On FC 4063

[DecentDad]

Hi Soc,

Stipulated orders:  parents will each pay half of healthcare costs not paid by insurance.  Nothing specified as to deadline for providing bills to other parent or deadline for reimbursement.

Also, via stipulation, biomom is ordered to have health insurance for child.  I provide dental and vision for child.

Biomom brought daughter to ER in December 2003.  In Feb 2004, she gave me copies of two bills, half of which I paid per our agreement.

Last month, she sent me another bill for $800 more from that incident.  It's the first I heard of it.  I asked her why it took so long and to provide all copies of paperwork related to that provider.  

She replied in email, saying that after she found out in February 2004 that insurance wouldn't pay it, she was trying to negotiate a reduced cost without success (i.e., in reality, it probably just went into collections, and she had to do something).  She wrote that she "didn't save" any prior invoices/paperwork that they had sent her.

My big picture issue with all this is that the insurance coverage I can provide for my daughter through my employer is far better for daughter than biomom's.  Her plan (i.e., as an individual, since she hasn't been employed for years) has a $5000 deductible and $7500 max out-of-pocket.   My plan has $0 deductible and $1500 max out-of-pocket.  My coverage is better across medical needs too.

Biomom won't agree to have me cover daughter on my plan, though it'd be best for all three of us.  The additional cost per month would only be $14 on my plan.  In terms of covering daughter without biomom's consent, I've noted in FC that the ordered parent's insurance must be the one used.

I've read in the past that you've made reference to 4063 for providing reasonable notice of monies owed.

I'm thinking that if I have a legal leg to stand on with regard to not paying this unreasonably late bill, it's added incentive for her to agree to have my coverage be the primary one for daughter.

I know I can reasonable argue best interest to all parties to have daughter covered on my plan, but it'd suck to return to court to do it.


1.  Based on these facts, am I able to advise biomom that she's responsible for entire amount of this $800 bill?  (...and add, "Btw, won't you reconsider switching daughter's plan at this time?").

Thanks,
DD

[socrateaser]

>1.  Based on these facts, am I able to advise biomom that
>she's responsible for entire amount of this $800 bill?
>(...and add, "Btw, won't you reconsider switching daughter's
>plan at this time?").

If your court order mouths the insurance language of the family code, and I'm betting that it does, then a parent who fails to take full advantage of the other parent's healthcare insurance, is SOL to the extent that said insurance would have paid a portion of the disputed bill.

So, ask her why she didn't submit any of these bills to your insurance company -- if your daughter is covered, then she likely may still do so. If she refuses, and you can demonstrate that, but for her failure to follow the court orders, she would have been covered to a greater extent by your policy, then you can tell her "uh huh, buh bye now!"

This is a much sounder argument than trying to prove that her bill to you wasn't timely. The court will find a way to keep you from wriggling out on the latter argument.

[DecentDad]

Current orders were stipulated and drawn up by ex's attorney in 2002.  They're a paraphrase of family code, but are really just a single line that says parents will each pay half of healthcare costs not paid by insurance.

Stipulated orders are also clear that my ex is responsible for health insurance for daughter.

Judgment language (whenever that is entered) will follow what's in family code, as that's what was proposed, and I didn't object to that particular part.

In instant situation, I have opportunity to sign up daughter on my plan, but she HAS NOT been covered to date under it.

So-- if I've got it straight-- I'm reading from you that the best way to handle it moving forward (and avoid having to pay ex's plan's deductible) is to just sign up my daughter to my plan and eat the monthly add-on cost.  Then with future expenses, advise my ex to submit it to my insurance company. ??

Thanks, as always.

DD

[socrateaser]

>So-- if I've got it straight-- I'm reading from you that the
>best way to handle it moving forward (and avoid having to pay
>ex's plan's deductible) is to just sign up my daughter to my
>plan and eat the monthly add-on cost.  Then with future
>expenses, advise my ex to submit it to my insurance company.

The standard language for a final judgment orders both parents to provide "healthcare insurance for the minor child(ren) if available from their employer at reasonable or no cost." I suggest that this language should be included. The existence of a liability for insurance from each parent has an effect on the amount of guideline support awarded, because that amount is deduced from a parent's income before determining the support obligation. So, if you're paying, then your deduction for insurance reduces your obligation, and your ex's deduction increases it.

In practice, the obligee parent usually fails to obtain insurance if the obligor parent's insurance is sufficient (contempt, but not usually prosecuted), and the result is that the actual Dissomaster(tm) will provide the obligor with the max deduction possible, because it won't include the obligee's amount, as his/her financial affidavit will show $0 on deductions for healthcare insurance premiums.

Since you have not obtained insurance for your daughter yet, then you are still free to argue that the 30 day submission period for unreimbursed healthcare has been exceeded, however, the court will probably force you to use a Laches defense, i.e., (1) unreasonable delay and (2) unfair prejudice. The statute provides a "per se" proof of unreasonable delay, but to prove that you have been unfairly prejudiced by the delay, you would need to show that you financial circumstances have materially changed as the result of the delay, and that would probably only get an penalties, interests and collection costs waived in your favor, but not the original on half of the debt.

Note: There is NO caselaw on this issue -- so it's a total crapshoot on how a particular judge will rule or what proof will be required.

[DecentDad]

Hi Soc,

Stipulated orders:  parents will each pay half of healthcare costs not paid by insurance.  Nothing specified as to deadline for providing bills to other parent or deadline for reimbursement.

Also, via stipulation, biomom is ordered to have health insurance for child.  I provide dental and vision for child.

Biomom brought daughter to ER in December 2003.  In Feb 2004, she gave me copies of two bills, half of which I paid per our agreement.

Last month, she sent me another bill for $800 more from that incident.  It's the first I heard of it.  I asked her why it took so long and to provide all copies of paperwork related to that provider.  

She replied in email, saying that after she found out in February 2004 that insurance wouldn't pay it, she was trying to negotiate a reduced cost without success (i.e., in reality, it probably just went into collections, and she had to do something).  She wrote that she "didn't save" any prior invoices/paperwork that they had sent her.

My big picture issue with all this is that the insurance coverage I can provide for my daughter through my employer is far better for daughter than biomom's.  Her plan (i.e., as an individual, since she hasn't been employed for years) has a $5000 deductible and $7500 max out-of-pocket.   My plan has $0 deductible and $1500 max out-of-pocket.  My coverage is better across medical needs too.

Biomom won't agree to have me cover daughter on my plan, though it'd be best for all three of us.  The additional cost per month would only be $14 on my plan.  In terms of covering daughter without biomom's consent, I've noted in FC that the ordered parent's insurance must be the one used.

I've read in the past that you've made reference to 4063 for providing reasonable notice of monies owed.

I'm thinking that if I have a legal leg to stand on with regard to not paying this unreasonably late bill, it's added incentive for her to agree to have my coverage be the primary one for daughter.

I know I can reasonable argue best interest to all parties to have daughter covered on my plan, but it'd suck to return to court to do it.


1.  Based on these facts, am I able to advise biomom that she's responsible for entire amount of this $800 bill?  (...and add, "Btw, won't you reconsider switching daughter's plan at this time?").

Thanks,
DD

[socrateaser]

>1.  Based on these facts, am I able to advise biomom that
>she's responsible for entire amount of this $800 bill?
>(...and add, "Btw, won't you reconsider switching daughter's
>plan at this time?").

If your court order mouths the insurance language of the family code, and I'm betting that it does, then a parent who fails to take full advantage of the other parent's healthcare insurance, is SOL to the extent that said insurance would have paid a portion of the disputed bill.

So, ask her why she didn't submit any of these bills to your insurance company -- if your daughter is covered, then she likely may still do so. If she refuses, and you can demonstrate that, but for her failure to follow the court orders, she would have been covered to a greater extent by your policy, then you can tell her "uh huh, buh bye now!"

This is a much sounder argument than trying to prove that her bill to you wasn't timely. The court will find a way to keep you from wriggling out on the latter argument.

[DecentDad]

Current orders were stipulated and drawn up by ex's attorney in 2002.  They're a paraphrase of family code, but are really just a single line that says parents will each pay half of healthcare costs not paid by insurance.

Stipulated orders are also clear that my ex is responsible for health insurance for daughter.

Judgment language (whenever that is entered) will follow what's in family code, as that's what was proposed, and I didn't object to that particular part.

In instant situation, I have opportunity to sign up daughter on my plan, but she HAS NOT been covered to date under it.

So-- if I've got it straight-- I'm reading from you that the best way to handle it moving forward (and avoid having to pay ex's plan's deductible) is to just sign up my daughter to my plan and eat the monthly add-on cost.  Then with future expenses, advise my ex to submit it to my insurance company. ??

Thanks, as always.

DD

[socrateaser]

>So-- if I've got it straight-- I'm reading from you that the
>best way to handle it moving forward (and avoid having to pay
>ex's plan's deductible) is to just sign up my daughter to my
>plan and eat the monthly add-on cost.  Then with future
>expenses, advise my ex to submit it to my insurance company.

The standard language for a final judgment orders both parents to provide "healthcare insurance for the minor child(ren) if available from their employer at reasonable or no cost." I suggest that this language should be included. The existence of a liability for insurance from each parent has an effect on the amount of guideline support awarded, because that amount is deduced from a parent's income before determining the support obligation. So, if you're paying, then your deduction for insurance reduces your obligation, and your ex's deduction increases it.

In practice, the obligee parent usually fails to obtain insurance if the obligor parent's insurance is sufficient (contempt, but not usually prosecuted), and the result is that the actual Dissomaster(tm) will provide the obligor with the max deduction possible, because it won't include the obligee's amount, as his/her financial affidavit will show $0 on deductions for healthcare insurance premiums.

Since you have not obtained insurance for your daughter yet, then you are still free to argue that the 30 day submission period for unreimbursed healthcare has been exceeded, however, the court will probably force you to use a Laches defense, i.e., (1) unreasonable delay and (2) unfair prejudice. The statute provides a "per se" proof of unreasonable delay, but to prove that you have been unfairly prejudiced by the delay, you would need to show that you financial circumstances have materially changed as the result of the delay, and that would probably only get an penalties, interests and collection costs waived in your favor, but not the original on half of the debt.

Note: There is NO caselaw on this issue -- so it's a total crapshoot on how a particular judge will rule or what proof will be required.

[DecentDad]

.