What can we do if we received a letter today from our insurance company claiming it overpaid us money 3 years ago and now it is asking us to pay it back?

Isn’t there a time limit that keeps them from trying to recoup money this many years after the fact? After calling them for more information about this bill, they are claiming that they overpaid us by $515 in pharmacy benefit reimbursements. Our insurance plan at the time required us to pay 100% of prescription costs up front and then our insurer would refund us 80% of our costs.

We do not remember ever receiving any payments that we were not due.

Asked on May 6, 2016 under Insurance Law, Tennessee

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 4 years ago | Contributor

Yes, there is a time limit (the "statute of limitations"), but in your state, the statute of limitations arising out of a written contract (i.e. the insurance policy) is six years, so if this allegedly occured three years ago, they are still well within time to take legal action (e.g. sue you) to recover the money. If you were truly overpaid, you have to repay it: the law states that an accidental overpayment does not entitle you to keep the money. If you refuse to pay and they sue you, to win, they'd have to prove (e.g. with cancelled checks) that you received more money that you were entitled to.


IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although AttorneyPages.com has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.