Connecticut Judge Rules Against Nurses In Aetna Claims Case

By John Hilton

The Second Circuit appeals court recently sided with Aetna insurance company in a case brought by a nurse who handled claims for the company and argued she was eligible for overtime pay.

The case -- Isett et al. v. Aetna Life Insurance Company -- was brought by Sharon Isett, a registered nurse charged with reviewing Aetna's claim denials. Since she performed non-clinical functions outside her professional job duties, Isett argued that she is entitled to overtime pay under the Fair Labor Standards Act.

The FLSA exempts professional employees from overtime pay. There were more than 20 other Nurse Consultants who had opted into the suit and their claims were dismissed as well. The Second Circuit Court of Appeals decision affirmed a lower court ruling for Aetna.

The appellate court concluded that the professional exemption, which requires “specialized intellectual instruction” in a field of “science or learning” applied because the named plaintiff used that specialized knowledge as a RN in conducting these reviews.

Isett's primary duty “as a nurse consultant requires the discretion and judgment characteristic of registered nursing — the ability to act independently, or under limited supervision, on the basis of collected clinical data," the court concluded. "Accordingly, we conclude that Isett’s job required the use of advanced knowledge, thereby satisfying the first prong of the primary duty test.”

The Isett case is "a strong indicator" that courts expect FLSA’s exemptions "to be construed narrowly," wrote Gregory V. Mersol of the law firm Baker Hostetler. "Whether in collective action litigation or otherwise, employers will now have a less uneven playing field in establishing statutory exemptions."

InsuranceNewsNet Senior Editor John Hilton has covered business and other beats in more than 20 years of daily journalism. John may be reached at [email protected]. Follow him on Twitter @INNJohnH.

InsuranceNewsNet Senior Editor John Hilton has covered business and other beats in more than 20 years of daily journalism. John may be reached at [email protected]. Follow him on Twitter @INNJohnH.