Double insured-Neither company will pay

[Loveourkids3]

What is the name of your state?Tennessee
My daughter is double insured. One policy Is her Fathers which he is court ordered to provide. The court order makes no provision for unpaid medical or who's insurance shall be primary. As a result when his ins. denies a claim he won't help with getting them to pay. After getting stuck with several bills my husband put her on his policy. Father's insurance paid as primary and ours paid as secondary. This worked fine for a while then Father's ins. refused to pay anymore so our's refused to pay until his did. I got stuck with more bills. It has been over a year of him refusing to speak to ins. on my behalf, ins. refusing to deal with me, etc. I finally called Human Resources at his work and asked if they could find out what the prob. was. I received a call back today stating that our ins. is primary because of the birthday law and that his ins. would be refiling al claims since we put her on our ins. Human Resources at Husband's work agreed that ours was primary. Both companies were aware of others coverage from beginning. Our ins has $2,800 per year that it will cover anything 100 percent until it is exhausted after that 80%. Will my ins. have to exhaust all of this before his has to pay anything? Can either or both ins. companies cause us problems over claims made with Father's as primary? If I drop her coverage with us does Father's as sole ins. again become primary? Can Father's ins. or Father be required to provide me with a copy of what their policy is. The only thing I have now is a card that tells me nothing. If I had anything explaining their coverage all of this could have been avoided. Father and his wife have stated from the time I received a card that his was primary policy. When ins. wasn't paying they tried to get me to stop filing with my ins. at all and just use theirs. I refused stating that was fraud. Main question is can they fault me for not knowing who was really primary?

[ablessin]

Sticky situation here.

Since he is court ordered to carry the healthcare, you should have set him up as the guarantor at the Doctor's office. This means, he guarantees payment (not you).

Now, his insurance carrier does not (should not) tell you anything about his policy. You are not on the policy, thus really have no right to call them and ask them anything (another beneift of having your ex as guarantor).

Both policies probably did know of the other one, however, someone probably did a coordination of benefits audit and the birthday rule typically applies unless the court order mandates otherwise. Which, as you stated makes your policy first, his second.

A can of worms has indeed been opened. If I was personally in your shoes, I would cancel the coverage since the Father is court ordered to carry your daughter. In the mean time, there is a COB mess to clean up... If you have a $2800 deductible, then you are going to have some medical bills to eat.
Most times if there are 2 policies and one has an annual deductible, the 2nd carrier doesn't pay...... BUT you can and should check, because a lot of times it's all in how the policy is written. Some do, so it's certainly worth looking in to.

Good luck