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03-10-2009, 05:52 PM
| | Junior Member | | Join Date: Mar 2009
Posts: 1
| | | can i be prosecuted? my ex kept me on his HMO fraudulently
I live in San Francisco, California. My question is this: based on the description below, will I be prosecuted or liable for charges incurred by using the health benefits my husband procured for me by refusing to report that we were divorced? please read the below:
My ex husband and i had an amicable, out of court "divorce settlement" that promised me health coverage for 3 years following our split. The court had nothing to do with our settlement. They only processed our divorce papers. Originally, his plan was for us to stay 'legally separated" so he could continue to legally cover me as his spouse on his work health insurance. He changed his mind and wanted to formally divorce within a few months of our split because his new girlfriend insisted he divorce me. When i remarked that doing so would make him unable to continue to legally claim me on his health insurance as his spouse, he was offhand and unwilling to shop around for coverage for me outside his work insurance. He kept me on his policy. I told him it was his job on the line, etc. I never dreamed of any recriminations that might trickle down to me. Well, he just got busted doing this. He was forced to resign, will not get unemployment and is being reported to Blue Shield for the fraud. Anyone out there know how I, the naive spouse, might be implicated in this?What is the name of your state (only U.S. law)? |
03-10-2009, 06:17 PM
| | Senior Member | | Join Date: Feb 2007 Location: Ohio via TX
Posts: 3,566
| | | How can you claim to be the naive spouse when 1) you were NOT the spouse and 2) you warned him of the probable reprecussions before you divorced?
Did you USE the insurance?
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| okay so basically I am supposed to look online at each particular state and then get their specific question answered?---kidyivau1
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03-10-2009, 07:45 PM
| | Senior Member | | Join Date: Feb 2006 Location: Philadelphia, PA
Posts: 17,309
| | | I don't think so and I'm not even sure anything criminal transpired. But if claim payments are taken back, you may end up being responsible for the payment and you will probably have to sue your ex to get that money back.
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03-10-2009, 10:37 PM
| | Member | | Join Date: Jul 2002
Posts: 314
| | Quote:
Originally Posted by eyzovblu  I live in San Francisco, California. My question is this: based on the description below, will I be prosecuted or liable for charges incurred by using the health benefits my husband procured for me by refusing to report that we were divorced? please read the below:
My ex husband and i had an amicable, out of court "divorce settlement" that promised me health coverage for 3 years following our split. The court had nothing to do with our settlement. They only processed our divorce papers. Originally, his plan was for us to stay 'legally separated" so he could continue to legally cover me as his spouse on his work health insurance. He changed his mind and wanted to formally divorce within a few months of our split because his new girlfriend insisted he divorce me. When i remarked that doing so would make him unable to continue to legally claim me on his health insurance as his spouse, he was offhand and unwilling to shop around for coverage for me outside his work insurance. He kept me on his policy. I told him it was his job on the line, etc. I never dreamed of any recriminations that might trickle down to me. Well, he just got busted doing this. He was forced to resign, will not get unemployment and is being reported to Blue Shield for the fraud. Anyone out there know how I, the naive spouse, might be implicated in this?What is the name of your state (only U.S. law)? | Wow. What you just described is, pardon me, potentially, likely, fraudulent. I was with you for the three years of coverage, assuming that would be COBRA coverage. You would be entitled to 3 years COBRA coverage if you lost health insurance due to divorce. However, someone has to pay the premium, and I'm sorry, but if you trusted the x to do so, oops, shame on you for not being more self sufficient and proactilve. But then, I lose a little in your description of coverage. It sounds almost as though you both knew that the x was providing coverage that was not legally defensible. If so, you both deserve what you get. Private agreements must be within federal and/or state law. I'm not sure that you meet that qualification based on what you have posted. IE, the "legallay separated" and description of the new squeeze have nothing td do with eligible dependants as described by the employer plan. The two of you were either married (don't have to live together) or had a legal arrangement or not. I suggest you read the Plan, (not to mention insurance law) and I bet you will firgure it out. Not to be terribly crude, but evesn though I don't make out all your details for sure, I think you are **** out of luck. Hope you figure it out. lkc15507
Last edited by lkc15507; 03-10-2009 at 10:49 PM.
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