Can Insurance Co know Divorce Status without Notification?

[mrgg1111]

What is the name of your state? CA

My divorce is recently finalized by the court. The martial settlement agreement stated that ex should cover health insurance for me thru his employment until the divorce is final. I have two questions:

1) If ex and I both never inform the employer or the health insurance on the divorce status, will the health insurance ever finds out in the future (let's say that I started seeing the doctors)?

2) I am going to add to my own employer's health plan as soon as possible. If my ex has never cancelled the coverage at his employer's health plan for me, will the insurance figure out in the future that I have dural insurance when I start seeing doctors and using my own insurance?

Anyone, please advise.

[cbg]

I'm sorry, I must have misunderstood your question.

It sure sounded to me like you were asking whether or not you would get caught if you tried to defraud the insurance company. But I'm sure you would never think of doing such a thing.

Want to try again?

[somarco]

In many areas carriers (and employers) are auditing their plans to determine if there are bogus dependents carried on the plan. When those audits are completed, individuals who are not legitimately covered by the plan are given the boot, retroactive to the point in which the carrier's liability for coverage began. Any claims paid are charged back against premium refunds. If claims are paid in xs of the unearned premiums, the responsible individual is liable for the difference.

[mrgg1111]

Thanks for all of the input. For sure I will get my own insurance. I have told ex to report to the divorce to his employer or the insurance company the last time I've seen him. He heard that he had said that he's not going to do anything. Being a very lazy person I believe he's saying the truth. Many months ago when I decided to file for divorce, I have given him back the insurance card so I don't have any info on it now, I don't even remember what insurance company was it because I have never seen a doctor with it and have never used it before. He and I haven't been talking since the divorce so I don't know if he has cancelled or not. I have hard time reaching him now.

So now, my question is that if I obtained my own insurance thru my employee and later seeing doctors and will my insurance company figure out if I have dural insurance and reject my claims? My own insurance will be primary right? So will it cost me any problem in the future? I hate med bills coming in to me and have me to clarify and fill out forms. I am not good at handling thos and don't have time for that. I am very worried.

Thanks in advance for any input on this.

[cbg]

Under most conditions yes, your own insurance will be primary. However, in this case when a court has already ordered that he provide your insurance, that is by no means certain.

It is not impossible that your own insurance will determine that there is other insurance. The likelihood of it happening is situation-specific, but I couldn't honestly tell you that there's no possibility. Divorce is a public record and as one of the above posters mentioned, many employers routinely audit their plans to determine whether there is anyone being covered who shouldn't, and that often results in the insurance carrier out and out asking whether you have other insurance. Lying to them would be, as I suggested above, fraud.

There is also the point that under the law, you don't get to just add yourself to your employers' insurance any time you want. In order to pick up the insurance outside of open enrollment, there HAS To be a qualifying event. Divorce is a qualifying event, but that would mean telling your employer about the divorce. Unless they can verify that a qualifying event occurred, they have no legal obligation to add you onto the insurance and in fact, it's entirely possible (depending on your plan) that they would be legally prohibited from doing so. You can add yourself to the employer's plan at open enrollment without giving them any information about your status but there is no possible way for us to tell you when your open enrollment might be. It can be at any time of the year.

I understand that you would rather forget about the court order that your ex provide the insurance but you could very well be setting yourself up for a very nasty can of worms by doing so, and he could be in even worse troupble by neglecting to follow the courts order. I strongly recommend that you do so.