Legal Question in Insurance Law in Utah

Recalculated Claims after 2.5 years

Received notice from Regence ValueCare claiming they overpaid three separate claims on three separate dates in 2004(March ($226), April ($76), and May ($14). They want me to reimburse them within 30 days. Reason was ''The allowable amounts or benefits payable for this claim have been recalculated.'' Isn't there a statute of limitations governing how far into the future they can recalculate claims paid? Am I under any legal obligation to reimburse them this late after the claim was paid?


Asked on 9/01/06, 11:34 am

2 Answers from Attorneys
Alvin Lundgren Alvin R. Lundgren, L.C.

Re: Recalculated Claims after 2.5 years

Here are your options. 1- you can pay. 2- you can refuse to pay, the creditor will send to collections, and may eventually sue you. 3- you can go to court either when you are sued, or now and argue that you do not have to pay for their mistakes based on the passage of time.

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Answered on 9/01/06, 11:56 am
Steven Murray Steven W. Murray, APC

Re: Recalculated Claims after 2.5 years

I believe there was a case a few years ago which held the insurer's mistake barred it from recovering. I would write and demand a detailed written explanation. Depending upon what the insurer writes (they may not bother), if they are correct then did they pay you or your health provider? If not you, then tell them they must argue with the health provider. If it is you, then you can either ignore them, or litigate with them if and when they pursue you.

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Answered on 9/01/06, 10:01 pm


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