Not sure if correct topic

[Galsal]

Florida

This has now occurred twice and I want to see about doing something about it. In early 2005 I learned that my former spouse (although at the time were still married but separated, not legally separated) had cashed medical insurance payment claim checks and kept the funds. That cost me almost $800 to pay up the doctor bills. Now I learn he did it again in April 2005 (while we were still married) after my Son was hospitalized. This time to the tune of $380. I just received notification of this in the past week or so. There was another hospitalization that I could find out he did it on again too.

Unfortunately, he was Union (UAW) with General Motors so even when I was covered but separated got treated badly by the insurance. No paperwork of any kind would ever go to me, only to him being the covered employee. The current information I received about this second bill claims that the check was sent to me at his address in Michigan. Odds are the check was made out to him.

This has just gone too dang far. Any suggestions as to what my recourses might be are greatly appreciated!

Thanks,
Sal

 

[ecmst12]

Sue your ex in small claims court for the amount of these checks.

 

[moburkes]

If the checks were written out to HIM, then he legally cashed them. If they were written out to YOU, then they were cashed illegally. If he is supposed to pay for some of the medical bills, but hasn't, then go back to court for contempt, and bring up the checks to the judge.

 

[Galsal]

The checks were obviously from health insurance claims and he took the funds that were sent to be paid for medical services rendered. If the checks were in any other name than his or even multiple names (such as his and doctor's), then it's obviously theft and forgery. If the checks were in his name, he gets to just take any and all amount no matter what? Sure seems that cashing the claim checks and pocketing the funds for himself is stealing from some one.

Thanks for the responses.

sal

 

[Galsal]

A good question would be if I can file in Florida where the claims were initiated instead of where he lives in Michigan. One might wonder if that is the cause of action or his retaining the funds is.

Sue your ex in small claims court for the amount of these checks.

 

[ajkroy]

Participating provider?

Do you know if the doctors were on the insurance plan? If they were, the insurance company had no business sending him the money. It is called accepting assignment. The insurance would be obligated to pay the doctor and recoup the money from your ex. All the insurance has to do is send your ex a letter telling him he is in breach of their contract with the insurance company and has a certain period of time to pay (usually one month) or the insurance will be cancelled. Too bad the doctor's office didn't know better as they should have pushed the insurance a little harder. It is the insurance company's fault...but your ex gets to profit from it. You are right to put a stop to it.

I would contact the insurance company now and give them copies of the bills that were paid by you. They can, and are contractually obligated to, still pay the doctor and the doctor can refund you. Easier than court, in my opinion. Plus it will stop your ex from doing it again.

Good luck.

 

[Galsal]

Thanks for the thoughts. These services were provided out of network which is why the payments weren't made direct to the physicians.

Have also posted this over on small claims forum for insight.

Sal

 

[ecmst12]

You can argue that by cashing the checks, he was accepting responsibility to pay for the services. Since he didn't and you did (pay for the services), then he should be reimbursing you that money.

You need to sue him where he lives though.

 

[Galsal]

Thank you.

Sal