Sued for back-premium

[djs]

I've never had this issue with health (all the time in P&C), but, common sense would say if they asked about it a few years ago, and it was cleared up to their satisfaction at that time, they would have to give notice to change rates, which it appears they did.

They would only be able to charge the higher premiums from when they gave notice, probably about the time they started charging you higher premiums.

Now, the fly in the ointment is what brought this up? If it was resolved, what suddenly made them change? This is where the problem lies.

Dan

 

[joshril]

Why are you guys posting on a 1.5 year old thread? I bet the guy got this stuff cleared up...

 

[moonlightandmargaritas]

It doesn't matter at all where you file your taxes.

Oh yes it does. This is a very "simple" view.

"Domicile" and "residence" can be two completely different things.

We run into it a lot here in Florida, as we have no state income tax, and retired folk who spend 7 months in say, New York and 5 months in Florida.

They want to claim they are "Florida residents" to beat the tax burden.

Unfortunately, it doesn't work that way.

Your domicile is where you spend at least 181 days per year. If that cannot be accurately determined, it will come down to:

1) Voter's registration
2) Tax return location
3) Driver's License

 

[Crabcake Johnny]

You're likely right but I can only go on the few actual cases I've written.

One case was Assurant - NY resident also owned and occupied a home in MD part of the year.

We coordinated this through Assurant and all they wanted was proof of MD residence to write him the policy. It was full disclosure that he ran his own NY biz but also ran it from MD part of the year.

Now...that being said I have no idea if he filed for duel residency regarding taxes. All I know is Assurant didn't ask for his state tax status - just proof that he resided in MD a portion of the year.

I had a similar case with GR - GR advised that no only would they issue the MD policy, but he could also be in-network while in NY using UHC.

Again, this was just the sale dep't advising both me and the client as to how to proceed....not the claims dep't.

I, however, feel that I did my due diligence by conferencing in my client when he called and asked how to proceed. Those conversation are recorded so if it goes sideways in claims I hope that's the CYA we need.

 

[retread]

Why are you guys posting on a 1.5 year old thread? I bet the guy got this stuff cleared up...

You really think anyone ever looks at the date of the post?

Why, that would take common sense... which is not very common.

 

[lyndell]

Boy this stuff is really complicated at times

 

[arnguy]

I am soooo glad that this post has been resuscitated after having been started over 3 years ago! It is truly wonderful what the EMTs can do these days.

 

[Bob_The_Insurance_Guy]

Although no one hear wants to hear this. We, as insurance agents, are not qualified to answer his question. He should contact an attorney who specializes in these matters.

Even though I don't sell it, I would suggest Pre Paid Legal. I use them and love the service.

 

[joshril]

Did you get sued "sc"?

 

[TXINSURANCE]

This is yet another example of the failures of GI which are soon to be a national problem.