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Loren
Loren, Lawyer
Category: Employment Law
Satisfied Customers: 29014
Experience:  More than 30 years in legal practice.
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I had medical coverage daughter from state of PA at no cost.

Customer Question

I had medical coverage for my daughter from state of PA at no cost. My wife employer added our daughter on to my wife's medical coverage without her permission. My wife's employer deducted for medical coverage each pay period. All the claims which were paid by state insurance for my daughter the are going to retract stating my daughter was covered through my wife's health plan. I am left with all the claims that the state of PA are going to retract. My question is do I have a legal case to go after my wife's employer for lawsuit. Thanks
Submitted: 11 months ago.
Category: Employment Law
Expert:  Loren replied 11 months ago.

Good evening. I am Loren, a licensed attorney, and I look forward to assisting you.

Customer: replied 11 months ago.
Did you get a chance to review my question?
Expert:  Loren replied 11 months ago.

There may be a claim by your wife against the employer for adding her daughter without permission. I do not see a claim you could assert since you have no privity of contract with your wife's employer. You should see if a letter from the wife's employer stating there was a mistake made by them will cause the state to back off on retracting the coverage.

Expert:  Loren replied 11 months ago.

The other possibility, if premiums were paid, is putting the claims through the wife's insurance.

Expert:  Loren replied 11 months ago.

Did you have further questions? Have I answered your question?

Expert:  Loren replied 11 months ago.

Are you still online with me?

Expert:  Loren replied 11 months ago.

If you have no further questions please remember to rate my service so that I am credited by JA for answering your question and also so that I may close the question. Thanks.

Customer: replied 11 months ago.
My daughter was placed on my wife's medical plan for year 2012 and 2013. In 2014 she was eligible for state insurance with no cost and was taken off my wife health insurance plan. In Dec of 2014 when time came to renew my wife health insurance plan for 2015 we decided not to enroll my daughter since she was still receiving free insurance for the state. I happened to look at my wife's pay stub for 2015 and found that her employer was deducting for my daughters medical insurance. I asked to have my wife speak to HR administrator and she said first my wife called to have our daughter added on to the plan, and latter when my wife said she never called her about the change the HR said she came in to her office to speak with her. I spoke to VP of HR, CFO, nad the corporate office in regards ***** ***** issue, and all are taking side of HR representative who made changes to my wife health insurance. I have communicated multiple time with the state health insurance about this and they said since my daughter had other insurance we will have to retract all the claims. I am left now to pay thousands in dedutible, co insurance, and co pays.
Expert:  Loren replied 11 months ago.

Your wife can file suit against her employer for adding her daughter without authorization. You can also file a claim with the state insurance commission and that may motivate some movement by the employer's insurer. They should be compensating you if you have damages.

Customer: replied 11 months ago.
Premiums were paid for my daughter through my wife's insurance. But I am still have to pay for deductible, co-insurance, and co-pays that comes out to be in thousands of dollars, where the free insurance from the state I had to pay nothing.
Customer: replied 11 months ago.
What and how one can file a lawsuit?
Customer: replied 11 months ago.
I have started to receive the retract claims from the state. I don't want them to be sent to collection agency can I have the claims be put on my wife's employer health plan, if doing this will IT EFFECT my case of suing them. Thanks
Expert:  Loren replied 11 months ago.

The first thing to do is submit the claims through your wife's insurance. If they will cover the claim then your problem is solved. That should also keep if from going to collection.

Expert:  Loren replied 11 months ago.

Your wife may have a clam against her employer under ERISA if the . In that case, you may want to retain local counsel, as ERISA claims require pretty specialized experience.

If you need assistance finding local counsel try Martindale Hubble. Many attorneys themselves use this site to locate attorneys outside their jurisdiction or expertise:

http://www.martindale.com/Find-Lawyers-and-Law-Firms.aspx

It is a huge worldwide database searchable by location and specialty.

Customer: replied 11 months ago.
My wife employer will cover the claims, but I would like not to pay out from my pocket for the deductibles, again if I have the claims put through my wife's employer insurance can I still file a lawsuit for the damages and unauthorized deduction from my wife's pay check.
Customer: replied 11 months ago.
I am aware about the Erisa and was told by HR director of my wife's employer.
Customer: replied 11 months ago.
Are there Lawyers fee associated with ERISA?
Expert:  Loren replied 11 months ago.

ERISA claims, if successful, can get attorney fees included in the award.

Customer: replied 11 months ago.
If not successful what are the fees.
Customer: replied 11 months ago.
on average
Expert:  Loren replied 11 months ago.

Whatever you negotiate with the attorney. There is no set fee.

Expert:  Loren replied 11 months ago.

You can negotiate the fee upfront before you retain the attorney.

Customer: replied 11 months ago.
In ERISA if you win the case what is awarded.
Expert:  Loren replied 11 months ago.

You can get punitive damages, as well as actual and incidental damages. Also, the attorney fees, as I said.

Expert:  Loren replied 11 months ago.

Did you have further questions? Have I answered your question?

Expert:  Loren replied 11 months ago.

If you have no further questions please remember to rate my service so that I am credited by JA for answering your question and also so that I may close the question. Thanks.