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Question

My husband, prior to our marriage, received a check from Cleveland Clinic stating it was an overpayment.   He contacted the hospital several times and the insurance company and both said that if the hospital sent the monies, it was his.
Monies were left in an account for almost a year and after one final call, monies were used.   Now 18 months later, he receives a letter from the insurance company that they paid a claim twice and demanded full return of all monies immediately. When researching this, I found City of Hope Medical Center v. Superior Court 8Cal.App.4th633(1992) indicating the monies are not to be repaid as no false misreprensentations were made to induce payment (hospital filed the claims, were paid and then sent monies to insured) rather than insurance company.

Submitted: 177 days and 17 hours ago.
Category: Legal
Value: $15
Status: CLOSED

Accepted Answer

Thank you for your inquiry. You did some good legal research and you do not have to pay the money back. However, non-payment is not for the reason you believe.

When an accidental payment is made, the payment ordinarily needs to be paid back to avoid unjust enrichment by the party receiving it. There are two exceptions. One is when the accidental payment is made to a creditor who is at all times honest and doesn't know a mistake has been made when the payment is issued. This applies only to creditors.

The other exception exists when a payment is made (to anybody) because of a mistake and the recipient has changed position in reliance on the payment. By spending the money he originally questioned as being proper, your husband changed his position, relying on the fact that the money belonged to him (per hospitals representations).   Therefore it cannot lawfully be recovered. If, however, the money was still just sitting around waiting to be reclaimed, the hospital would have to be reimbursed.

Under the facts you presented, absolutely no repayment is required. If the hospital staff continues to bother you, contact an attorney in your area to write a cease and desist letter.

Best of luck!

If this answer was helpful, please remember to click "Accept." Positive feedback is appreciated and will be reciprocated.

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This response contains general information, only, and does not constitute the provision of legal advice. No attorney/client relationship has been formed by this communication.

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Expert: Attorney 1
Pos. Feedback: 100.0 %
Accepts: 268
Answered: 5/15/2009

Attorney

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