Insurances

Rhode Island Divorce - Attorney Pearsall on Healthcare Coverage

Healthcare is another aspect considered in a Rhode Island Divorce, particularly if there are minor children involved.

In a divorce involving minor children, Judge's typically want to hear whether there is health care coverage afforded to any minor children of the divorcing parties, who the primary insured on that insurance plan, who will continue to maintain the plan and how, and how the expenses of the minor children that are not covered by the existing health insurance will be paid for by the divorcing spouses.

On it's surface it can be as simple as this little fact pattern below:

John and Julie are getting divorced. John has family medical care through his employer at a moderate cost that is deducted from his check each week. John agrees to continue that coverage for the benefit of his child(ren) and his soon to be ex-spouse for as long as they are eligible. John and Julie will each pay 50% of all uninsured expenses for the children. These would include co-pays, prescriptions that aren't covered, etc. John and Julie shall each be responsible for their own out of pocket medical expense.

That instance isn't complicated and two reasonable people could come to that agreement without too much difficulty and not even realize that they have complied with the needs of the court and what the judge wants to know.

Unfortunately, divorces aren't always so amicable and agreements such as these can become complicated if the parties become difficult with each other when emotional tensions run high or if the parties simply become "penny pinchers" such that they want the same amount as their spouse right down to the last penny.

Let's add a little glitch to John and Julie's scenario. Rather than wanting to pay their child's uninsured and uncovered out of pocket medical expenses equally, Julie makes $10,000 less per year than John so she only thinks she should pay in proportion to her income which is 40% of their total income. Julie thinks John should pay 60% of each expense. Yet here's the problem.... what if either of their incomes fluctuate. How often will it be monitored? What documents will be required for disclosure? How can full compliance with disclosure be assured?

Though Julie is trying to get herself out of paying an extra 10% she is complicating the process immensely and possibly causing a situation that could cause her and John to expend much more in unnecessary legal fees than if she were simply to pay half of the uninsured medical expenses. Instead, such an endeavor could lead to a computational nightmare trying to keep up with who makes how much money and when and whether the percentage relates to the time the service is rendered, the time the bill is sent, or the time the bill is eventually paid.

If delays in the calculations or court proceedings then who may be responsible for the late charges, interest or costs of collection?

Do you recognize the other issues this scenario could raise? 

All My Best to You on Your Journey Through The RI Family Court,
Attorney Christopher A. Pearsall - "The Rhode Island Divorce Coach"™ 


Rhode Island Family Lawyers and Medical Provisions

There is a great concern about medical coverage today.  This is not surprising with the skyrocketing premiums  of medical insurances and increasing deductibles and co-pays.

For these reasons and many others, medical insurances and healthcare expenses should be given serious consideration when settling your Rhode Island Divorce or if you are involved in a Rhode Island Family Court matter involving the establishment of healthcare related provisions.

The Todd & Liz Story - An Illustrative Example of What Could Happen:

Todd and Liz have been living in Cumberland, Rhode Island for six (6) years.  They have been growing apart steadily since the day they got married and have three (3) minor children.  They mutually decide to get a divorce.  They are amicable and civil about it and come to an agreement that addresses splitting their assets, and debts, and also provides for their children's needs. 

In their Rhode Island Divorce both Todd and Liz each had their own attorneys and were pleased with the representation they received. When the divorce was finalized, Todd was awarded placement of the minor children by agreement because he has a good, longstanding income to support himself and the children and Liz felt it was best for Todd to buy out her share of the house to allow their children to remain stable by staying in their existing home.  They both felt the divorce would be hard enough for the children.

Several years later two of the children visit with their mother and they have braces.  Liz wasn't consulted by Todd about the braces, who would provide them, why they needed them or what it might cost.  Todd tells Liz she has to pay him $4,000 for 1/2 the cost of the braces. Liz isn't given a bill and is surprised that she has to pay for braces and wasn't even consulted about them.  Liz looks at her Final Judgment of Divorce. 

Paragraph 6 reads,

Husband and wife shall each be responsible for one-half of all costs for the medical and dental expenses of the minor children.

Liz does not find anything else in her Final Judgment stating that she has to pay for one-half of any orthodontic expenses. 

Liz calls a local dentist and asks him if orthodontic is the same as dental.  The dentist assures her that they require different degrees and are two separate areas of medicine dealing with teeth so they shouldn't be considered the same.  Liz has a boyfriend Tom who is concerned because Liz is so upset.  Tom has dental insurance and calls Blue Cross Dental to see if it covered braces.  Blue Cross confirms for Tom that dental coverage does not cover orthodontia because it is not considered a dental expense.  Tom decides to call Delta Dental of Rhode Island and asks them if their plan would cover children's braces. Delta Dental tells Tom that dental plans do not cover braces because orthodontia is not dental because it could not be performed by a dentist and only work performed by a dentist or dental hygenist is considered dental.

When Liz divorced Todd she said she had no problem with Paragraph 6 because she believed "dental" meant the "services performed by dentists".  Liz and Todd were divorced during a nominal proceeding in which all the terms were reached by agreement to by the parties.  Yet Liz never believed that dental included braces otherwise she would not have agreed to it.

Liz does not pay for the braces and Todd takes her to court by filing a Motion to Adjudge in Willful Contempt asking that she pay the entire bill in full plus other medical expenses that Liz is unaware of. 

The matter goes to a hearing before the court.  The court does not find Liz in Willful Contempt but orders Todd to produce the bills for the braces and the medical expenses as well as the payments he made on them.  The judge also orders Liz to pay 1/2 of the braces and medical expenses that Todd can produce the bills and proof that he paid the bills for the minor children.

The court makes a finding that in Paragraph 6 Liz was ordered to pay one-half of dental expenses for the minor children and that braces and orthodontia fall are "dental" and though she is not in contempt because she did not realize it, she is being ordered to pay it because it falls within the court's order in Paragraph 6.

The Lesson

It is important to realize the significance of medical provisions. This entire example revolved around one word, namely "dental."    Be specific on your medical provisions.  It could cost you thousands of dollars in  payments, costs, interest, attorneys' fees and an award of fees to opposing counsel if the court believes your defense to the payments was unreasonable.

Questions

1)  How important would it be for Liz to know that she might not be ordered to pay these amounts (over $4,000) if Paragraph 6 of her Final Judgment Divorce ended with ", except orthodontia"?

2)  How important would it be to you if you were in the same situation?

3)  Would it make any difference to you if you knew that the Rhode Island Family court judge in the courtroom across the hall had addressed the same issue and ruled that "dental" and "orthodontia" are separate from one another and that braces didn't have to be paid where the word "dental" was used in the Final Judgment of Divorce?

4)  Would you be upset at your attorney for not making the agreement clearer?

5)  Would you be upset at your attorney if you knew that what happened in Question #3 was true? 

Authored by:

Christopher A. Pearsall, Esquire
PEARSALL LAW ASSOCIATES
571 Pontiac Avenue
Cranston, RI  02910
Phone:  (401) 354-2369

Attorney Pearsall's practice is focused almost exclusively in the areas of Divorce and Family law.

CALL (401) 354-2369 now to schedule for your low-cost, no obligation legal consultation!

NOTE:  The postings on this website are NOT legal advice, DO NOT create an attorney/client relationship and are NOT a substitute for a detailed consultation with an attorney experienced in the state where you have your legal issue.  This site is based on Rhode Island and is presented for the convenience of the internet public.

* The Rhode Island Supreme Court licenses all lawyers in the general practice of law and has no procedure for recognition of specialty in any area of law.

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