Rowe Plastic Surgery of New Jersey, L.L.C. v. Aetna Insurance Company
- Sidney Stein
- 1:23-cv-06206
- U.S. District Court · Southern District of New York
- 2
In Rowe Plastic Surgery v. Aetna, Judge Stein granted Aetna’s dismissal motion, dismissed the action with prejudice, and denied sanctions.
The plaintiffs, Rowe Plastic Surgery of New Jersey, L.L.C. and Norman Maurice Rowe, M.D., M.H.A., L.L.C., lost their action against Aetna; Aetna prevailed on dismissal but did not receive sanctions.
What happened
Rowe Plastic Surgery of New Jersey, L.L.C. and Norman Maurice Rowe, M.D., M.H.A., L.L.C. sued Aetna Life Insurance Company over Aetna’s refusal to pay the plaintiffs’ preferred price for surgeries performed on Aetna-insured patients. The complaint was based on an Aetna employee’s oral description of insurance coverage during a verification call.
Aetna asked the court to dismiss the complaint because it did not state a legally valid claim. The court noted that an appellate court and several judges in the same district had dismissed materially similar cases. The court also considered Aetna’s request for sanctions against the plaintiffs and their attorneys.
Judge Sidney H. Stein granted Aetna’s motion to dismiss in full and dismissed the action with prejudice. He denied Aetna’s request for sanctions because Aetna had not shown that the plaintiffs’ or their attorneys’ conduct met the required standard.
The detailed version
- Rowe Plastic Surgery of New Jersey, L.L.C. v. Aetna Insurance Company · No. 1:23-cv-06206
- Sidney Stein
- Aug. 5, 2025
Background
Rowe Plastic Surgery of New Jersey, L.L.C. and Norman Maurice Rowe, M.D., M.H.A., L.L.C. brought this action against Aetna Life Insurance Company. The opinion states that the plaintiffs sought payment at their preferred price for surgeries they performed on patients insured by Aetna. According to the court, the complaint alleged only that an Aetna employee orally recited insurance-coverage terms during a verification call.
The court stated that this action was one of dozens of nearly identical actions brought by these plaintiffs against Aetna in the Southern and Eastern Districts of New York. It also noted that the U.S. Court of Appeals for the Second Circuit had affirmed dismissal of one materially identical action and that several judges in the Southern District of New York had dismissed similar complaints. The court relied on the reasons given in those prior related proceedings.
Aetna’s Motion to Dismiss
Aetna moved under Federal Rule of Civil Procedure 12(b)(6), which allows dismissal when a complaint fails to state a claim upon which relief can be granted. The court concluded that the plaintiffs’ allegations were insufficient to state such a claim. It therefore granted Aetna’s motion to dismiss the complaint in full and dismissed the action with prejudice.
Request for Sanctions
Aetna also asked the court to impose sanctions on the plaintiffs and their attorneys. The court denied that request. It explained that Aetna had not demonstrated that the plaintiffs’ or their attorneys’ conduct satisfied the applicable standard for sanctions. The court cited the requirement that a challenged claim lack a legally supportable basis and have been brought in bad faith, such as for harassment or delay.
Disposition
The motion to dismiss was granted in full, and the action was dismissed with prejudice. Aetna’s request for sanctions was denied.
Read the full 2-page opinion on CourtListener, the free public archive maintained by the Free Law Project.