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 Posted: Wed Feb 04, 2009 12:24 pm Post subject: medical insurance fraud |
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My ex boyfriend was divorced in 2002, and I don't believe his exwife ever told her employer (the state) that she got divorced, moved or remarried. She had made an agreement with him to carry him on her medical insurance when they got divorced in lieu of him paying for day care. So for 7 years he has been receiving her benefit. I have read you can get Cobra in these cases, but only for 36 months, and I do not believe she would pay that kind of money for him. All her mail for 7 years has come to his home, so I know she never did report these changes to her employer, and she also continues to use his name and not her married name.
Are they committing a crime?
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concerned
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| Posted: Wed Feb 04, 2009 1:47 pm Post subject: |
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| Quote: | | Are they committing a crime? |
Yes, if I am understanding that she has kept him on her group health policy as a spouse when there were indeed divorced...then yes they are...has he used this coverage in the past seven years (or since the divorce)?
How is she insuring new husband? he must have his own coverage with his own employer maybe? And what about your boy friend does he not have a job with group health ins offered where he works?
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Lori
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| Posted: Wed Feb 11, 2009 11:09 am Post subject: |
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| Quote: | | She had made an agreement with him to carry him on her medical insurance when they got divorced in lieu of him paying for day care. |
how this agreement can be done? does it have any relevance in the eyes of the court.one need to find it out from attorney's only. 
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amit
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| Posted: Wed Feb 11, 2009 12:19 pm Post subject: |
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Well, if I decide to keep my ex-spouse under my group health coverage, can't it be done under any circumstances? I was of the idea that one can even keep the ex- spouse under the plan when the premium payments are made regularly towards the policy. Is it wrong?
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bandit-baby
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| Posted: Wed Feb 11, 2009 12:36 pm Post subject: |
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| Quote: | | Well, if I decide to keep my ex-spouse under my group health coverage, can't it be done under any circumstances? |
None that I'm aware of...but I could be wrong... | Quote: | | I was of the idea that one can even keep the ex- spouse under the plan when the premium payments are made regularly towards the policy. Is it wrong? |
They are insured as your spouse, they are no longer your spouse, so in truth they are about the same as a neighbor (as far as the carrier is concerned)..would they insure the neighbor? no...look at your policy, I'm willing to bet that their definition of people that can be covered under the policy will not include 'ex's'...by the way this happen to us about two years ago...my husbands ins company (thru his work) sent us a 'random verification' now keep in mind I've been on this policy with him as his spouse for over 30 years...anyway we had to send them a certified copy of our marriage license (which I couldn't find and had to go to the court house and get a copy  to find it a year later in my Grandma's safety deposit box!  )...so we sent it and all was well, however the letter said if we did not provide this proof they would drop me! I'm assuming they used that license to further run a check to make sure we were not divorced...but the fact is this could most certainly be considered fraud, and any payments made after the divorce could be owed back to the carrier!
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Lori
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| Posted: Sun Mar 29, 2009 9:19 am Post subject: |
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wow. this sure is some complicated case. yes, it is likely that they are committing a crime. it's deception, and you should let your ex know about this situation ASAP. is the woman aware of what she's doing? perhaps she was just lazy to go through the trouble of changes, but given the current circumstances, i would advise her to do the relevant changes immediately.
as lori had said, as long as they are no longer your spouse, they should no longer be insured under the same policy. this could be considered as an attempt of fraud! |
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seven7
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