About insurance primary/secondary and fraud...what a mess...
For the last 4 years, since crazy witch took DH to court for more child support, DH has had to cover his daughter on his insurance policy through work. The additional cost to the insurance is over 80USD a month...The mother already covers her through her work, and it is NOT an additional cost to her...but obviously, she wanted to be a witch and make DH pay the money anyway...(ps. her work insurance is employe, employe+spouse, employee+spouse+kids and she has both a spouse and 3 kids -only one is DHs, so that's why her cost is not anything extra anyway) Anyway, although DHs insurance should be primary crazy witch has not ONCE in the last 4 years used the insurance. Yes, she does have all the information. Meanwhile, DHs job has asked him numerous times if anyone of his dependents has "another insurance"...he continues to tell them no, because as far as we are concerned, he is primary and the witch REFUSES to give him any information at all. There is nothing we can do, although he has tried through the idiots at the CSE office to get the info...but I constantly worry that someday the witch will get caught (obviously she is lying to her plan who should be secondary) and she will then take him to court to pay back all the money he never paid (she's never sent him a single bill because she doesn't want him to know anything about her insurance or what she takes her daughter to the dr for, etc...)
Am I worried for nothing? If we take the witch to court to do this, we would need a lawyer, etc...as the CSE office doesn't care one bit about this...as long as they're getting their money, they don't care that DH wastes his and the witch doesn't use it or that she is committing fraud...of course, she's put us through hell and back and if we take her to court, she'll probably just ask for more money, which is the last thing we need...
I am so disgusted with this witch...she is so amazingly selfish...I wouldn't mind if she needed the money, but she doesn't even ask for him to pay for any medical, since she wants him to have no contact with his child basically (unless is to give her extra money) or about her life...and yet we spend an extra 1K a year almost on her stupid insurance...
Our son is special needs...we spend thousands a year on medical...it is ridiculous that we have to throw this money away...and where we be living soon (as we were before), there is no tax free insurance...we must pay taxes on that money...so it's not even just 1K...
I sometimes want to report her somewhere, but I'm afraid that it'll all be filed to his insurance then and we'll get stuck with the bill instead of the witch...actually, that could even happen anytime if her insurance ever found out...
Anyone out there who works for an insurance company?
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What does the decree say?
What does the decree say? Most should delegate who is primary, if it doesn't then there are 2 rules that insurance companies follow.
Birthday rule - Who's ever birthday is first in the year is primary.
Gender rule - this is where the man is primary.
The insurance company would ask for the money back for claims that they have paid if the ex is primary.
If it's in the decree that your DH is prime, then mail a copy of the decree to your plan and whenever you get the information on her's send it as well...then everytime she would try to file a claim on hers...everything will be denied.
The insurance information
The insurance information states that if they have a child support order for insurance, that then that insurance is primary.
The insurance plan has the decree/copy of the child support order, the problem is that we have never been able to get the information for her insurance...she will not give it to him. The child support office has basically blown my DH off on this. She has blown him off. She told him it was none of his business...so after almost 2yrs of trying to get it, he gave up.
That's why I'm worried. Because I wonder if the other insurance company ever finds out, if they will then ask her for reimbursement, come after OUR insurance company for payment and then we'll be stuck with major bills from our insurance company if she doesn't pay it...
If a patient has TWO
If a patient has TWO insurances this is the they determine who is the primary carrier:
The birthday rule: If a minor is covered under both parents, the parent with the birthday coming first in the year is the primary insurance carrier, this is determined by MONTH, not day.
For patients I have dealt with, unless you have some sort of special agreement filed with your insurance company they do not listen to what's in a divorce decree. If a child is covered under two policies, the parent is REQUIRED to provide BOTH insurances to the medical facility requesting the information. The medical facility will then call the insurance companies for coverage information. If a patient has TWO insurances, they typically WILL NOT have a copay. My office rarely collects a copay from individuals with two insurance carriers. We file with the primary carrier first based on birthday rule THEN when that EOB comes back to us, we forward it to the secondary insurance for the remaining payment.
~Why run away? I know who I am...you know who I am. Just let me be~
You should still have a
You should still have a right to the information regarding insurance on the child whether she likes it or not.
If BM is taking you back to court, this is a good thing to bring up. BM isn't giving you the information. In my DH case, his BM kept it for 3 years that that were on Medicaid and she never used his insurance. They are both ordered for health insurance and she is to be primary. His insurance doesn't coordinate with her. Which basically means premiums really for nothing. If her insurance pays more than his then they pay zero. That is more the trend then the norm for insurance. We got lucky and I carry the kids only and they pay the balance normally but it seems like you throw money away. I would rather split the difference then BM wouldn't take the kids to the doctor as often if she has to pay 50%.
That information helped us settle the case. She was going to be shown as "not in agreement of the decree" to openly share the information and be a co-parent. BM is now paying CS to DH which covers the premium.