Uncovered medical expenses

[amberlea434]

What is the name of your state? TN

In my fiance's current parenting plan, it states that he and his ex-gf are responsible for paying half of all "uncovered reasonable and necessary medical expenses". Three years ago, his ex took their 8 year old daughter (then, 5) to the doctor and was prescribed all of these medications for asthma and allergies, among other things. She has been on them ever since. The ex has yet to send my fiance any kind of bill from the doctor or for any prescriptions showing the amount of his half to pay. All he receives are his EOB's from his insurance company. The ex has never once complained about not getting reimbursed. In fact, she's never brought it up...until now.

My fiance was informed that the CS he's paying should only be what is court ordered. He's been "overpaying" for the past few years, based on when he gets raises. So, naturally, he lowered the support back to what is in the order. The ex got pissed and threw in his face that he hasn't been paying his half of the medical bills. He asked her how he was supposed to pay for something if she didn't send him copies of the bills and prescriptions. She says she'll go back and get copies of everything and send them to him so he can pay them...from three years ago.

Is there some kind of statute of limitations for something like this? Will a judge order him to pay back these bills even though the ex never took the initiative to send him anything?

 

[Ohiogal]

He should argue that she waived reimbursement on the bills that are older than 90 days by her delay.

 

[bononos again]

What is the name of your state? TN

In my fiance's current parenting plan, it states that he and his ex-gf are responsible for paying half of all "uncovered reasonable and necessary medical expenses". Three years ago, his ex took their 8 year old daughter (then, 5) to the doctor and was prescribed all of these medications for asthma and allergies, among other things. She has been on them ever since. The ex has yet to send my fiance any kind of bill from the doctor or for any prescriptions showing the amount of his half to pay. All he receives are his EOB's from his insurance company. The ex has never once complained about not getting reimbursed. In fact, she's never brought it up...until now.

My fiance was informed that the CS he's paying should only be what is court ordered. He's been "overpaying" for the past few years, based on when he gets raises. So, naturally, he lowered the support back to what is in the order. The ex got pissed and threw in his face that he hasn't been paying his half of the medical bills. He asked her how he was supposed to pay for something if she didn't send him copies of the bills and prescriptions. She says she'll go back and get copies of everything and send them to him so he can pay them...from three years ago.

Is there some kind of statute of limitations for something like this? Will a judge order him to pay back these bills even though the ex never took the initiative to send him anything?

This is as a basic TN order reads:

http://co4.shelbycountytn.gov/court_clerks/circuit_court/forms/parenting_plan_06.pdf

Go to section D.

It appears she must provide the bill within 10 days and he pays within 30 days.
She would be out of luck on 3 years worth of bills.

Another good link:
www.tn-childsupport.com

 

[amberlea434]

This is as a basic TN order reads:

http://co4.shelbycountytn.gov/court_clerks/circuit_court/forms/parenting_plan_06.pdf

Go to section D.

It appears she must provide the bill within 10 days and he pays within 30 days.
She would be out of luck on 3 years worth of bills.

Another good link:
www.tn-childsupport.com

Thank you for those links.

Since his current parenting plan doesn't reflect language with a certain time-frame, does it still apply? His plan is very vague, it just says that both parties are to pay half of the uncovered medical expenses...that's it. Could it be argued both ways because of that?

 

[bononos again]

Thank you for those links.

Since his current parenting plan doesn't reflect language with a certain time-frame, does it still apply? His plan is very vague, it just says that both parties are to pay half of the uncovered medical expenses...that's it. Could it be argued both ways because of that?

It's not a reasonable timeframe, 3 years.
He should request, in writing, certified mail, save a copy, he be sent any bills within 10 days and make sure he makes the payment within 30.
He should request any bills from 2007 ONLY! Get those paid.
She would have to take this in to court to try to get money from previous years...not.
If she does, he'll have proof that their is an issue in the timeframe, he has addressed it, and is keeping up with the bills.
She can threaten all she wants, she should have handled this 3 years ago.

 

[amberlea434]

Sounds good. Thanks, guys.

 

[MrsK]

It's not a reasonable timeframe, 3 years.
He should request, in writing, certified mail, save a copy, he be sent any bills within 10 days and make sure he makes the payment within 30.
He should request any bills from 2007 ONLY! Get those paid.
She would have to take this in to court to try to get money from previous years...not.
If she does, he'll have proof that their is an issue in the timeframe, he has addressed it, and is keeping up with the bills.
She can threaten all she wants, she should have handled this 3 years ago.

I agree with this.

Not to mention if she takes him to court, he could argue that this was only a problem for her when he stopped OVERPAYING his support. Even though the overpayment will only be considered a 'gift', it will be very obvious to the judge that she is just being vindictive. Not to mention a judge is probably unlikely to award bills from THREE years ago, and would probably tell mom those are HER responsibility and then set a time frame that she must give the bills to dad in for the future.

 

[IrishLady47]

Agree with the points raised by other posters on waiting so long & only making it an issue when voluntary extra CS was stopped. However, in your first post, you state that he was receiving the EOBs from his insurance all along. Maybe his insurance is different, but when I receive an EOB from mine, I know exactly what was covered by the insurance and what charges were not covered. Wouldn't he know from the EOB what his half was? Or does she have insurance too on the kids that picks up some of that? Or could she argue that he WAS notified when he received the EOBs? Just a thought.

 

[MrsK]

Agree with the points raised by other posters on waiting so long & only making it an issue when voluntary extra CS was stopped. However, in your first post, you state that he was receiving the EOBs from his insurance all along. Maybe his insurance is different, but when I receive an EOB from mine, I know exactly what was covered by the insurance and what charges were not covered. Wouldn't he know from the EOB what his half was? Or does she have insurance too on the kids that picks up some of that? Or could she argue that he WAS notified when he received the EOBs? Just a thought.

Usually c/o's state that the bills must be submitted to the NCP. What if you didnt get some of the EOB's, or you dont get them for a long time? I've had that happen to me. It can also be requested that you DONT get EOB's, and you have to look them up online.

If she didnt submit them to him, she is probably pretty much going to be out of luck.

 

[LdiJ]

Legally I don't disagree with any of the other posters.

However, the way I see this is that when he voluntarily upped the CS, that made her voluntarily not ask him for the medical reimbursements.

Now he has decided to lower the CS back down again, so she is no longer willing to be generous with him either.

I don't blame him for sticking to the court order, but I understand how she feels as well. Of course, what she is probably going to do is take him back to court to have the support raised, since he IS making more money, AND she will likely insist on medical reimbursements from now on as well.

So, in the end his decision to stop the voluntary increase is likely to end up meaning that he will be paying even more than he was before.

 

[MrsK]

Legally I don't disagree with any of the other posters.

However, the way I see this is that when he voluntarily upped the CS, that made her voluntarily not ask him for the medical reimbursements.

Now he has decided to lower the CS back down again, so she is no longer willing to be generous with him either.

I don't blame him for sticking to the court order, but I understand how she feels as well. Of course, what she is probably going to do is take him back to court to have the support raised, since he IS making more money, AND she will likely insist on medical reimbursements from now on as well.

So, in the end his decision to stop the voluntary increase is likely to end up meaning that he will be paying even more than he was before.

But, mom may be making more $$, or the amt he has been making may not be enough for c/s to increase through SES or there may be no more daycare costs or higher insurance costs, etc etc etc.

So really we have no idea without more info from the OP if/when an increase in support through SES will happen.

 

[amberlea434]

Legally I don't disagree with any of the other posters.

However, the way I see this is that when he voluntarily upped the CS, that made her voluntarily not ask him for the medical reimbursements.

Now he has decided to lower the CS back down again, so she is no longer willing to be generous with him either.

I don't blame him for sticking to the court order, but I understand how she feels as well. Of course, what she is probably going to do is take him back to court to have the support raised, since he IS making more money, AND she will likely insist on medical reimbursements from now on as well.

So, in the end his decision to stop the voluntary increase is likely to end up meaning that he will be paying even more than he was before.

Well, it's not like he's been reimbursing her up until he upped the CS, then she all of a sudden stopped asking. She's NEVER sent him anything, even from the beginning when he was only paying what the order states.

They're already going to be headed into court soon because my fiance filed to have the plan modified, anyway, based on a new visitation schedule. So, the CS will be upped to reflect his current amount. It will also be different now that CS will be calculated based on the shared income model. It WAS just based on 21% of his income.

I know it sounds silly to lower the CS to just have it raised again. But, the new parenting plan won't go into effect until Oct. 1 of this year, so that's a lot of money he'll be saving.

He understands he'll have to start reimbursing her from now on, but that's what he wanted. He doesn't want to leave room for anymore arguements. But, he also doesn't think he should have to reimburse her for anything that's three years old if she didn't find it necessary to send him anything.

 

[Neal1421]

Will he be going for more/less visitation with the child? That will also have an effect on whether or not the child support amount will change.

 

[amberlea434]

Will he be going for more/less visitation with the child? That will also have an effect on whether or not the child support amount will change.

It will almost be the same number of days, just grouped together consecutively.

 

[amberlea434]

Just an update for anybody searching this site on the same topic. My fiance went into court for his modification of visitation and his ex's lawyer brought up the issue of the medical bills, like we knew she would. She admitted to the judge that she's never sent him the first doctor/prescription bill - past or present - and doesn't tell dad when she's taking their daughter to the doctor. The judge told her that she can't expect him to pay for something that he doesn't know exists. BUT, he did reserve his ruling on the issue. He's giving the ex 30 days from the court date to find any doctor/prescription bills and submit them to dad and he has 30 days from that date to reimburse her for half or he can go back to court to contest them. Then, from that date on, she'll have 15 days to submit any and all bills to him and he has 30 days to reimburse her.

It could have been worse, so we're thankful for what he got. We're just wondering now, what if she comes back with an obscene amount of money that he owes and he's only got 30 days to pay it? Is there a way that he could take it back to court and ask to pay it in monthly installments?