Rowe Plastic Surgery of New Jersey, L.L.C. v. Aetna Life Insurance Company

Background

Rowe Plastic Surgery of New Jersey, L.L.C. and East Coast Plastic Surgery, P.C. sued Aetna Life Insurance Company. The court described the plaintiffs’ theory as treating telephone calls verifying benefits for an out-of-network provider as a promise to pay 80% of the amount charged for one patient’s bilateral breast-reduction surgery and panniculectomy.

The complaint asserted four causes of action: breach of contract, unjust enrichment, promissory estoppel, and fraudulent inducement. The opinion states that the same plaintiffs had brought similar claims against Aetna in prior related proceedings involving different patients. Other judges had dismissed those claims on the same theory, and the Court of Appeals had affirmed one of those decisions.

Court’s analysis

In January, the court ordered the plaintiffs to explain why the complaint should not be summarily dismissed based on the Court of Appeals’ decision. The plaintiffs’ response did not identify a reason to keep the case going. Judge McMahon concluded that the earlier decisions were factually and legally indistinguishable from this case and adopted the reasons stated in those decisions rather than issuing a duplicative analysis.

Disposition

The complaint was dismissed with prejudice and without leave to amend because the court found no possibility that the plaintiffs could plead a legally cognizable claim. The Clerk of Court was directed to remove the motion at Docket No. 20 from the list of open motions and close the file.

Classification

This is classified as a procedural order because the court dismissed the complaint as legally noncognizable without independently analyzing the underlying claims, relying instead on earlier decisions addressing the same theory.