Metlife annoyance. Paging Martha...

SecondCor521

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Hi all,

I received in the mail today two letters allegedly from Metlife asserting that they paid $246.00 to my kids' dentist after my dental coverage was terminated. These payment occurred in the spring of 2006. They're asking me to pay them back.

The letters do have the correct first names of two of my children. Even more interesting, they were mailed to me at my current address. I don't know how they got my current address, since I probably stopped using them as my dental insurance provider in the fall of 2005.

Am I obligated by law to pay them back? It seems like it was their error to pay a claim on someone who was not covered.

Even if morally I do owe them $246.00, I don't like that they screwed up a year and a half ago and are now coming to me to fix it. I also don't like the fact that they haven't really proven that I owe them this money, they're just saying I do. They don't have the name of the dentist listed, or the procedure, or any proof that they paid the dentist.

Opinions? Martha?

2Cor521
 
Additional comments:

If they did pay this amount, they certainly paid the dentist and not me. Shouldn't they seek reimbursement from the dentist?

Back then I was still married. If I am legally obligated somehow, isn't my ex somehow obligated for some portion? If so, what portion?

2Cor521
 
I am not Martha but my thoughts FWTAW. Fishing expedition? Wonder if they did try to collect from the dentist and they could not so you were next on the list? Since it took them so long to wake up, maybe you should take a like period to respond. Having said that, doesn't dental insurance, unlike medical insurance, usually reimburse the patient after the patient, having paid the dentist, submits a claim, or have the claim submitted by the dentist? Any chance the check (if there was one) was cashed by someone you know or knew?
 
Does it matter if you are legally obligated? This seems pretty clear to me. If they paid something that you should have paid, your should pay the money back. If they paid something that you should not have paid, you do not. I would assume that you would know whether or not you took your kids to the dentist, and if you did whether or not you paid the bill. I your cannot remember with certainty, which I can understand given the time frame, ask them for backup.

Obviously, this is not a legal opinion, but I think, given the user name, you would understand about being responsible for your debts, if they are yours. If they are your debts, I agree the ex should pay half.
 
Not enough facts. They have the kids' names wrong so you can't be sure that they paid for dental work on your kids. I would want to know when the payment was made, what exactly for, and to whom. And then compare that with what the dentist's records show. But if they prove to you that they did pay, odds are you are obligated to pay them back. Even though the payment went to the dentist, it was for your children's benefit. Probably the dental insurance contract also requires repayment in these circumstances. Your ex may have the same obligation to pay them, Metlife won't care who repays. However, as between you and your spouse the divorce decree would govern who is responsible.

One issue may be a statute of limitations issue. I don't know the limitations period in your state for Metlife to sue to recover erroneous payments. Though if the payment was only a year and a half ago, there is a good chance that the statute of limitations has not expired.

Get more facts before you pay.

And don't forget my signature line.
 
So did your ex take the kids to a dentist and provide your old dental insurance information to that dentist?

Did you take your kids to a dentist and provide your old dental inurance information to that dentist?

Or did the dentist have that insurance information on file?
 
Well, I can tell that I am just a chump!! I would have paid them immediately upon receiving that letter.

Carry on.... :p
 
So did your ex take the kids to a dentist and provide your old dental insurance information to that dentist?

Did you take your kids to a dentist and provide your old dental inurance information to that dentist?

Or did the dentist have that insurance information on file?

Years ago we used to have dental insurance. It took about 4 years before the dentist would quit submitting claims to the company, even though we told them that we didn't have the insurance anymore.
 
Even if morally I do owe them $246.00, I don't like that they screwed up a year and a half ago and are now coming to me to fix it.

From my experience in the employee benefit arena, MetLife probably wrote to the dentist also and requested that he/she refund the $246.00 that was paid "in error." Most providers (dentist) will comply with a request like this as they do not want to get involved in any future claims problem with MetLife. So, you will owe the dentist the $246, not MetLife.

You may wish to contact the dentist to get his/her take on it. Also, you may choose to just sit tight and ignore the letter for now and expect more correspondence in the future.
 
Thanks to everyone who responded. Good advice from all, as usual.

I am not Martha but my thoughts FWTAW. Fishing expedition? Wonder if they did try to collect from the dentist and they could not so you were next on the list? Since it took them so long to wake up, maybe you should take a like period to respond. Having said that, doesn't dental insurance, unlike medical insurance, usually reimburse the patient after the patient, having paid the dentist, submits a claim, or have the claim submitted by the dentist? Any chance the check (if there was one) was cashed by someone you know or knew?

I don't know if they tried to collect from the dentist or not. I will certainly be calling the dentist and finding out their perspective on all this.

Even though I am annoyed at this, I will respond in a timely fashion. But I will expect more substantiation of the debt before I pay. If they are this incompetent -- to pay erroneously in the first place and then take nearly two years to find their error -- I don't trust them to be correct about the amount or that I do in fact owe them.

It has been my practice to go to the dentist, have them submit insurance, wait for insurance to pay the dentist, then wait for the dentist to bill us for the balance, then pay that in full as soon as we received the bill. Therefore, the most likely scenario is that they paid the dentist this money.

Does it matter if you are legally obligated? This seems pretty clear to me. If they paid something that you should have paid, your should pay the money back. If they paid something that you should not have paid, you do not.

As you probably know, the law and ethics are two different realms which overlap. Both areas influence how I will proceed and whether or not I will repay them.

I would assume that you would know whether or not you took your kids to the dentist, and if you did whether or not you paid the bill. I your cannot remember with certainty, which I can understand given the time frame, ask them for backup.

My wife asked me for a divorce on February 6, 2006, a divorce which I did not want. The dates of service on the letters are 3/28/06 and 5/10/06. So no, I don't know if I took my kids to the dentist. I barely knew which way was up during that time frame.

You're right, given the time frame, I am certainly going to ask them and/or the dentist for more information. Interestingly, in my research last night, since this is the original creditor and not a debt collector I don't have any standing to ask for proof that I owe them this money. Although it is common sense that I could ask for it. This was part of why I was asking what the law said.

Obviously, this is not a legal opinion, but I think, given the user name, you would understand about being responsible for your debts, if they are yours. If they are your debts, I agree the ex should pay half.

Of course. I agree that my ex should pay half as well, since we did a 50/50 split in the divorce. Again I wonder if my ex refuses (I doubt she will), what legal recourse I would have there. Probably none other than small claims court or some sort of contempt of our divorce decree.

Not enough facts. They have the kids' names wrong so you can't be sure that they paid for dental work on your kids.

I think you misread. They do have the correct names of my children on the letters.

I would want to know when the payment was made, what exactly for, and to whom. And then compare that with what the dentist's records show. But if they prove to you that they did pay, odds are you are obligated to pay them back. Even though the payment went to the dentist, it was for your children's benefit.

Yeah, I want to know all that too. I just want to know if I the law is on my side if I refuse to pay until they prove to my satisfaction that I owe them.

Probably the dental insurance contract also requires repayment in these circumstances. Your ex may have the same obligation to pay them, Metlife won't care who repays. However, as between you and your spouse the divorce decree would govern who is responsible.

Sure. In this case, I was the breadwinner, the dental insurance would have been through my employer, and I'm sure I was listed at the dentist's office as the responsible party. I don't know if there is any clause in my divorce decree about debts discovered after the fact.

One issue may be a statute of limitations issue. I don't know the limitations period in your state for Metlife to sue to recover erroneous payments. Though if the payment was only a year and a half ago, there is a good chance that the statute of limitations has not expired.

Get more facts before you pay.

And don't forget my signature line.

Yup. I don't know what the SOL is but 2 years seems reasonable, if annoying.

So did your ex take the kids to a dentist and provide your old dental insurance information to that dentist?

Did you take your kids to a dentist and provide your old dental inurance information to that dentist?

Or did the dentist have that insurance information on file?

As I said above, I don't really remember that period in my life very well. If you go back and read my posts on this board at that time, I was probably griping a lot and whining about my divorce.

I don't know who took the kids to the dentist; it would have been me or their mother. My kids have all seen the same pediatric dentist since birth, so generally the dentist's office has our insurance information on file. I know they try to ask us each time we come in if it's still current, but I can't say for sure what happened in that time frame.

From my experience in the employee benefit arena, MetLife probably wrote to the dentist also and requested that he/she refund the $246.00 that was paid "in error." Most providers (dentist) will comply with a request like this as they do not want to get involved in any future claims problem with MetLife. So, you will owe the dentist the $246, not MetLife.

Yes, I thought this is what they should have done. I don't know if they tried or not, or if they just figured it would be more direct and easier for them to go after me -- one less transaction that way.

You may wish to contact the dentist to get his/her take on it. Also, you may choose to just sit tight and ignore the letter for now and expect more correspondence in the future.

I plan to be proactive about it, and yes, I'll be calling the dentist's office next week to find out what's up. At least they should be able to tell if they submitted to insurance for those amounts and dates of service, and which insurance they submitted to, and whether the insurance paid them those amounts. If that all checks out and matches the information in the letters, I will probably complain to MetLife but pay them back and ask my ex to reimburse me half.

2Cor521
 
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