Sunlife - medical benefits.

[Corona99]

Both my fiancée and his ex have the same insurance provider for health benefits.

Different plans as they have different employers though.

Separation agreement stated that the children should go to counseling - and they do need it.

Ex has been difficult about it. Refusing to get the referral from the kids family DR, took 20 emails and 3 months just for that. She approved the counselling practice and the counsellor. But refuses to take either child to appointments, or even call to reschedule them. It seems she doesn’t like the counsellor now as the child is the client - not Mom, and she has control issues.

He has paid upfront (for most psychologists you have to), and then claim.

She had refused to pay for any. So he is at approx 2000$ in counselling fees.

Her birthday falls before my fiancée’s does, which means that the claim HAS to be submitted through her plan first, so 80% will be DEPOSITED INTO HER BANK ACCOUNT.

She won’t give him the money. We know this.

We’ve called Sunlife 20 times. They understand but say there is nothing they can do.

He has coverage too (80%) but they won’t let him submit as his birthday is second.

How can this be allowed? 🤬😥

[Janus]

Make the claim.


I think you are wrong, she will give you the money.


In the event that she does not, bring her to court. It will be a slam dunk win. You could probably even self-rep that one, though I would use a lawyer so that the ex could be pinged for some good costs to remind her that she shouldn't be an idiot.


The birthday rule is a well established rule, and it works to keep things fair for the insurance companies. The insurance companies will not change that rule because your fiancée and his ex can't play nicely in the sandbox

[rockscan]

You may also want to speak to your insurance company if you have eow custody. My partners insurance company clearly states in the benefit booklet that for divorced families, the parent with full custody goes first followed by the eow parent followed by the spouses of the divorced couple.

[denbigh]

I often wondered what would happen. Luckly my birthday is first so it hasnt been a problem, you might have to go to court?

[rockscan]

You could also tell them that if they do not provide the amount paid to you by x date you will report it to the police. Technically $8000 is serious theft.

Or you could go through small claims court. But reporting them as a fraudster is worse.

[Corona99]

Sadly she doesn’t give a -*#+ about the police. Or anyone else. Which is sad, and surprising because she is a registered accountant, and claims to be the best mother ever, and such a good person, etc, etc. But she really does some horrible things, considering how high on herself she is.

She insisted that the separation agreement include a clause that prior consent was needed in writing if he wanted to take the kids out of Ontario (specifically the province, not just the country).

Then he found out she took the kids to Quebec on vacation when they accidentally told him. When asked about it she said “I don’t have to check some stupid agreement every time I want to do something with my own children”.


He’s already had to send a letter to CRA as last year after they were separated, she had their tax refund go into the joint account. His refund was $2000. Hers was $89.00. She emailed him and told him she took “her half of their refund”, just over $1000.00, seconds after it was deposited. Then she told him that the bank “accidentally” took her mortgage payment out of the joint account. So he only got $200.00 of his own tax return.

He asked for it back in writing. She refused. He sent a registered letter stating that if she did not return the funds owed that he would notify CRA, as well as the local police service and the bank, for possible fraud. She couldn’t care less.

Unfortunately the police look at it as a civil matter, and to take her to court would cost more than he lost. He’s trying to get it back a few dollars at a time, when she says she owes him money for kids shoes, etc, he deducts it from what she owes him.

Now it’ll be another 2 years to get 1/2 the money back from the $2000 of counselling that should have been covered. That’s the crazy thing - it’s COVERED!

And in the best interest of the kids and mandated in the separation agreement.

But he’s the bad guy. 🤬

[kate331]

Why do they have a joint account if they are separated?

[Corona99]

She was in charge of all the banking and bill paying, etc, their whole marriage. It’s long closed now but this was last year - he lived in the basement after they separated for child care and until he could find a place to live so they had it until he moved out.

[kate331]

Your finance seems to have a lot of baggage, a high conflict, controlling ex, who is out for blood (your words), kids that are need counselling. Thats a lot to take on in a new relationship.

I dont know what the stats are for second marriages to survive, but your not off to a great start. You need to set up boundaries around your spouse's ex, his ex is his problem not yours. Or you will drive yourself nuts. Be supportive but let him do the battle, dont let him dump this on you.

[Janus]

Unfortunately the police look at it as a civil matter, and to take her to court would cost more than he lost.

Self-rep and go to court on that narrow issue. Cheap, and sends a message to the ex.

Anyhow, I still think she will give you the money. You are assuming she won't, because you have conjured up this image of a super evil person. She probably is not as evil as you think. Time to find out!

[Berner_Faith]

The whole tax refund thing doesn’t make sense. If they are separated he should have done his own taxes and therefore changed his banking info. If he wasn’t responsible enough to change his own banking info for his tax return that’s his fault... it was deposited into a joint account that he should have closed when they separated. Don’t put all the blame on his ex because he wasn’t responsible.

Hey I get it, my husband was going through a divorce when we met... it’s easy to get dragged into their drama but I don’t believe everything he says about their relationship. He has his view points and she has hers and well I wasn’t there so I don’t have a view point on their relationship. All I know is he must have changed who he was because if he did the crap with me that she said he did with her we wouldn’t be together.

It’s fine to ask questions for your partner but remember this is his battle to fight. Support him in his battle but don’t get involved in his battle. Trust me it’s easy to wash your hands of his ex and let him put on his big boy pants and deal with her himself


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[Corona99]

The whole tax refund thing doesn’t make sense. If they are separated he should have done his own taxes and therefore changed his banking info. If he wasn’t responsible enough to change his own banking info for his tax return that’s his fault... it was deposited into a joint account that he should have closed when they separated. Don’t put all the blame on his ex because he wasn’t responsible.

She’s an accountant. She did their taxes every year. She handled ALL the money, bills, banking. He wasn’t allowed to touch any of it. For years.

He is VERY dumb for allowing her to do his taxes. I warned him. But he said she’d never risk her professional certification by doing something incorrectly.

Boy was he wrong!

They still had a joint account for the children’s expenses etc.

She was given the account that it was supposed to go into. She had in go into the joint account and took it right out.

Hey I get it, my husband was going through a divorce when we met... it’s easy to get dragged into their drama but I don’t believe everything he says about their relationship. He has his view points and she has hers and well I wasn’t there so I don’t have a view point on their relationship. All I know is he must have changed who he was because if he did the crap with me that she said he did with her we wouldn’t be together.

Unfortunately he has a learning disability and many things are incredibly difficult for him. Admin stuff is one of them. He can build anything - but taxes etc. Nope.

So he tells me how he feels etc and I write everything out for him. I don’t need to question things he says about her as I see it all. It’s not pretty. 😔


It’s fine to ask questions for your partner but remember this is his battle to fight. Support him in his battle but don’t get involved in his battle. Trust me it’s easy to wash your hands of his ex and let him put on his big boy pants and deal with her himself

I only wish. But he can’t. Slowly he will, but he’s got 20 years of not being allowed to even speak or have an opinion that differed from hers. The controlling was awful. Basically emotionally abused for years. And I see it now still.
He can’t even talk to her. She berates him and he just cowers.