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mistaken payment by health insurance co.

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L

linea

Guest
I was in an auto accident and for some reason the health insurance paid some of my medical bills directly to the providers of service. The auto insurance paid me directly for all the bills submitted regarding the accident. I paid all balances of bills as they came to me and now 15 mos. later the health insurance co. has sent a collection agency to collect the money they paid to the providers. This is the first time I have handled an auto related injury and I didn't know that the health wasn't suppose to pay. I never heard from them directly and the collection agency has let me know that I have to pay NOW! I don't have the money to pay and I'm not sure if I owe them for a mistake they made 15 mos. ago. The collection people contacted me last week for the first time and they are being very aggresive. Please tell me what you think.
 


L

lars coltrane

Guest
what is the basis for the requested payment? Make sure that you are directed to the place in the contract which supports their claim; then let us know what it says, along with the basis for the collection agencies claim.
 
L

linea

Guest
This accident occurred in Illinois. I never heard directly from the health insurance company about this bill. The collect. agency said these 4 bills were paid mistakenly by the health ins. since the medical was a result of auto accident. Coll. said I agreed when I signed on for insurance to reimburse for any overpayments made. I no longer am insured through this policy but am still insured by same company through my new employer. I do not have a copy of old policy but will request that coll. agency send me a copy of that policy. I already told them I will not pay anything until I am sure I am liable for this payment.Thanks for your response.
 

ALawyer

Senior Member
Were you paid twice? For example, once by the health company and the other time by the auto company -- yours or theirs? If so you owe someone the money.

If not, then contact the auto insurer and let it and the health company resolve it -- and tell the both companies, in writing, that you expect them to do so and if they can't it is -- and use these words BAD FAITH.

------------------
This is intended as general information only and NOT LEGAL ADVICE. You are not my client, and I have no obligation of any kind to you. To retain a lawyer, go to http://AttorneyPages.com
 
L

lars coltrane

Guest
I do not know the law of your state. In CA, if are allowed to submit your bills to your own insurance companies and recieve the benefits of the policies (i.e. payments). You only have to reimburse your own carrier when you collect a recovery from the insurance carrier of the other driver.

In this case, you did not collect from the other driver. You only collected from your own policies. Therefore, your need to look at the policy and see what it says about reimbursement. Finally, if all else fails, then I would suggest contacting a local lawyer and get their advice.

good luck
 
L

linea

Guest
I was paid directly from my auto insurance for all my medical bills but in the meantime the health providers collected 4 of the bills,directly from my health insurance so when the providers billed me it was for the balance of the bill which I paid. Now the health insurance wants me to pay them for those 4 bills.
 
L

lars coltrane

Guest
You need to have the collection agency send you THE POLICY and point to the exact language that requires reimbursement.

You also need a lawyer in your state who knows the law and knows this issue. I understand your facts; I don't know your state's law.
 

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