Need Legal Advice

by Rayvin 9 Replies latest social family

  • Rayvin
    Rayvin

    My daughters birth father has taken her to a therapist using my insurance after we told him to use his own. We already took her to a therapist. Not only did he still take her to a therapist and use our ins. the Dr was OUT OF NETWORK!!!! $$$$$$

    Should I just keep record of this and of every other thing he does wrong till I have a rock solid case against him? Or should I fight every issue as it happens?

  • skyman
    skyman

    I am no legal authority but I would fight him now so HE can not say YOU know and did nothing about it. One thing for sure contact your insurance today and tell them what is going on.

  • nilfun
    nilfun

    Nip it in the bud.

  • rebel8
    rebel8
    My daughters birth father has taken her to a therapist using my insurance after we told him to use his own.

    Are you in the US? If not, disregard the rest.....

    Policyholders cannot legally pick and choose which insurance to use. If a child has 2 insurances, one is primary and the other is secondary, period. It is actually fraud to conceal coverage and you can go to jail for that.

    If you don't have a court order stating whose insurance is primary, usually the primary insurance is the one from the parent whose birthday comes first in the year (regardless of birth year). The 2 insurance companies come to an agreement regarding which one is primary, and that's that. Usually they use the birthday rule to agree upon it.

    If your custody agreement/court order doesn't specify that the other parent is required to use only in-network providers, you are out of luck for what has already occurred. What you can do is petition the court to order that so it doesn't happen in the future.

  • Rayvin
    Rayvin

    I just spoke to the ins co. and they can't really do much to prevent anything since they aren't aware of appts etc. untill they get the claim from the doctor. He isn't on their list as someone they can speak to or give out info to so that is good.

  • Rayvin
    Rayvin

    our paperwork does state that you have to try every effort to use in network doctors. Unless its an emergency and out of network is the first/only available. Otherwise the person choosing out of network without permission has to pay the entire amount. But I would have to go to court to get the money since i am sure he is just not willing to pay cause i ask him nicely.

  • rebel8
    rebel8

    Yes but you don't have any document binding him to follow that.

    The bio dad doesn't have legal access to info about your policy.

    If you need more advice you can click here. Check through the old threads in the health insurance folder because this question has been asked a million times. Just in case you want to verify what I'm telling you.

  • Rayvin
    Rayvin

    The paperwork is a legal document and if he fails to follow every rule he is in contempt. If it says he has to pay - he has to pay!

  • rebel8
    rebel8

    Oh. What I mean is, the dad isn't bound by the insurance policy. He is bound by a court order if there is one that it says he must comply with the terms of the insurance policy.

    Basically, the insurance policy is a contract between you and the insurance company. If the dad isn't court ordered to follow it, then he doesn't have to because he's not a party to the policy.

    Think of it this way. Say you have a credit card and gave permission for your brother to use it. Your brptjer uses it but buys a pair of expensive sneakers that you didn't want him to buy. Now this is an issue between you and your brother. It is still your name on the credit card and you still must pay the bill. Visa isn't going to let you off the hook because you didn't want him to buy the sneakers. If you had a court order telling your kid he had to get permission from you for each and every purchase, then you could sue him for the charges.

    That is the way the insurance company is going to look at it--it's an issue between you and the dad. Like I said though, if the court already ordered him to follow the terms of your insurance policy, then you can force him to pay the out of network charges. If you want to pursue it w/o a preexisting court order you'd have to get advice from an attorney to see if that's feasible.

  • Rayvin
    Rayvin

    Thank you for your posts. I did find a free legal consultation number and they said I could take him to civil court.. etc but it will cost me upfront alot of money to get a little money back. They suggest just documenting every issue that I can and then when i have alot i can get it all hashed out at one time.

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