Please advise about the following confusing situaiton (sorry in advance for a long post):
A few years ago my friend had dental coverage policy through his (now ex) wife (her job to be specific). They were already physically separated but haven't filed for a divorce. He had a need to see a dentist, checked with his ex whether he was still on the policy and if it was ok with her for him to use the insurance. She had no problem with that since he still was an official secondary policy holder and he went. After a visit or two the Dr's office mentioned that it seems this Insurance Company sends checks for services to the policy holder's home, instead of the Dr's office. When he asked if this means they send the full coverage for the Dr. or just a portion, they couldn't clarify and said they'll give him a full report when they process all claims for his services.
Meanwhile, he called his ex, and she actually confirmed that a check had arrived from the company (to her house, since she's the primary holder) and she deposited it into her account. She agreed however, to give him the money in cash and he subsequently paid the Dr's office the amount his ex claimed the insurance company sent.
He never received any bills from the Dr's office and after some time assumed that the insurance did take care of all of his procedures.
Three years later (they are divorced now), he gets a collection letter regarding an unpaid oustanding balance for the Dr's services. He calls the collection agency and without going into any details mentioned above (regarding his situation with the EX), he first of all, explains that he never received a single bill for the services. He says that in order to confirm what he really owes the Dr. he needs to see a record of services, bills, claims and what the insurance covered and didn't cover. The collections company says they'll investigate and contact him. He gets no response from them for some time. A couple of months later another letter arrives from an attorney with a collection request but for a significantly smaller amount then the other collection agency was asking and it is now on behalf of the Dr. AND the office where the Dr. worked.
Please advise if this could mean he owes to both, or did they settle on a smaller amount? Also, what can he possibly do and how can he respond to these collection letters properly considering he never ever saw any bills, statements or insurance company report as to what was paid for and what wasn't. Just feels like they pulled this amount out of no where and haven't shown anything to prove it.
Thanks for your help!
A few years ago my friend had dental coverage policy through his (now ex) wife (her job to be specific). They were already physically separated but haven't filed for a divorce. He had a need to see a dentist, checked with his ex whether he was still on the policy and if it was ok with her for him to use the insurance. She had no problem with that since he still was an official secondary policy holder and he went. After a visit or two the Dr's office mentioned that it seems this Insurance Company sends checks for services to the policy holder's home, instead of the Dr's office. When he asked if this means they send the full coverage for the Dr. or just a portion, they couldn't clarify and said they'll give him a full report when they process all claims for his services.
Meanwhile, he called his ex, and she actually confirmed that a check had arrived from the company (to her house, since she's the primary holder) and she deposited it into her account. She agreed however, to give him the money in cash and he subsequently paid the Dr's office the amount his ex claimed the insurance company sent.
He never received any bills from the Dr's office and after some time assumed that the insurance did take care of all of his procedures.
Three years later (they are divorced now), he gets a collection letter regarding an unpaid oustanding balance for the Dr's services. He calls the collection agency and without going into any details mentioned above (regarding his situation with the EX), he first of all, explains that he never received a single bill for the services. He says that in order to confirm what he really owes the Dr. he needs to see a record of services, bills, claims and what the insurance covered and didn't cover. The collections company says they'll investigate and contact him. He gets no response from them for some time. A couple of months later another letter arrives from an attorney with a collection request but for a significantly smaller amount then the other collection agency was asking and it is now on behalf of the Dr. AND the office where the Dr. worked.
Please advise if this could mean he owes to both, or did they settle on a smaller amount? Also, what can he possibly do and how can he respond to these collection letters properly considering he never ever saw any bills, statements or insurance company report as to what was paid for and what wasn't. Just feels like they pulled this amount out of no where and haven't shown anything to prove it.
Thanks for your help!
