without going back and re-reading the entire thread ... I think the OP planned to returning the money...he just cashed the check since they told him he was wrong to try to refuse it ... the interest is his .. I seem to remember he just wanted the "brain trust" to come up with options for him to best berkeley with the ins. co. before they got their money back ... I wouldn't call that stealing ...
Sure, he should totally berkeley with the Accounts Receivable department at the big bad insurance company whose Claims Processing department paid the claim at the direction of his Employer.
Boy that'll show them!
I bet Accounts Receivable will..... ummm... never pay a claim "in error" again....? Or.... something?
just to be clear ....
are you directing your sarcasm towards me or the OP ?
The brain trust giving ideas on how to berkeley with the insurance company.
Though really, this entire thread is beyond stupid.
ok .. I just thought it was funny ... i.e. poking fun at the stupid ins.co. .... that is until folk started advocating actually keeping the money ... meh... berkeleying with the accounts receivable dept ... could be fun
If the claim was paid because the coverage was still active, then someone was paying the premium on that policy. So the insurance company paid the claim as specified in their contract, and as part of their obligation for being paid to provide the coverage.
So who is committing theft, breach of contract, fraud, or whatever other term people want to call it, if the claim was paid on a policy when the premium was paid? Before throwing around those terms, does anyone know if the insurance company returned any premiums paid for the period in question?
I'd ask them to send proof the policy was inactive and a copy of the letter they sent to notify you the coverage was cancelled. I'd also ask for a letter requesting the return of the money paid on the claim.
That should keep someone busy chasing documents for a while, and the delay is for them to provide proof, so you aren't the bad guy even though your request is what is slowing it down.
It's unlikely that anyone was paying a premium specifically on that policy. Group business/ASO accounts rarely charge on a "per-person" basis. It's one lump administration fee for the entire group that's determined based on plan and manpower needed to administer the plan.
If someone leaves the employer's company in June, the whole contract doesn't get altered just for that one person.
wbjones wrote: without going back and re-reading the entire thread ... I think the OP planned to returning the money...he just cashed the check since they told him he was wrong to try to refuse it ... the interest is his .. I seem to remember he just wanted the "brain trust" to come up with options for him to best berkeley with the ins. co. before they got their money back ... I wouldn't call that stealing ...
At least what I was doing was pointing out the huge amount of hypocrisy in the group, perfectly illustrated by this thread and the EBT thread.
I suspect no one will admit it, but essentially it was "berk poor people for stealing food, but it's totally OK to berk the insurance company because we all hate them"
jstand wrote: If the claim was paid because the coverage was still active, then someone was paying the premium on that policy. So the insurance company paid the claim as specified in their contract, and as part of their obligation for being paid to provide the coverage. So who is committing theft, breach of contract, fraud, or whatever other term people want to call it, if the claim was paid on a policy when the premium was paid? Before throwing around those terms, does anyone know if the insurance company returned any premiums paid for the period in question? I'd ask them to send proof the policy was inactive and a copy of the letter they sent to notify you the coverage was cancelled. I'd also ask for a letter requesting the return of the money paid on the claim. That should keep someone busy chasing documents for a while, and the delay is for them to provide proof, so you aren't the bad guy even though your request is what is slowing it down.
You are aware about the problem with multiple insurance policies, double payment..........ahh nevermind. I need to quit looking at these threads.
I don't believe I said to keep the money, but if that's how you read it, that's fine.
What I did say was to put the burden of proof on the insurance company to show when the coverage was cancelled and to provide documentation requesting the return of the payment.
Still a hassle for the company, and less work for OP than trying to pay in pennies.
As for having two policies, that a different issue and unless the OP was purchasing his own policy, it's something that was beyond his control. He has stated he is prepared to return the money because he was aware of the issue and tried to notify the insurance.
To create more hassle for the insurance he could notify the previous employer (or whoever the policy was through) and let them know they paid for an extra month of coverage.
Although depending on the circumstances, like leaving a company mid month, it is possible the policies will overlap even if everyone does their paperwork properly.
Offer them about 30% of the total. That is what they would do to the Ortho...
I just... errmmm... ugh.
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