camden,
N.J., denied the insurer's motion to move the case to federal court and said that the complaint "cannot be read to allege
that Aetna made an administrative decision to deny a benefit." The lawsuit was filed in February 2001 by Douglas and Debra
Connolly, parents of prematurely born twins; one died, while the other is a quadriplegic with cerebral palsy. The couple charged
that Aetna negligently adopted a policy for treating pregnant women having preterm contractions without adequately considering
whether the policy was medically appropriate. -- by Laura B. Benko
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Eighteen years after bringing their son home from the hospital, the Hunters
discover they are not his real parents. Who are Phillip's real parents? And who is the Hunters' biological son? In the journey
to uncover lost identities, this compelling novel explore the curiosities, family secrets, questions, and changed relationships
that come with the family's astounding discovery.
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