Posted by: koherston | November 2, 2015

Failure to Timely Submit Uncovered Medical Expenses Allowed in Franklin, TN: Eberbach v. Eberbach

Facts: Mother and Father divorced in 2011. Their parenting plan provides that the children’s “uncovered reasonable and necessary medical expenses . . . will be paid by pro rata share in accordance with [the parties’] income[s].” According to the parenting plan, the pro rata share was 100% to Father and 0% to Mother.

The parenting plan further provides that “[a]fter insurance has paid its portion, the parent receiving the bill will send it to the other parent within 10 days. The other parent will pay his or her share within 30 days of receipt of the bill.”

In 2014, Mother filed a motion for judgment against Father for reimbursement of uncovered medical expenses totaling over $25,000.

Father argued he is not liable for the children’s uncovered medical expenses because Mother failed to comply with the requirement that she send those unpaid medical bills to him within 10 days of receipt.

The trial court awarded Mother a judgment for the entire amount of the uncovered medical expenses, i.e., over $25,000, plus her attorney’s fees and expenses.

Father appealed.

On Appeal: The Court of Appeals affirmed the trial court.

The proof showed Father received at least some of the children’s EOB (Explanation of Benefits) statements from the children’s health insurance company. Because Father was responsible for 100% of the children’s uncovered medical expenses, the Court concluded he reasonably should have known he was responsible for all of the children’s uncovered medical bills.

After reviewing the record, the Court reasoned:

Although the parenting plan does set out a timeframe for sending copies of bills as well as a timeframe for paying same, importantly, the parenting plan does not specifically provide that any violation of the time constraints will result in a party being relieved from his or her obligation to pay his or her pro rata share of the children’s medical expenses.

Accordingly, the trial court’s judgment was affirmed.

K.O.’s Comment: One of the main reasons for the timeframe is to prevent uncovered medical bills from accumulating to a point where — like here — the total amount owed becomes unmanageable. Should there be a consequence to noncompliance with the timeframe requirements? If so, what should it be? If not, why have a timeframe at all?

Eberbach v. Eberbach (Tennessee Court of Appeals, Middle Section, October 23, 2015).

Information provided by K.O. Herston: Knoxville, Tennessee Divorce and Family Law Attorney.


Responses

  1. As one who deals with this type of thing as part of my parenting plan, there are aspects to this appeal that I find interesting and frustrating. The appeal court states that:

    “the parenting plan does not specifically provide that any violation of the time constraints will result in a party being relieved from his or her obligation to pay his or her pro rata share of the children’s medical expenses.”

    K.O., I thought that the parenting plan was one of the parts of the decree that loses its ‘contractual nature.’ Is that not true? How could one actually create a contractual clause in the PPP that would relieve a parent of financial obligation towards medical costs, and that could not be overruled by the court?

    • Al, I can’t think of a way to do it where it wouldn’t violate the child support statutes and guidelines. There is always contempt as a remedy for noncompliance but that would be cold comfort for an obligor having a $25,000 judgment for unpaid medicals accrued over the course of several years that can be executed immediately on the obligor’s bank accounts.

      I suppose one could TRY by explaining the importance of timely compliance and then say the party receiving the bill has to submit it to the obligor within X number of months or the obligee will be responsible for the entire amount and forfeit any right to be reimbursed for the obligor’s pro rata portion. Of course, such a provision could be attacked with the child support statutes, guidelines, and public policy.

      You asked for a way that could not be overruled by the court. I just don’t see it. Some trial courts might enforce it but I think you’d face a tough audience on appeal. It can’t hurt to try. Someone has to be first.


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