Can my employer retroactively charge me for medical insurance coverage that was not active due to IT issues?
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Can my employer retroactively charge me for medical insurance coverage that was not active due to IT issues?
I needed to be seen at an urgent care on a Sunday and to my surprise was told I did not have an active insurance policy. I had to wait until the next business day to find out what was going on and was told there was an IT issue that somehow deactivated me. I still did not become active until the next day Tuesday and could not see a doctor when I really needed it. I am now being told I am responsible for $1500 in arrears for 6 months. Should I have to pay that seeing as how I did not have coverage and could not be seen with my insurance policy. If I would of never been sick, I would of never known either. No one informed me of this deactivation.
Asked on July 5, 2019 under Employment Labor Law, Florida
Answers:
SJZ, Member, New York Bar / FreeAdvice Contributing Attorney
Answered 4 years ago | Contributor
No, you cannot be charged for something you did not receive, on two different legal bases:
1) Breach of contract--you pay for health insurance in exchange for getting health insurance; the agreement or contract is that you pay the premiums and in exchange for doing so, have coverage. If you were denied coverage, you did not receive what you were paying for--the contract or agreement was breached and you do not have to pay.
2) Unjust enrichment--the employer (or the insurer: whomever would receive the money) would be "unjustly" or unfairly enriched by receiving money without providing the thing the money was paid for.
So you cannot be retroactively charged for something you did not receive.
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