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  1. #1
    Join Date
    Apr 2009

    Default Insurance Benefits Retroactively Terminated During Divorce


    My husband stated he couldn't handle responsibility of marriage or family & asked for a divorce. I later found out he moved his pregnant girlfriend in 3 days after he kicked the children & I out of our home. Almost 2 months after I filed for divorce I realized my medical, dental, & vision coverage had been retro terminated. His HR said he had told them the divorce was final.

    05/28/09- We speak with an Attorney for an uncontested divorce
    06/01/09- Children and I are kicked out of the house
    06/27/09- Divorce filed stating insurance not to be modified
    08/17/09- I find out my coverage termed on 5/31/09
    09/08/09- I contact carrier and his employer to question coverage termination. I advised them of court order and HIPAA laws prohibiting the terming my coverage in this situation. Faxed copy of court papers to his employer and coverage was reinstated.
    09/10/09- I confirmed my coverage was reinstated and claims for Sept and Aug were paid.
    09/14/09- Called carrier requesting no PHI be released to anyone without my permission for any reason. Password created for verification. Stated I would pursue any HIPAA violation to the full extent of the law.
    09/28/09- Judge agrees coverage should remain active at my husband's expense until 10/1/09.
    09/28/09- Carrier mails EOB for my approved claim to my husband.
    11/10/09- Carrier mails EOB to husband stating same claim is being reversed due to retro termination of coverage.
    11/13/09- Carrier mails EOB for denied claim due to retro termination of coverage.
    12/11/09- I called carrier questioning coverage dates & unauthorized PHI releases. I was never asked my password. I was told my coverage was "waived" 5/31/09 & had never been reinstated. They say they didnt violate HIPAA by releasing PHI, terming coverage, not sending HIPAA notices, or offering COBRA after they termed. They told me I had to get a lawyer, because they would not stop sending my PHI to my husband, reinstate coverage, etc.

    I would like the carrier (Principal) and his employer to be held accountable for their negligence. I know the fines can be $50,000+ for each PHI violation and $150 for each day I wasn't offered COBRA. Please advise on my options to sue civilly.
    Thank you!

  2. #2
    Join Date
    Jan 2006

    Default Re: Phi Violations and Coverage Termed During Divorce

    if he carries the policy, the ins. company has to send the EOB's to him. If you do not want them to send the EOB's to husband, do not avail yourself of the insurance. They have no contract with you so they cannot sent the EOB's to you.

    as well, you need to understand you are chasing the wrong party. It appears husband is telling HR what is happening and since he is their employee, the deal with him, not you. Until you get a court order addressed to the insurance company to maintain insurance, they do not have to react to what you showed them.

    Your argument is with husband; drag his butt into court and have the judge tell him that he needs to quit trying to defeat your insurance. Then ask the court for a finding of contempt since the order did state what it did and husband did what he did.

    Then, since husband has been (apparently) actively seeking to term your insurance, you need to seek compensation from him for the bills that would have been covered by the insurance.
    They told me I had to get a lawyer, because they would not stop sending my PHI to my husband, reinstate coverage, etc.
    sounds like the best advice you can get.

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