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BizAttorney, Attorney
Category: Legal
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Experience:  Over 12 years of business and legal experience.
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is it fraud if you do not inform a health insurance about another

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is it fraud if you do not inform a health insurance about another health insurance? say you have 2 insurances because both married people work...
It is only fraud if they specifically ask you and you say you don't' have insurance with anyone else. It isn't a crime to have more than one insurance carrier.

Don't lie on the application because should something happen to you and they find out you have another insurance, then they don't have to cover any of your medical expenses and can cancel your policy.

Good luck!
Customer: replied 8 years ago.
When I filled out the forms to join my souse's insurance, I didn't list my employer's insurance. My spouse's birthday is XXXXX in the year than mine, so I think that in New York state, that would make my spouse's insurance primary. I have used my spouse's insurance exclusively.

Now, they sent a form asking if I have other insurance. I don't know what to do.
You have to list that you do have other insurance or risk them catching you if they ever look into it and cancel your policy. You should tell them and also that you plan to use their insurance as primary (or secondary if you decide to do that).
Customer: replied 8 years ago.
Am I in any danger of legal problems? Or will my honesty now clear up this issue? What's my worst case outcome? Canceled insurance or fines?
You have a valid argument for doing what you did, so the worst that could happen is they cancel the other policy on you. They could try to recover any money they paid out on your behalf, but the burden would be on them to show you committed fraud intentionally.
Customer: replied 8 years ago.
I appreciate your advice.

If they were to call my employer's insurance, does HIPA prevent them from saying anything, or would my employer's insurance be allowed to give them information?

If I drop my spouse's insurance now, would this go away, or would it look suspicious?

The letter from my spouse's insurance is very non-threatening and just asks for information. I'm just very nervous about it.
You are very welcome. Technically HIPAA prevents disclosing any medical information, but many times people do disclose if you at least have insurance through them.

Dropping it would look suspicious, however if you have a legitimate reason for it, then you can always make that argument should you ever need to.

The letter is nonthreatening because many people have dual insurances. They just need to know that whenever a claim is filed.
Customer: replied 8 years ago.
One last thing. I work in the medical profession (not in billing). Would they try to say I should have known better?

P.S. I had my employer's insurance first and the form asks for the effective date of the other insurance.
Yes, that may be a factor and you may be held to a different standard than someone who doesn't work in the medical industry. It isn't a solid argument though, because providing healthcare is different than the insurance industry.

You could interpret the effective date to mean the date the new policy was made (which is usually in the past year)
Customer: replied 8 years ago.
Thank you very much. I will try to find out the last date that my employer's policy was made and put that on the form. What does it mean if I have to put the original date, which is a year or two earlier than when I joined my spouse's policy?
You are very welcome! Original date would be the very first date they issued you a policy.
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