INDIANAPOLIS (AP) — UnitedHealth Group Inc.'s fourth-quarter net income jumped 20 percent, but the insurer saw signs of health care use picking up and left its 2012 earnings forecast unchanged.

The Minnetonka, Minn., company said Thursday medical costs, its largest expense, climbed 8 percent to $18.6 billion compared with 2010′s fourth quarter, when utilization hit unusually low levels.

The insurer also saw an increase in its medical-loss ratio, or MLR, which measures the percentage of premiums it spends on medical care.

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