Welcome to SPARC Forums. Please login or sign up.

Mar 28, 2024, 10:18:56 PM

Login with username, password and session length

Medical out of pocket

Started by ForAly, Aug 29, 2006, 04:06:16 PM

Previous topic - Next topic

ForAly

This is for Illinois:  

Stepdaughter, at the age of 13, was asked to leave by BM/CP 18 months ago with nothing, not even a coat on her back in January in Chicago.  There has been no contact between BM and stepdaughter and no legal intervention.  Sepdaughter wants nothing to do with BM (long history of emtional/physical abuse but courts found in BM favor).

The BM's current husband carries medical insurance and has attached it to our medical insurance for payment of anything our insurance does not cover, i.e. copayments, etc.  Consequently all co-pays, etc. we pay are reimbursed directly to BM's husband - which they keep.

Question #1:  Is this legal?

Question #2:  How can we get the husband's insurance disconnected from ours?   (Our insurance company says they cannot do it)


socrateaser

>This is for Illinois:  
>
>Stepdaughter, at the age of 13, was asked to leave by BM/CP 18
>months ago with nothing, not even a coat on her back in
>January in Chicago.  There has been no contact between BM and
>stepdaughter and no legal intervention.  Sepdaughter wants
>nothing to do with BM (long history of emtional/physical abuse
>but courts found in BM favor).
>
>The BM's current husband carries medical insurance and has
>attached it to our medical insurance for payment of anything
>our insurance does not cover, i.e. copayments, etc.
>Consequently all co-pays, etc. we pay are reimbursed directly
>to BM's husband - which they keep.
>
>Question #1:  Is this legal?

If both parents are court ordered to carry healthcare ins. for the child, then the insurers will attempt to subrogate whatever costs exist between them. If the other parent's insurance is superior, such that reimbursement for a copay that you already paid under the inferior plan is available, then your simple solution is to direct the provider to bill under the other parent's policy first, and then yours. Then you won't be deprived of the copay.

This having been said, if the other parent is obtaining some portion of your payments back, then that parent is being unjustly enriched at your expense and you should be entitled to reimbursement to the extent that you would ordinarily have been required to pay under the current court order. So if it's 50/50, then you are entitled to money from the other parent to equalize both parents' contributions. If it's some other court ordered apportionment, then that would be the amount of your reimbursement right.

>
>Question #2:  How can we get the husband's insurance
>disconnected from ours?   (Our insurance company says they
>cannot do it)

I don't know what this "connection" concept is about. Insurers routinely subrogate claims between themselves to limit exposure. If the other parent's policy is superior then you should be listing that as the primary insurer on the child's insurance information with the provider.

What I'm not getting is why you're not in court with a custody mod motion right now, on grounds that the other parent has abandoned the child? But, you didn't raise this issue, so, there's nothing for me to address at the moment.

ForAly

Since the BM refused to every follow the agreement and supply medical insurance information to us, we have no idea which is superior.  I do believe ours is.  My question was to find out if they were committing any kind of fraud and could be prosecuted.

Regarding the custody mod, we fought BM in courts for 3 years to get custody of both daughters (now 15 and 20) and had everything well documented.  BM worked for best lawyer around and somehow the evaluator, although admitted both would be better in our care, still stated there was not enough to warrant custody change.  The oldest called DCFS, started a case and the BM's husband got scared because he is a teacher and gave the BM a choice:  Him and their one year old or the daughter.  BM chose them and asked me to bring clothes and shoes and pick her up.

She has tried to contact daughter and daughter has refused to communicate with her.  The courts, in our opinion, could possibly send her back which would again put her in harms way - in our opinion.  In three years, we are hopefully done.

socrateaser

>Since the BM refused to every follow the agreement and supply
>medical insurance information to us, we have no idea which is
>superior.  I do believe ours is.  My question was to find out
>if they were committing any kind of fraud and could be
>prosecuted.

No fraud or crime.