Legal Question in Employment Law in Pennsylvania

How can I get my previous employer to pay my healthcare bill?

Was let go from job last business day of Sept. '06. Company HR rep. said to me when I picked up my last check that healthcare coverage was paid for Oct. b/c they had already paid their health ins. premiums for that month. Had note in paycheck from HR rep. saying ins. was paid for me for Oct. In Oct., had doctor visit and labwork done totalling est. $900. Now I'm getting billed from former health insurance carrier b/c I was not effective in Oct. per their info. Health ins. said I could not file an appeal b/c effective dates comes from employer. Contacted prev. employer 2x regarding having my effective date reinstated to end 10/31/06 not 09/30/06 based on info they gave me both verbally and in writing. They refuse saying my insurance ended in Sept. Also stated that since I did not pay toward ins. coverage for Oct. I was not effective for that month. They said they weren't eligible to provide COBRA coverage, so any ins. after 10/01/06 was my responsibility. I was told/given info that I was effective for October '06 and now I am being billed for services I was led to believe I still had coverage for. What are my options for getting these bills paid? Thank you.


Asked on 3/02/07, 12:17 pm

1 Answer from Attorneys
Roger Traversa Arjont Group (Law Office of Roger Traversa)

Re: How can I get my previous employer to pay my healthcare bill?

You asked about insurance issue with regard to an old employer.

There are a number of issues here. It breaks down to to parties though: you and your employer. The way it works out is that you both are probably right. Here's the hard part, because you relied on verbal and written information provided to you by the employer you should have your bills covered by the employer. This would be under a theory of detrimental reliance. You would need to proof that the employer said what you say it said.

Detrimental reliance means that you placed yourself in a worse position than you otherwise would have been in based on the promises of another party. Moreover, had they properly informed you of the reality then you could have prevented the damages (by getting other insurance or just not going to the doctor).

In almost no case will the insurer be responsible for the coverage unless you were on the plan as of the date of service.

You will have to pay (and should pay) the medical bills yourself. You should then seek recovery from your former employer. If you aren't worried about burning bridges you could take the employer to small claims (and risk getting a bad reference from that employer). This isn't easy but is always a great learning experience.

Regards,

Roger

Read more
Answered on 3/02/07, 5:54 pm


Related Questions & Answers

More Labor and Employment Law questions and answers in Pennsylvania