Maio v. Aetna Inc

Maio v. Aetna Inc.,
No. 99-1854 (3rd Cir., August 11, 2000)

Plaintiffs filed a class action
suit against Aetna alleging violations of the Racketeer Influenced and Corrupt
Organizations Act (“RICO”) and state law. The plaintiffs alleged that
Aetna engaged in a fraudulent scheme designed to induce individuals to enroll
in its HMO plan by representing “that its primary commitment, in connection
with the healthcare services provided to its HMO members, is to maintain and
improve the quality of care given to such members and that defendants’ policies
are designed to accomplish these goals.” The United States District Court
for the Eastern District of Pennsylvania granted defendants’ motion to dismiss
the RICO claims. The court also dismissed the state law claims without prejudice
for lack of subject matter jurisdiction. The plaintiffs appealed. The United
States Court of Appeals for the Third Circuit affirmed the district court’s
decision. In so ruling, the court found that the appellants failed to establish
that they suffered a tangible economic injury compensable under RICO. In its
opinion, the court said: “a showing of injury requires proof of a concrete
financial loss and not mere injury to a valuable intangible property interest.”