T
texasrose617
Guest
What is the name of your state?tx
A young woman with whom I am acquainted is 7 months pregnant with twins. She called her sister and myself yesterday because her and her husband went to the hospital to preregister for delivery yesterday. She filled out all the paperwork as married and presented her insurance cards. The hospital was given a call in code or something, because the registrar had to call the insurance company before they could go any further. Once in contact with the insurance company they verified the information the hospital had been given versus the information the insurance company had. The big snafu was in that the young woman's mother had enrolled her daughter on the mother's employers insurance plan as a dependent without informing the insurance company that her daughter had recently married(prior to be enrolled on the plan).
Needless to say the insurance company informed the hospital that as the young woman was married and of legal age and not a student that she was no longer eligible for coverage and that the insurance would not be paying any further claims on the young woman's behalf.
Now I am in no way defending her because both myself and her sister told her that sooner or later the insurance company would find out that she was married and drop her from the insurance.
The question I have is, is this considered fraud? What recourse does the insurance company have to recover monies already paid on behalf of this girl to her doctor? Is the mother or the young lady responsible for paying the doctor back? Does the insurance company have a claim against the mother for knowingly placing her daughter on her insurance even though she knew her daughter was married and not eligilbe to be covered?
I appreciate any and all responses!
Thanks.
A young woman with whom I am acquainted is 7 months pregnant with twins. She called her sister and myself yesterday because her and her husband went to the hospital to preregister for delivery yesterday. She filled out all the paperwork as married and presented her insurance cards. The hospital was given a call in code or something, because the registrar had to call the insurance company before they could go any further. Once in contact with the insurance company they verified the information the hospital had been given versus the information the insurance company had. The big snafu was in that the young woman's mother had enrolled her daughter on the mother's employers insurance plan as a dependent without informing the insurance company that her daughter had recently married(prior to be enrolled on the plan).
Needless to say the insurance company informed the hospital that as the young woman was married and of legal age and not a student that she was no longer eligible for coverage and that the insurance would not be paying any further claims on the young woman's behalf.
Now I am in no way defending her because both myself and her sister told her that sooner or later the insurance company would find out that she was married and drop her from the insurance.
The question I have is, is this considered fraud? What recourse does the insurance company have to recover monies already paid on behalf of this girl to her doctor? Is the mother or the young lady responsible for paying the doctor back? Does the insurance company have a claim against the mother for knowingly placing her daughter on her insurance even though she knew her daughter was married and not eligilbe to be covered?
I appreciate any and all responses!
Thanks.