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  • Insurance Question

    Hi everyone,

    Here is the situation:
    My child had some psycho-educational testing done recently. The ex and I agreed that we would each pay our share proportionately and then claim through our insurances. I paid and submitted my receipt through my insurance, only to find out that because I am not the primary coverage, I cannot claim anything - the entire bill has to go through my ex's first, followed by his spouse, and then to me (it would be 100% covered then between the two of them).
    I was hoping to do everything independent of him, so this throws a wrench in the plans. I am out a large chunk of money now unless he resolves it.
    I reached out to ask him to submit my portion and provided my receipt as well, but I was met with resistance and an overall reluctance to "help me out". I am over a barrel now with him in control of the situation (the way he likes it), and not sure what I can do to recoup my money.
    I am in possession of BOTH receipts, as the agency actually sent me receipts for both portions.
    What should I do here?

  • #2
    Do you have his insurance info? If yes, send it in yourself.

    If not, impress upon him that this is completely covered by his insurance and all he has to do is submit it and pay you back and if that is an inconvenience, you have no problem doing it for him with the numbers.

    Im surprised he is primary. Normally its the custodial parent then their partner then him and his partner. My husbands insurance specifically says that for divorced couples even though his bday is before hers.

    Comment


    • #3
      I do not have his insurance info.
      I am custodial parent; however, I am covered under my husband’s plan, which means we are secondary for insurance purposes. I was told the order is bio dad, bio dad’s spouse, stepdad. I did not know this until today and would not have paid anything out of pocket had I known it was going to be 100% covered on his end.


      Sent from my iPhone using Tapatalk

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      • #4
        I am in the same situation, my ex has a birthday before mine. I handle pretty much all health and dental care, so I used to pay money and then she would collect the insurance and keep it. It was unaffordable.

        I kept tabs, and then when it got high enough I would threaten court and she would pay up. I got tired of doing that so now I just find providers who bill insurance directly and I have her call in her information to the provider directly. Limits who I can choose as a provider a bit, but the headaches it saves are worth it.

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        • #5
          Wow, that’s pretty wrong of her to do.

          In this case, I think my ex just enjoys the fact that he can choose to submit my bill or not. I don’t think he plans to claim it all and keep it, although I may eat my words on that one.
          Right now my inquiries are being totally ignored, so next step is to contact the insurance provider to see if they can do anything (his policy and my husband’s are from the same provider). Then I guess I threaten legal .... because I don’t have enough of that in my life.....


          Sent from my iPhone using Tapatalk

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          • #6
            Originally posted by Ange71727 View Post
            Then I guess I threaten legal .... because I don’t have enough of that in my life.....
            For obvious claims such as insurance benefits, threatening legal is usually enough. People don't like to go to court if they are guaranteed to lose.

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            • #7
              Update: he has now pocketed the money. His wife wrote my husband an email claiming that I have committed “insurance fraud” because I submitted my claim according to the Coordination of Benefits policy of our insurance provider (ex has the exact same insurance provider). This means I indicated the full amount (not just my portion), attached documents showing who paid what, and entered his policy number when prompted. Somehow this is fraud to them.
              I called the insurance provider who told me that this was the correct course of action when there is shared custody; however, he (ex) collects the reimbursement because he is the primary insurance.
              What a crappy system!!
              What is my recourse here?
              Lawyer has already stated that a Motion would not be cost effective for me and could open the door to him trying to make custody/schedule changes if he gets in front of a judge.


              Sent from my iPhone using Tapatalk

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              • #8
                Well, you could report it to the insurance provider if you haven’t already and see if there is a way in the future that they simply pay the service provider directly.

                At this point your lawyer is right and sadly there is no way to fix his stupid. In the future you could also have them take the kids to appointments and have them pay the fees directly and try and get money from you.

                It is little bs things like this that drive people crazy and allow assholes like your ex to get away with it. Lesson learned, don’t give in to anything.

                It really sucks and your ex is a piece of work. Sorry you have to go through this.

                Comment


                • #9
                  Ex has done the same - currently owes me over $5000 in reimbursements. Save the paper trail and request your reimbursement from him. If you ever need to return to court (very likely given who you’re dealing with) you can have it dealt with then.

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                  • #10
                    That’s exactly what my lawyer says. Play the long game and bring it up in court the next time. And there will be a next time I’m sure.... (eye roll).


                    Sent from my iPhone using Tapatalk

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                    • #11
                      Keep a running total going that you email to your ex. I'll make a handy dandy formula for you. Send the email every time and once you are up to $2k or 3k, go to court:

                      Old total owed by dad to mom:$710

                      A- New expense incurred by mom: $350
                      B- New expense incurred by dad: $0
                      C- Reimbursement obtained by mom: $0
                      D- Reimbursement obtained by dad: $300

                      Net amount owed by dad to mom: (A-B) + (D-C) - (A+B-C-D)/2

                      Net amount owed by dad to mom: $325

                      New total owed by dad to mom: $1035

                      Comment

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