8 legal methods for recovering benefits overpayments
December 30, 2009 by Jared BilskiPosted in: Employment law, Health care, In this week's e-newsletter - benefits, Latest News & Views, Money, Pay and benefits, policies
Every now and then an employee’s benefit claim gets overpaid by the plan carrier. So what happens after that?
In those rare cases where a worker is overpaid on the claim, it’s usually legal for the plan sponsor or insurer to try and get that money back — and doing so could help stop your premiums from going up the following year.
Here are eight legal methods in which overpayments can be recouped (in increasing order of difficulty):
- Negotiating a monthly repayment plan with the employee (normally through a wage deduction)
- Sending billing statements from the carrier to the employee
- Deducting from future benefits until the overpayment is satisfied
- Referral to a private collection agency or state revenue department
- Intervening in workers’ comp or unemployment benefit claims
- Filing for court-ordered wage garnishments
- Contesting state income or property tax refunds, and/or
- Filing liens on property.
Tags: Benefits claim, Benefits overpayments, Billing statements, Insurer, Plan carrier, Repayment, Wage deduction
January 7th, 2010 at 3:32 pm
How do you get the Insurance Company to PAY an Injured Employee.
I am owed over 2 years of TTD.
Yet the IC refuses to pay for my Medication for more than a year. Medicare is paying for it now, and they will go after the Insurance Carrier for re-imbursment.
Wouldn’t it be SMARTER to pay the charges that are due, instead of “Spending Dollars to Save Dimes”?
Everytime we go before the ALJ, he rules in my favor. Yet the IC continues this Farce called Workmans compensation.
January 7th, 2010 at 6:38 pm
What about a variation of this: a former employee who selected COBRA benefits through President Obama’s reduced premium plan, received a few thousand dollars’ of medical treatment during the payment grace period, then never submitted ANY payment toward the benefit. She was subsequently dropped from the health plan by the employer’s carrier, but meanwhile our claims history is adversly affected. Any recourse?
January 8th, 2010 at 10:54 am
Duffy,
Your recourse is the same as above. Let’s say the person fails to pay her premiums for January and in February her grace period runs out. You should cancel her insurance back to the last date she paid, or to the effective date of COBRA if she made an election but no payment at all. So, in my example, you would cancel her COBRA as of December 31st. If she had claims in January, they would be claims for a period in which she had no coverage. If the insurance company paid them before they were aware that her coverage was terminated, then your company or the insurance company can use the above stated methods to get that money back. Sending the former employee and bill and trying to negotiate repayment is generally the simplest way. However, if the person refuses to pay, you may need to go the route of court order or otherwise trying to file a claim against her earning/unemployment/etc, and often that is more costly than the amount owed.