An employer let my friends health insurance laspe

UPDATED: Sep 30, 2022

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An employer let my friends health insurance laspe

Trying to help a friend out. An employer let my friends health insurance lapse
without notice. My friend went in for a physical assuming her insurance was
valid and later got a bill for somewhere between 200.00-300.00. She made some
calls to find out why bills were coming to her and found out from her employer HR
that let her insurance lapse without notice even though they we’re taking out
premium payments every paycheck. What recourse does she have legally? I think
they should pay for her doctors visit and reimburse he all premiums paid prior to
them letting her policy lapse. Please advise.

Asked on December 30, 2016 under Employment Labor Law, Colorado


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 5 years ago | Contributor

She can likely either get them to return her premiums OR to cover her procedures--not both. (I.e. if you get coverage, you have to pay for it, of course; you are not entitled to coverage without paying premiums) Based on what you write, however, she should be entitled to one of these options, and possibly to the reinstatement of her policy going forward under the same terms as it had been. They have no right to take the money without providing the agreed upon coverage, so it is clear that she has legal rights to some compensation here--it's a matter of which is most appropriate. Your friend could sue them for the premiums or the coverage; if the amount at stake is less than the limit for small claims court, she shold probably sue in small claims, as her own attorney or "pro se," to minimize costs; if the amount is greater than the small claims limit, she would retain an attorney to help her.

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 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.

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