HELP subscriber not paying claim

[Guest lbegando]

Ok. I will try to make this as short and to the point. My xhusband (we were married at the time but seperated) carried our family medical coverage. I was not living with him or even in the same state. I had a medical emergency and was taken to the ER via a ambulance. The claims were all submitted and paid. EOB's were sent to my x but not to me. Now the ambulance visit is showing up on my credit report. I called the insurance company and they said that the claim was paid to the subscriber (my x). He never reimbursed the ambulance company but cashed and kept the check for himself. What can I do?? Does he somehow take on the responsibility of the claim by cashing the check?

[QDROphile]

Nice law school exam question. Taking your story and the reasonable inferences as true and complete, he is not entitled to keep the insurance proceeds for himself. The exact explanation might be that he undertook to pay the expense, depending on the insurance claims procedures and representations that are implicit or explicit in filing a claim. Or the explanation might be different and it would be a matter involving "unjust enrichment." Unfortunately, what you do if he refuses to take care of the matter properly requires legal help.

[Guest lbegando]

Nice law school exam question. Taking your story and the reasonable inferences as true and complete, he is not entitled to keep the insurance proceeds for himself. The exact explanation might be that he undertook to pay the expense, depending on the insurance claims procedures and representations that are implicit or explicit in filing a claim. Or the explanation might be different and it would be a matter involving "unjust enrichment." Unfortunately, what you do if he refuses to take care of the matter properly requires legal help.

Well being that this happened 5 years ago and he is refusing to pay anything, I'm pretty sure he is not going to take care of the matter properly. Isn't there a way that I can at least get this put on his credit report...if I get a copy of the check from the insurance company and send it to the creditor?

[masteff]

You need to talk to a lawyer, perhaps your divorce lawyer if that person is still around.

This board is really more for people involved in the actual administration of the plans, not for legal issues outside the plan (while it does involve money paid from a plan, you're particular problem is occuring outside the plan that paid it). It's really a question beyond this forums areas of expertise.

[Guest JPHomeDesign]

Ugh good luck!