Can I be sued for using his insurance?!?! HELP!

[BlairW]

So it's a bit complicated so please bare with me!

My now ex-partner (not married, but living together for over 10 years) covered me as part of his work private medical insurance scheme when he started with with current company years ago.

Roughly a year before we split up, I was given a major health diagnosis (not cancer) but now need regular scans, bloods, consultant reviews etc +/-medications depending on multiple factors.

When we split, my ex partner acknowledged the fault was his and that he would continue to cover me on his private policy 'for as long as I needed'. I did tell him that this could be lifelong and he looked uncomfortable (probably guilty conscious) but seemed to agree.

Fast forward a few months... the amicable nature of the break up went up in flames when I said I wanted to buy him out of the house as my mortgage had been approved. He went crackers - threats, stole legal documents from the house whilst I was at work, intimidated me near the house dressed in black.... basically long story short - the courts got involved and it has taken years and cost a bloody fortune!

The house is now mine and my next series of scans/bloods are due. In a court statement he gave during the proceedings, he stated that he cancelled me off his private policy shortly after I qualified for the mortgage several years ago.... but... and this is the legal issue.... he hasn't. My policy is very much still active and has been since he initially covered me many years ago.

I've spoken to the private provider but they are unable to do anything including remove me from the policy, as only the main policyholder can make any amendments.

Will I get in trouble legally if I still use the policy? Could he someone claim against me?

I have looked at going with another provider but they won't cover pre-existing conditions, and the same private company will transfer me to my own personal policy within 3 months of him cancelling me off his policy if/when that happens.

Have you actually checked with the insurer? You would be staying on the same policy, just paying for it independently and therefore pre-existing conditions are typically included (hence the big £4k/year price tag)

Oh my word.
If relationship has has broken down to this extent, I would immediately cease using this policy. You are opening yourself up to all sorts of grief, even if technically you haven't broken the law.

You've stated that you can afford the policy of £4k. Call the insurance company, tell them about the restraining order and you can't contact policy holder. Tell them you do not give consent for him to have you on that policy and that it's a breach of GDPR for them to continue to have your details on that policy without consent. So they need to remove you immediately.

Starting a case against you? But you have a record of him lying to a court.

Could you make an inquiry to the insurance company as if you were taking out a new policy?

As the policy is paid for it would be a shame not to use it.

I do agree though about getting on the NHS waiting list as a back up.

Of course you can get cover before he cancels you off the other. You may have to wait to claim again but it would do away with this doubt hanging over you.

If he can't be bothered to.temove you from his insurance policy then you are still covered so can still use it. It's not costing him anything more for you to be included.

Problem is the OP doesn't want to be taken off completely, but to migrate to paying her own way on the same policy number - if she threatens the insurers with GDPR they could say, OK we'll take you off and don't want to do business with you independently.

Saying that I can't see how you can retain the policy number from a corporate policy and pay as a sole policy holder - I'd really want all that in writing first.

The easiest solution is just to contact the employer and ask to be removed from the policy. That way you aren’t breaching anything, you aren’t contacting him, and then you can start your new policy.

Not with the condition pre existing, as OP has explained she would not be able to get the condition covered on a completely new policy as a pre existing condition.

I do think that is the easiest route, the employer is the policy holder, and I doubt the person dealing with that would bother telling OPs ex, they would just inform the insurer to remove and move on.

Can you get yourself on the NHS waiting list? I hear what you're saying about not being able to wait that long, but you might be able to make it to the top of the waiting list before this comes to a head?

Yeah exactly. We have a similar policy via work, only for adults sharing same household, and the employer is able to make any changes without even needing to inform anyone. Definitely the easiest way.

The restraining order presumably restrains him, not you?

However, if you don't want to make direct contact, did he have solicitors when the order was taken out? If so, you could contact them.

Right but if the ex is sufficiently volatile that she tool a restraining order .. nothing can be worth this risk surely?
If costs are 5k and she can afford 4k policy then honestly she could afford to just pay private? Meanwhile get on the NHS waiting list and even if it takes 2 years then she migrates to nhs

Yes - him from contacting me unless via a solicitor.

So we went to court again in June and I was notified by the court in advance, that he was no longer using solicitors and was self-representing. So there's no solicitors involved now.

Even group phi policies aren't "free". At best it's a Benefit in Kind and he will be taxed on it. And I'd expect a policy that covered an unmarried partner would cost more than just a single policy.

But OP knows this and is why she has repeatedly not answered the question about telling his employer. She knows she shouldn't now be claiming on the policy but hides behind " but the insurance company say I'm covered" even though if they knew the full story they would probably tell the policyholder......which will ultimately be his employer.

So there's a chance I would need major surgery if the condition worsens (like impacting eye sight) so I need to make sure I have cover so if that happens I get it done privately - not waiting years on the NHS

I have answered - I am not contacting his employer under any circumstance. He would go absolutely mental

Make sure your dealings with the provider are in writing so you have proof that you have OKd everything through them. If they positively say you are covered just carry on as usual, I would also check the status periodically.

I can see him coming back looking for half the premiums at some point, so I might try to save that money just in case.

Fine. Carrying on defrauding his employer then. The policy will be for employees & their spouses/partners/children. You are none of these so you are not entitled to the cover.

End of.

Edit.

And if anyone comes after you it wont be him....it will be his employer & they will have more money & clout to sue you.

Can you get a solicitor to send him a letter saying that you need to be removed from the policy? I'm not sure if that would be considered breaking the protection order.

The pickles are for spouses, you can't just add anyone

Then yes you leave yourself open to being sued as you have not taken reasonable steps.

I can't amend the policy myself and don't have access to the portal for the T&Cs.

How can it be fraud if I'm still covered?

*policies!

If you're not a spouse any longer, it's fraud