Aetna Inc. (AET), the third-biggest U.S. health insurer, said fourth-quarter profit fell 49 percent as the company settled a lawsuit over medical claims while costs for patient care climbed. Aetna's profit was hurt by $147 million in charges, including the lawsuit settlement and costs for its $5.6 billion deal last year for insurer Coventry Health Care Inc. (CVH) The company also saw profit margins drop in some of its health plans, possibly as a result of a flu outbreak during the quarter, said Matthew Borsch, a Goldman Sachs Group Inc. analyst in New York.