Active discussions

Meet the Other Phone. Only the apps you allow.

Meet the Other Phone.
Only the apps you allow.

Buy now

Please or to access all these features

Talk
Legal matters

Mumsnet has not checked the qualifications of anyone posting here. If you have any legal concerns we suggest you consult a solicitor.

Original poster

Health insurance lapsed - I was not informed

41 replies

ClaraMint · 20/12/2022 21:22

My ex husband and I had a verbal agreement that I would stay on his company private health insurance until our youngest reached 18 (he is now 17). He has since moved in with his new girlfriend and in July had a baby.
I needed treatment and a minor op, which I preauthorised with the insurance company and booked for 20th Dec. I had pre assessment bloods and ecg on 8th Dec. I needed an admission letter for my employer and messaged his him to ask if it had been sent to his address. He replied to say I was no longer on the insurance. It turns out he removed me in November when he added his girlfriend and baby. He did not inform me of this and apparently my membership ended on 30th November.
Insurance company informed me that they had no notification but it was likely when they were informed that it would be backdated.
Apart from the fact my needed op will not go ahead, it looks like my pre assessment will not be covered.
Who will the hospital pursue for the cost of this? Would it be the policy holder, i.e. my ex, or me, the user? If me, do I have any legal recourse against him? If he refuses to pay, I guess the cost of legal action will be more than the bill.
He earns 250k, I earn 30k. It’s not fair. What are my options?

OP posts:
Marblessolveeverything · 20/12/2022 21:43

Why would he be liable if there is no written agreement?

You as the patient would be liable as I am sure every form you signed had the standard clause stating you agreed to paying if insurance didn't.

If there are children between ye then they should be covered but ex spouses would not be typical.

Bigbadfish · 20/12/2022 21:47

Where are you?

Rainbowshit · 20/12/2022 21:50

A verbal agreement is worthless.

ohioriver · 20/12/2022 21:50

Yeah sorry but I'm sure the forms will have had a clause making you liable if the insurer didn't pay.

Why didn't you get his agreement in writing? Or check before you organised the surgery?

Krakenwakes · 20/12/2022 21:55

This is nothing to do with the insurance company, though. The insurance doesn’t cover you. You’ll have to pay, unless you can persuade your ex to cough up as a one-off.

Original poster
ClaraMint · 20/12/2022 22:46

Yes I get all that but he did not inform me and I preauthorised the treatment in good faith. The insurance company was not aware and nor was I that he had taken me off the policy mid way through the year.

OP posts:
Original poster
ClaraMint · 20/12/2022 22:47

Bigbadfish · 20/12/2022 21:47

Where are you?

Why?

OP posts:
Bigbadfish · 20/12/2022 22:48

ClaraMint · 20/12/2022 22:46

Yes I get all that but he did not inform me and I preauthorised the treatment in good faith. The insurance company was not aware and nor was I that he had taken me off the policy mid way through the year.

As you are separated he wouldn't have to make you aware. It would be your responsibility to check your cover before racking up bills.
You will be liable for the money you have spent.

Bigbadfish · 20/12/2022 22:49

Because shockingly different countries have different laws.

Original poster
ClaraMint · 20/12/2022 22:50

Bigbadfish · 20/12/2022 22:49

Because shockingly different countries have different laws.

UK

OP posts:
Bigbadfish · 20/12/2022 22:51

So you have access to healthcare with the NHS?

Original poster
ClaraMint · 20/12/2022 22:54

Bigbadfish · 20/12/2022 22:51

So you have access to healthcare with the NHS?

And,,,?

OP posts:
Bigbadfish · 20/12/2022 22:56

So he hasn't forced you into a position that risks your health or left you without access to medical help. Which would be the case in a country like The USA.

You failed to ensure the insurance was still active before your appointment and had an alternative option. And you have no court agreement saying he will continue to pay.

You will be their only point of contact.

Basilthymerosemary · 20/12/2022 22:59

It's going to be on your bill OP.

Original poster
ClaraMint · 20/12/2022 23:00

Krakenwakes · 20/12/2022 21:55

This is nothing to do with the insurance company, though. The insurance doesn’t cover you. You’ll have to pay, unless you can persuade your ex to cough up as a one-off.

I think this my only option but I expect it won't happen. I just don't understand why be would not have the decency to let me know.

OP posts:
DivorcingEU · 20/12/2022 23:05

I just don't understand why be would not have the decency to let me know.

Quiet life for him.

You're not important to him any more (not that you're not important, it's just to him!).

He loses nothing by not telling you.

Totally shitty thing to do though.

YoBeaches · 20/12/2022 23:08

I don't understand when you say the insurance company was not aware that he had taken you off the policy? They had to be aware, surely? Otherwise you are still covered until they are made aware.

Original poster
ClaraMint · 20/12/2022 23:08

DivorcingEU · 20/12/2022 23:05

I just don't understand why be would not have the decency to let me know.

Quiet life for him.

You're not important to him any more (not that you're not important, it's just to him!).

He loses nothing by not telling you.

Totally shitty thing to do though.

Yep

OP posts:
OverTheRubicon · 20/12/2022 23:15

It's almost guaranteed that his company health insurances wouldn't legally have covered you anyway, as the requirement is virtually always for a cohabiting partner/spouse, and you are presumably neither.

I'm sorry this is happening, it's clearly a crap situation and he should have told you. It's also fairly reasonable for his girlfriend to want herself and her baby to be covered on his insurance, when you have presumably split up some time ago and your youngest is nearly 18. Even if he's on a much higher income, that is what divorce settlements are meant to be fair - clean breaks tend to work better for all concerned.

Hope you are better now, and this can sort out.

Original poster
ClaraMint · 20/12/2022 23:19

YoBeaches · 20/12/2022 23:08

I don't understand when you say the insurance company was not aware that he had taken you off the policy? They had to be aware, surely? Otherwise you are still covered until they are made aware.

This is the crux of the problem. They explained there is sometimes a delay in the company letting them know and the company will instruct them to backdate the lapse in policy. Which just seems really crap but I guess most people in this situation would have been aware anyway.

OP posts:
YoBeaches · 20/12/2022 23:27

But the policy hasn't lapsed. You would have been a dependant and he's changed it from you to his GF. I don't think there's any backdating your either on the policy or your not.

Also they preauthorised the treatment. You were covered at the time - their policy record said so and they have no record of you being removed. You shouldn't be liable.

Nimbostratus100 · 20/12/2022 23:27

I hope the ecg and blood test results are still of use to you. Do you know what they will cost? Will you take the results to your GP and ask for the operation on the NHS?Sorry you are in this situation - it must be horrible to be expecting an op then for it not to happen in these circumstances.

mattyprice4004 · 20/12/2022 23:37

ClaraMint · 20/12/2022 22:50

UK

Show quote history

The UK consists of 4 countries, all with different laws - you’re best being specific

taxpayer1 · 20/12/2022 23:41

You are fully responsible. When you do a procedure, you normally agree to pay if the insurance doesn't cover it. Your ex has nothing to do with it.

bevelino · 20/12/2022 23:46

In the UK, patients are normally required to obtain pre-authorisation from the health insurer before treatment commences. It is unusual to self authorise treatment because you could book yourself in for any treatment and certain conditions are not covered by health insurance.

Swipe left for the next trending thread