AboutMichael Higgins Expertise All questions pertaining to health insurance, whether group, individual/family, student, child-only, COBRA, HIPAA, Portability, dental. No expert knowledge in areas such as life insurance, disability, workman's compensation, auto, etc.
Experience 27 years as owner of health insurance agency, primarily dealing with Blue Cross Blue Shield of Arizona.
Education/Credentials College, Business Administration.
Question My son's wife lost her job of 12 years as a manager at hard rock cafe in myrtle beach. She applied for cobra, sent in two months payments and they never cashed the checks. She has since gotten pregnant and had an emergency and ended up in the ER. They are claiming she never had cobra because since they never cashed her check, she stopped payment on it. Is there anything they can do to go back and correct this situation? It would seem that the old company withheld cashing the check intentionally. What are your thoughts and do you have any advise I could pass on to the two of them? My son has since secured a job and their insurance went into effect today, 1 July, but they were in the ER last week. Any help or info would be greatly appreciated. thanks so much.
Sincerely,
Sharon
Answer Hello Sharon:
My first question would be why your daughter stopped payment on the checks? Understanding that the company had not processed the checks in a timely manner, was there any other indication that she had no coverage during this time, such as something in writing stating as much?
This situation, in my opinion, is going to come down to an issue of law, which is not my specialty. The question will be how long a company has to cash a check I believe. If your daughter in law stopped payment before this time period to cash a check expired, I can't see her coming out on top.
Her financial exposure to date is an ER visit. She is now covered as you have mentioned, so the only bill to pay is the ER visit last week. Assuming she does not get the previous health insurance plan to cover the ER bill, her best bet will be to negotiate directly with the doctors and hospitals she received care from last week. The only question remaining is how much is the ER bill? If it's not much more than two or three month's worth of COBRA premium payments, (something she would have to pay up front to have the COBRA put back in place,) she's better off to just settle up with the hospital on her own after negotiating an agreeable amount.
If the ER bill is very large, say over $10,000, and it looks like your daughter in law was within her rights to stop payment on the premium checks, a lawyer may be the way to go. This is assuming that she has done everything she can think of to get the COBRA coverage and nothing has worked.
