Legal Question in Criminal Law in North Carolina

Re: Court Ordered Mental Evaluations without Parental Consent

Interesting questions here. I have had several pre-sentencing

evaluations done at John Umstead

and area mental health (for clients)

and have never heard or thought of insurance. I know we

sometimes check to make sure a juvenile client can qualify for medicare

ifthey are to be hospitalized. I cannot speak to the insurance company's

position, but I am curious what exclusionary language they use

to deny coverage if the procedure was a coverable expense but

for the court order. I don't understand how the

fact of court ordered would cause an exclusion of an

otherwise covered procedure. If anything I would suggest that

the existence of court order, compulsory in nature, would

be presumptive evidence that the eval was not

discretionary or elective on your part as teh responsible

party. You also could not call ahead for prior

approval because you had no idea this would happen until it was

pronounced from the bench.

Start by finding out why specifically coverage is denied.

Get a copy of the exclusion that they claim operates in this regard.

Good luck. DG