Can my employer retroactively charge me for medical insurance coverage that was not active due to IT issues?

UPDATED: Oct 1, 2022

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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


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 3 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.

IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

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