About two months ago, I received and cashed a check from my insurance company for over $200. There was no letter, but as I had just incurred some large medical bills, the clear implication was that I had overpaid/been overcharged.
Today, I get a letter from them saying that check was an overpayment to me, and they want their money back. What the hell? Do I have a leg to stand on if I tell them to go piss up a rope?
I don’t know any legal stuff relating to this, but one time at Walgreens the pharm tech only charged me $7 for my prescription (normally $50) which is the covered-by-insurance price. I didn’t think much of it cause that prescription used to be covered and I figured maybe they were covering it again. Got a letter a month or two later from Walgreens asking for the money cause it wasn’t really covered. I debated not paying them cause it was their fault kinda but Walgreens is the easiest place to fill my prescriptions so I just did.
You have to give it back, but perhaps you can work something out where they apply the credit to future payments rather than having to write the check now.
What if the situation were reversed? If they had overcharged you $200, would you be content to let it stand? I somehow doubt that you would. Why should the insurance company just let you keep the money?
They’re a big, faceless, and billion dollar company who got that way by nickel-and-dime-ing and occasionally weaseling through every loophole to avoid covering the sick and dying, whereas I am a small-pocketed living saint.
Given that, do you really think that you have any legal standing to keep the money? They’re a massive corporation with many lawyers. Don’t you think they’ve covered themselves in case of accidental overpayments?
I think that you should pay it back. I believe you are required to legally as well. Also, if you refuse to repay, can they drop your coverage?
So just how important is it for you to remained insured?
Give it back.
I would send a letter telling them there is a $15.00 fee for research and then return the $200.00 minus the $15.00 and see what they do?
Never mind research fees - just call it a handling charge. 
(Yeah, it has to go back.)
Same thing happened to me, only my STBX wife did not tell me about the check and she cashed it then blew off the letter demanding repayment. 3 months later I am scheduled for a minor surgical procedure and arrive at the outpatient surgery place right on time only to be told the my insurance would not cover the procedure and I would have to pay cash up front. I had to pay $75 to cancel the procedure because I did not have the $1400 needed to pay up front. It took a couple of months to get everything figured out. This was over a $56 check. With the other things like paying full price for prescriptions and paying for doctors appointments, it ended up costing me over 10 times the amount of the check.
Thanks for the advice. I’ve found a solution I can live with.
I’m cutting them a check for the amount. Then, having already received approval from my physical therapist and doctor, I’m getting fitted for an optional $500 brace – which, since I’ve met my deductible, the insurance company will be paying for.
I’m sure your fellow insured will thank you. :rolleyes:
So, because of a clerical error you’re going to order $500 of unneeded equipment? The cost of which is going to passed on to your fellow customers of the insurance company without them taking a hit in their bottom line? I don’t think you’re covering yourself in glory here.
Wait till your check to the insurance company clears and you receive notification that you have paid in full and that your insurance is now up to date and everything is as it was before the lash up. Then get your brace but only if you need it. There is nothing to be gained and a lot to be lost by challenging your insurance company to go a few rounds in a dark parking lot, which you seem to want to do: You can’t win.
:::snicker::: - excellent solution
I had a similar situation - the dental insurance paid for some work, then realized they’d already paid up to the annual limit for my work for that year so wanted their money back (it was 900ish bucks). I had them take it out of the next year’s reimbursements.
I’m pissed at them over this, however. They make a habit of denying practically every claim for anything other than cleanings, their reimbursement rates are far below what local dentists charge, and they don’t cover anesthesia under any circumstances. So they’re scumbags, as well as idiots.
Mama, my dental insurance is like that, too. They do cover more than cleanings, but not nearly enough of the actual critical stuff for teeth as you get older (crowns, etc.), and no anesthesia either (I’ve started doing sedation dentistry after decades of being hard to freeze). What pisses me off all out of proportion, though, is the way they call procedures 100% covered, then I get the bill for the remainder of the procedure. No, 100% covered means I get NO BILL, you bastards. Grr.
Well, ours specifically has coverage for crowns etc… (if I had the basic coverage, it wouldn’t do anything more than cleanings and regular fillings so some policies don’t have crown coverage).
However, their default mode for the crowns etc. seems to be to deny all claims the first (and often the second) time around. They’re hoping we’ll give up in frustration.
The anesthesia… they say one one hand “your policy doesn’t cover that”, and on the other hand “but you can send a letter of explanation and we’ll think about it”. Which is weird and contradictory. “Novocaine doesn’t numb my teeth at all” doesn’t work, either. So any time I (or my son) has to have anything done, I have to shell out 100 bucks out of pocket for nitrous.
I’m sympathetic on hard-to-freeze and needing anesthesia. My first visit with our then-new dentist, I told her I was hard to get numb and as a result had HORRIBLE anxiety. She told me that with a combination of nitrous, and Halcion (basically a benzo-class sleeping pill) she had excellent results. And boy howdy was she right - they coulda cut off my toes and I wouldn’t have cared. In the chair for 5 hours and limp as a noodle the whole time.
So that 100 bucks for nitrous? TOTALLY worth it.
I’ll occasionally use it for sports and the like - which is the doctor’s intention.
OK, that clears it up pretty well. I have no problem with that. But I assume you would have ordered it regardless of this mistake on their part, no?