Legal Question in Business Law in Pennsylvania

Uncollected Premium

A health insurance policy was obtained in 2003 by my 75 year old mother. She had it set up for the premium to come out of her savings account every month.In Dec of this year they sent her a letter saying that they discovered that the premium was never being drafted from her account and now they want her to pay for the covarge from 2003 to current which is $5668.34 which she does not have. Is it not true that since this was their mistake they can only go back 3 months for premium payments?

Asked on 12/20/06, 9:03 pm

1 Answer from Attorneys

Douglas Humes Law Office of Douglas P. Humes

Re: Uncollected Premium

I know of no law or rule that says that an insurer can only seek three months of unpaid premium, no matter whose fault it is that the original payments were not made. If a person sits there and accept services that they know are not being paid for, then I think they are being unjustly enriched. In that situation, it is equally the mistake of both parties - the insurer for failing to collect, and the insured for failing to point it out after some reasonable time. I think the best that can be done here is to explain that she no longer has the money, and try to negotiate some reasonable settlement; or let them take a judgment against her that is ultimately difficult for them to collect. They may not choose to sue a 75 year old woman for $5600. It will cost them several thousand more in attorney's fees to do so, with the prospects of collecting any of it unclear. Perhaps someone on this network has a better idea, but that's all that I see. Find yourself a really aggressive collection attorney to see whether he can give you some other ideas.

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Answered on 12/21/06, 6:29 am

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