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Go Back   ECCIE Worldwide > General Interest > A Question of Legality
A Question of Legality Post your legal questions here (general, nothing of a personal nature)

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Old 04-11-2013, 03:56 PM   #1
Whispers
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Default Rights under COBRA

in a divorce decree the husband was required to maintain medical insurance... he changed jobs and ignored Cobra paperwork.... and does not qualify at new job yet.... so now she is uninsured.....

from what I can ascertain..... the bottom line at moment is all he has to do is communicate with insurance company regarding his intentions under COBRA and his EX and she can exercise her rights, split off the account and have coverage for up to 18 months....

She has contacted them trying to exercise her rights but until HE communicates with them they will not assist her... She already spent about $500 more than normal this month on Dr and pharma.... She has sent written notice of her demand as well as copies of divorce decree.... Law seems to dictate they split her off and treat her as an individual with rights under COBRA...

Her EX is simply being an ass and won't provide them whatever it is they are asking for.

Not sure WHY it affects her but in my experience insurance companies tend look for reasons to NOT do something rather than do it..

Seems she has certain rights guaranteed by federal law under COBRA but can't get anywhere on her own at moment....

Family Law lawyer can get a hearing of course and drag husband back in IF they can serve him and he's never in the state....

But it seems here that the Insurance company should be serving HER rights as she was covered up to the date he left the job and she has the money and desire to exercise her rights and maintain coverage.

What to do?
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Old 04-11-2013, 04:07 PM   #2
Capt. Lincoln F. Stern
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Not to sound cold but SHE is not the one paying for the insurance.. he and his employer.
When he changed jobs the contract between he and them ended. It is not up to the insurance company to follow the court order as they were not part of the preceding's. They were doing what HE told them to do.

Him not getting COBRA shows a clear violation and I am not certain she can call on his behalf to set up COBRA till he gets insurance
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Old 04-11-2013, 05:45 PM   #3
Whispers
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Dependants coverred at termination have the right to continue coverage under federal law.
From what I read. Whether or not the former employee wants to. She is fully capable and desires to pay the premium and avail herself of the coverage for the tolerant allowed by law.

What I get out of the conversations I'm listening to is that this is solely an administrative issue for the insurance company. Seeking her former shop spouse permission to split her off the accountseems to me to be unreasonable.
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Old 04-11-2013, 07:15 PM   #4
JohnnyYanks
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Timeliness is key. As a qualified Beneficiary she should be contacting the Insurer (she can start with number on her Insurance card - surely they can reroute her) directly to make arrangements to elect to receive coverage. Her ex-husband's intentions are irrelevant.

Good luck.
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Old 04-11-2013, 08:18 PM   #5
Whispers
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She contacted them... sent a copy of her divorce decree..... stated in writing her desire to elect coverage under COBRA for herself..... asked for the account to be set up and the amount to be paid and has been willing to make payment now since 2 weeks prior to the election date.

They keep saying they can't do anything until they "verify" with her ex-spouse.....
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Old 04-11-2013, 09:24 PM   #6
seantlpc
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She may want to contact her attorney, since it seems as though her ex violated the divorce decree by not maintaining insurance for her. The insurance company will be very difficult to deal with, since the EX was the policy holder and she was probably listed as beneficiary. Also, she may want to consider getting some type of coverage in short term filing papers with courts and have her ex cover the premium.
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Old 04-13-2013, 07:34 AM   #7
ShysterJon
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Quote:
Originally Posted by Whispers View Post
Family Law lawyer can get a hearing of course and drag husband back in IF they can serve him and he's never in the state....
It sounds to me like H's insurer is dragging its feet to shield itself from possible liabilty to H. Why waste time dicking around with the insurance company when there's a final decree that's enforceable by a court that orders H to provide insurance?

I don't practice family law, but I do 100% litigation. W doesn't need a lawyer to file and have a hearing on a motion to enforce the decree. Texas Family Code section 157.001 applies:

http://law.onecle.com/texas/family/157.001.00.html

Keep the motion SIMPLE, BRIEF, AND TO THE POINT. Attach a copy of any RELEVANT documents. The following form was created to use in New Mexico courts, but with a few changes I think it'd do just fine.

https://firstdistrictcourt.nmcourts....%20enforce.pdf

Good luck!
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