Expert: Timmy Chou - 3/14/2008

Question
Dental Insurance provided by employee changes
Dental insurance A coverage stopped 2008
Dental insurance B coverage started 2008
Ortho coverage 1500 max two years
Dental A paid 830
Dental B paid 670 1500 total max met.
Dental A says they overpaid me 85, want me to repay them
The time I would have to invest to repay A and refile with B is worth more than 85 in question.  
Am I legally bound to repay A?

Answer
Thank you for your question!

Mediators act as neutral third parties to disputes and never "get involved" in judging the merits of conflict, but merely use special techniques to help the parties decide how to negotiate their own settlement.

I am not a lawyer and cannot really speak to the legal questions you raise, but I can respond to your question from my business consulting experience.

Note that this issue may have legal ramifications and you may wish to consult an attorney.

First of all it is well to note that big organizations like insurance companies may, in fact, do improper things knowing that if you want to challenge them it will be up to you to try to fight it at your own expense.  you will have to count the cost to see if it is worth your time and trouble -- even if you are in the right.

Second, from a mediation standpoint, most organizations make poor mediation participants because there is no investment on the part of any one person in resolution, and usually people are reluctant to go out on a limb personally on behalf of an organization.  

Wish I could be more help to you.

For your information, the pros and cons of the types of dispute resolution methods follows.

GOOD LUCK!

Arbitration, Mediation, and Litigation

Arbitration: the referral of a dispute to one or more impartial persons for final and binding determination outside of the judicial system

Benefits of Arbitration:

   Confidential, no public record
   Limited exchange of documentation, information
   Quick, don't have to wait for a court date
   Arbitrators have expertise in the subject matter and are trained in conflict resolution
   Cheaper than litigation
   Preserves business relationships

Negatives of Arbitration

   It's a compromise, no %100 winner
   Complex arbitration can be costly
   If not satisfied, may litigate the arbitration procedure
   Poor results with an unskilled arbitrator
   Both parties must agree to cooperate in the process

Mediation: the process by which parties submit their dispute to a neutral third party (the mediator) who works with the parties to reach a settlement of their dispute.

Benefits of Mediation:

   Neutral mediator can objectively suggest alternatives not considered before
   Parties are directly engaged in negotiating the settlement
   Can be quicker than litigation
   Less costly than litigation
   Preserves business relationships
   85% of American Arbitration Association cases mediated find successful solutions

Negatives of Mediation

   may not reach a binding decision
   unskilled mediator

Litigation: using the judicial system to resolve disputes

Benefits of litigation:

   a clear winner and loser
   uses a prescribed set of procedures
   more predictable outcomes
   is final

Negatives of Litigation:

   waiting for court dates can do more harm
   usually more expensive than mediation and arbitration
   part of the public record