insurance company pay back

UPDATED: Oct 1, 2022

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insurance company pay back

My ex husband and I separated about 10 years ago but remained married so I could stay on his company insurance. We finally divorced earlier this year, it was final in 02/2019. We are now working on the QDRO. After he learned from the QDRO and his company trust fund that I would get part of his pension because we were technically married for 26 years, He has said he is going to tell them we actually separated years ago so that I don’t receive as much money from his pension. I have had several health problems over these years. I am sure the medical bills paid by the insurance for me were very high. Their rules say that in order for me to be included on his insurance we must be living together. If not living together, the spouse me would be immediately removed from the health insurance policy. So as we have not been living together for 10 years I was not supposed to be on his insurance. If he does this, can the insurance company require we repay all of the premiums and medical bills they have pain on my behalf for those years?

Asked on May 26, 2019 under Insurance Law, California


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 3 years ago | Contributor

Yes, they can, since you were not legally entitled to that coverage and committed insurance fraud. When someone is not entitled to something, whether coverage or some other benefit, and are improperly paid or provided it, they can be forced to repay all the benefits they obtained.

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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