If an insurance co. (health)?

Question

NC residents, state Blue Cross plan. Insurance company accepted payments for both working parents at separate employers, covering same minor. Insurance company reports state doesn't "allow" dual coverage. However, premiums were deducted from both checks for several months. First question, if an insurance company accepts premium payments are they or are they not required to provide coverage? Secondly, if they accepted payment in the form of payroll deductions from my employer, are they obligated to return payment, since coverage wasn't effective? In the event we "should" get a refund, do we work with our employer or the insurance company? If the insurance company is difficult, what sort of steps can we take to remain assertive in this endeavor? Thank you!

Answer 1

Call customer service.  At that level they will do nothing.  Be firm, ask to speak to a supervisor.  They will hand you off to a higher up and be firm.  Tell them if you will not provide double coverage, then give half the money back or you will have to sue for it to pay your doctor bills. Maybe that will light a fire under their butts to give your money back.  Definately drop coverage from one paycheck.  Hey, you got a raise!

Answer 2

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Answer 3

Contact an attorney and ask what your legal recourse is.

Answer 4

Most companies DON'T allow dual coverage because nobody wants to have to figure out who should have to pay a claim.  That's why nobody carries two plans anymore --although 30 years ago it was common practice.

If you used a broker to begin with they could've let you know that you couldn't do this AND now they'd be able to help you get the refund.  So, if you did use a broker call them and ask for help.  If not, call your company's broker and see if they can help you get the premium back for one of the plans.

You DON'T have a legal recourse as far as I can tell...and an attorney probably would be of no help.  I've done this twice in the last month and the company (if you talk to the right people) should be able to help you out.

Just because they 'accepted' the payment doesn't entitle you to additional coverage, but they should refund it since you didn't know and their systems weren't sophisticated enough to pick up on it..

Good luck....and if you didn't use a broker do it next time and save yourself a headache.  Remember they're free to use but can be an invaluable resource.

Answer 5

OK, the INSURANCE company isn't deducting the payments from their paychecks, the EMPLOYER is.

1.  No.  Because an employer will remit $10,000 or such, for one month of THEIR polciy coverage.  It will take an audit or some such, to catch which employees SHOULD be there, and what exactly is being paid for.  It doesn't work that way.  You can't sneak Fluffy onto your health insurance policy, just because your employer is deducting extra money.

2.  Likely, they DID return the premium to the employer, in the form of a credit applied to the next month's bill for the employer to pay.  Any refund you need to get, you need it from the EMPLOYER.

3.  I'm questioning what "dual coverage" means.  Because you can't have two policies that pay out the same time - but it's very, very common to have two policies in force.  That means, one is primary, one is secondary.  If that was the situation, both policies would have been in force, and no return premium was due, because coverage WAS in effect - even if it was "secondary" coverage, and didn't actually pay a bill for you, because, say, the deductible hadn't been met.  IN any case, IF a refund is due, it's going to be from the employer, not the insurance company.