Can an insurance company drop you after receiving a bill and refusing to pay? In June of 2018, I had a dental procedure done that ended with a total cost of about $1400. At the time, I was under my parents dental insurance. The dentist office confirmed my policy and claimed that I would pay 50% of the total cost and they would charge the insurance company the rest. I ended up paying, in full, as soon as they allowed. The next month, after the procedure, my insurance company contacted my parents to let them know they are dropping me from the plan. It turns out that I wasn't supposed to be on there since I was out of college at the time (recently graduated). They refused to pay the rest of the cost. I had absolutely no idea about any of that. Apparently, neither did my parents. Now, I'm being charged with a bill for $1400, which seems to be double the cost they were supposed to charge the insurance company. The last I heard, the dentist has tried to charge the insurance company several times without success. Had I been informed before the procedure that my insurance wasn't going to cover it, I would have waited until Jan 2019 so that I could use my new insurance provided by my job. Question: Can the insurance company refuse to pay the bill? I understand why they dropped me from the policy, but the policy was active at the time of the charge. What is my best option? Should I refuse to acknowledge the debt as mine? Can I claim it's the insurance company's debt? Contact my old insurance company and try to get them to pay up? Negotiate with the dentist office to reduce the bill and just pay it? Simply have them fix the charge so that it's accurate (it should be $700, not $1400, since I already paid half), and pay in full? Do I have other options?
If you were on your parents policy with the understanding you were a student in college, then yes, they can drop you and refuse to pay. You need to read the terms of the insurance very carefully, somewhere in there it says that the policy is only in effect while you are enrolled as a full time student. You (or your parents) broke this agreement, and the insurance company doesn't have any obligation to pay. Should I refuse to acknowledge the debt as mine? Can I claim it's the insurance company's debt? No, the debt is yours from the moment of service, the insurance company's job is to cover some of that expense on your behalf. It isn't the insurance company's debt, it is yours. Contact my old insurance company and try to get them to pay up? Unfortunately you will not be successful at this. You violated the terms of your insurance (not being enrolled in school), the company has no obligation to pay. Your parents may be owed some refund of money for any extra premiums they paid while you were not enrolled, but that would be the extent of the insurance company's obligation. Negotiate with the dentist office to reduce the bill and just pay it? This is probably the best route to go. Insurance companies often negotiate fixed prices for certain procedures that are different than what they would charge uninsured customers. You can ask your dentist if they have any kind of help for uninsured patients. Simply have them fix the charge so that it's accurate (it should be $700, not $1400, since I already paid half), and pay in full? If you already paid $700, and $700 was your insurance providers portion, then yes, the bill that the dentist sends to you should be $700, not $1400. Make sure though that the entire bill is $1400 though, not $2100 ($700 your portion, and $1400 insurance).
Suppose Bob gets a typical term life insurance policy and pays the premiums through the contestability period. . . . If Bob elects not to receive any such treatments and, as a result, dies of this illness in the policy's term, does the insurer have grounds to deny or reduce the claim? No. This is not one of the reasons that an insurance company is allowed to refuse to pay a death benefit when an insurance policy has become incontestable. Once premiums have been paid through the contestability period, the only grounds upon which the insurer may deny or reduce the claim are: Bob isn't actually dead. A life insurance company almost never disputes this issue if it is presented with an apparently authentic death certificate, and it routinely requires claimants to provide it with a death certificate if it doesn't already have one in its file. But, if Bob walked into the insurance company's office alive and well, with his own death certificate, and handed it to the claims adjuster for the insurance company, the insurance company wouldn't write him a check. After the contestability period expired, Bob stopped paying the premium, was given a warning that the policy would terminate or have a reduced premium if he didn't pay the premium by the end of the grace period for doing so, and he didn't pay the premium. In the case of a term life policy this failure to pay would result in the insurance company having no obligation to pay the benefit. In the case of a whole life policy that has not already had all premiums contemplated by the policy paid in full, failure to pay the premium will usually only reduce the amount of the benefit that is payable by the insurance company upon death relative to what it would have been if the premium had been paid in full. Bob has transferred the policy to someone else who will be entitled to the benefit instead (e.g. in a viatical settlement or a transfer of the policy to an ex-spouse or trust). Bob died after the life insurance policy expires for reasons other than non-payment of a premium (usually because the death happens at an age older than the age covered by the policy). For example, my life insurance policy has a provision that states that no life insurance benefit is payable and the policy terminates upon my 75th birthday. This reduces the premium I pay and isn't a concern to me because after I'm that old I won't need to make up for any lost income in order to provide for my children. Another kind of life insurance policy that doesn't always pay a benefit when the insured dies is a "second to die" policy that pays a premium only when both of the insureds (typically a husband and wife who anticipate a large estate tax liability at a second death) have died. Bob had an accidental death policy rather than a plain vanilla life insurance policy. In this case, Bob's death from a terminal illness would not be considered accidental unless, for example, he actually died because a tornado hit the hospital he was in before he died from his terminal illness. What constitutes an accidental death is sometimes the subject of litigation. The whole point of an incontestability clause (which typically makes the policy not subject to contest after one to two years) is to prevent life insurance companies from refusing to pay a death benefit in situations including those like the one described in the question. Generally speaking, state law requires that life insurance policies to be incontestable after one to two years. An incontestable policy can also generally not be contested on the grounds that misrepresentations were made in the application for the life insurance policy, and preventing refusals to pay benefits in these situations is the other main reason that life insurance policies become incontestable. Note that even in the case of an accidental death policy, after the incontestability period expires, the life insurance company may not refuse to pay a benefit on the basis of fraud in the life insurance application. Once an accidental death policy is incontestable, the only reason the insurance company may refuse to pay a premium other than the reasons that apply to any other life insurance policy (as described above) is that the death was not accidental. Because it doesn't cover all possible deaths of the insured, accidental death policies are generally very inexpensive relative to the size of the benefit, compared to term life policies covering the same period of time for the same insured. Also, even if the insurance policy was still contestable, the insurance company could not refuse to pay the death benefit if Bob had been truthful in his insurance application at the time that it was made and Bob had kept his premiums current through the date of his death. For example, if Bob applied for his life insurance policy in January and answered every question on his application truthfully thinking that he was healthy, his application was approved in February, he was diagnosed with a terminal illness in March, and refused treatment and then died in April, the insurance company would not have a right to refuse to pay his death benefit, although in that situation, the insurance company would probably conduct an in depth investigation before agreeing to pay the death benefit. One of the reasons that the law doesn't allow insurance companies to refuse to pay in these situations is that (1) everyone dies eventually, so dying sooner only modestly adjusts the timing of when the benefit gets paid, and (2) the vast majority of people try to stay alive, even when there will be a death benefit payable when they die, if there is any realistic chance of doing so. Therefore, the economic cost to the insurance company of allowing some people to decline medical treatment when faced with a potentially deadly illness is very modest. The contestability period only exists at all to prevent people from applying for life insurance policies and lying about their lack of a known terminal illness when they apply for life insurance, which would allow people to avoid paying a life time of premiums and still receiving a life insurance benefit. But, since a terminal illness is pretty much defined as something that is expected to cause you death in six months or less, a year or two of contestability is usually sufficient to prevent this potential loophole from being exploited by unscrupulous terminally ill people.
Threatening to report the uninsured driver to avoid payment would be blackmail and illegal / criminal. As a result, they are not going to do this. Reporting the uninsured driver on the other hand is their civic duty. So they can get your friend into trouble, but they can't get around paying. Is your friend insured now? If not, tell him to get insured IMMEDIATELY. And if they are very lucky, the other company doesn't figure out your friend was uninsured, and they get away with it when they make a claim. Alternatively, tell them to figure out how much the damage is, how much the repair will cost, and whether it is worth taking the risk.
Tell your parents Given the circumstances it is a near certainty that the least he will do if you do not pay for the damage is make contact with them. It will be far, far better for you if they learn it from you rather than him. What could he do? He (or his insurance company) can contact your parents - he will almost certainly do this. He (or his insurance company) can sue you for negligence. Children are responsible for their own torts providing they have the capacity to recognize and avoid risk and harm - based on your question I have (and a court would have) no doubt that that you are. If you lose the case, and don't pay, he can have the government seize whatever you own in order to sell it to pay the debt you owe. If this happened in British Columbia or Manitoba he can sue your parents. He could report you to the police - they may or may not choose to prosecute if what you did was criminal: it probably wasn't but the police may investigate to determine this. If he is insured he may be required to notify the police.
The company can't force you to settle out of court. But if it pays you what it says you owe it in an unconditional payment, it can cause your claim to fail on the merits at trial for a lack of damages. A company might want to do this to avoid the collateral estoppel consequences of a judicial determination of your liability. The doctrine of collateral estoppel would make judicial determinations on the merits on particular issues resolved in the case against it binding on the company in future lawsuits against other plaintiffs. A company cannot simply pay to defeat a claim on the merits, however, in a class action suit, without paying all of the amounts owed to all members of the proposed class. Some states also have procedural penalties such as costs or attorney fee shifting when a settlement offer is refused and the outcome at trial is not significantly better than the settlement offer, but I don't know if Florida has such a provision. If it did, your net win could easily be converted to a net loss.
In the U.S. severance payments are not provided for statutorily, and are rarely made when an employee quits or is fired for cause. However, even when not provided for within contracts it is common to see voluntary severances paid during lay-offs. Furthermore, in the U.S. it is more likely that they would be "laid off" in order to qualify for unemployment insurance. In Pennsylvania one can make claims on the state-run unemployment insurance system only if one is able to work and does not refuse suitable work when offered. If one quits one is not eligible for these payments. Ultimately unemployment claims are born by the employer (since their legally-mandated unemployment insurance premiums are adjusted based on realized claims). So managers with the authority to layoff employees can impose real costs on their companies, both in terms of direct severance payments (which may be optional), and in terms of the inflated unemployment premiums that will hit the company down the road. However, I have never heard of a company attempting to recoup such costs from managers, since such decisions are specifically delegated to managers with hiring/firing authority. It seems much more likely that a manager deemed to have abused the company's purse would be demoted or fired rather than being sued, unless there were some gross fraud involved (e.g., kickbacks).
You missed a bit: Unless, of course, the patient was a private patient and the doctor accepted half a guinea for his trouble: As well as the state-run National Health Service (which is generally free to most patients) the UK also has a number of private health care providers where patients pay, for example, to be treated sooner than they would if they went with the NHS. Some NHS doctors also work on a self-employed basis in this private sector, called private practice, which creates the contractual relationship alluded to by Lord Devlin. Re: Don't NHS doctors receive consideration, even if patients don't pay? Yes they do. But not from a (non-private) patient - they are paid by the NHS (or related entity). There are different contractual relationships available, such as being on a salaried payscale or in a partnership but all remuneration comes from the NHS.
As a former rental car employee I can explain why this is. Cars that are rented to customers for insurance reasons (accidents, etc) are supposed to match the size of the car that was damaged as close as possible. I'm speaking for one rental car company in particular here but I'm assuming others have a similar policy but every 2 years old the car is it goes down a size in rental. So your 2014 would and could be considered a "standard" size or even "compact depending" on what is available on that rental lot or how that agent is feeling. With that being said, I've seen customers complain to insurance companies to get bigger cars sizes or even pay out of pocket for larger vehicles. In most insurance rental situations, the company provides "X" amount of dollars per day, generally between $20-25. These insurance companies have deals with rental agencies to secure rates that align with these low daily costs - the same car they get for $20 a day would cost a walk in customer double or triple that. You could use that $20-25 a day towards the cost of your rental and then just pay the difference on the larger car if you'd like. So to answer your question, yes you can push back all you want. Direct your concerns to their insurance company. In my experience, I've seen more often than not they agree to the larger vehicle. You can also petition the rental agent to let you get the larger car for the cheaper rate - however bear in mind these rental agents hear this 100 times a day and this can be your quick ride into that dusty PT Cruiser that nobody wants in the corner of the lot.