So my friend applied for disability and SS because he lost his job and scholarship for school because he had a heart attack at 21. So we was hospitalized a couple times while waiting because of his heart condition. He doesn’t have health insurance and this was the main reason why he applied for SS. So he decided to get an under the table job at a commission based telemarketing office because his bills were adding up. 4 months later he hears that he is eligible for SS but denied disability. He also realizes that his boss filed a tax form on him based on the money he was making. So when he applied for disability he was unemployed but because SS was taking so long and the bills were adding up, he felt he had to get some sort of job to pay them. So would it be considered fraud since when he applied he said he was unemployed but currently employed now? He hasn’t received any money from SS yet but will he still be in trouble for being employed while waiting? Is there a way that he can still receive SS benefits if he quits his job?

reporting a deadbeat dad working off the books
I would like to report my husbands co-worker for fraud. He claims he does not work and there fore can not pay child support for his two kids. His ex-wife is barely getting by and because of him she and her kids had to go on food stamps and gov’t health insurance. He brings home alomst ,100 a week off the books. He is working for his uncle(the same place my husband works). I think it is horrible what he is doing to his children, and that my taxes have to support his kids when he is able to. My question is if I call the phone number to report him, will they be able to track me by my phone number and will i be talking to a real person or a voice recording. I want to help his wife and kids but if his uncle (the boss) finds out my husband will lose his job and we can not afford that.

reporting a deadbeat dad working off the books
I would like to report my husbands co-worker for fraud. He claims he does not work and there fore can not pay child support for his two kids. His ex-wife is barely getting by and because of him she and her kids had to go on food stamps and gov’t health insurance. He brings home alomst ,100 a week off the books. He is working for his uncle(the same place my husband works). I think it is horrible what he is doing to his children, and that my taxes have to support his kids when he is able to. My question is if I call the phone number to report him, will they be able to track me by my phone number and will i be talking to a real person or a voice recording. I want to help his wife and kids but if his uncle (the boss) finds out my husband will lose his job and we can not afford that.

I live in a state where health insurance is over ,000 a month. I have family out of state where they have many more options and because of this insurance is around -100 a month. I really need insurance. I need to get some things checked out.

I’m going to school as well (my school doesn’t offer insurance) and the school will be in my home state. So, technically can I still get coverage out of state since I can justify being in my real state because of school?

I live in Pittsburgh, PA and I know of someone who is collecting disability from the city, and they are not disabled. Our taxes pay for people like this.

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I switched employers last year and when doing so kept my health insurance with ex-employer threw the cobra rights. well a month after leaving the company they switched health insurance carriers to National Alliance somthing this compnay is a total crock. I had a baby during the time of coverage with them and they have paid NOTHING they hae given me the run around saying one thing and doing another even the benefits package and paper work i have gives the run around. one page says one thing and the next page condradicts everything on the prior page… and on top of that i got a letter from SDS, LLC. saying they needed me to call ASAP about my health coverage (my coverage ended wtih them in Dec) i called and was transfered to a full mail box so i looked them up online found a page about them being linked to National Alliance insurance and how they are a fraud… what do i do next, get a lawyer i spent alot of money to keep that insurance and now i am paying alot of hospital bills because
I am being considered un insured sicne they are not paying a dime for anything.

This has put me a financial hole big time and i have a 6 month old daughter to take care of on top of all this in order to do so i need to work meaning putting her in daycare i’m barley making ends meet and if there is anyway i can get at least the m oney i spent to have the insurance back it would help a little… any ideas or suggestions

a coworker of mine is committing auto insurance and health insurance fraud and im sick of standing by and knowing about it without saying something. whats the best way to go about alerting the companies?

My "con artist" ex-wife, deceived me from the very first day we started corresponding as to her intentions (I wanted a wife……..while she wanted to swindle me).

Since she already knew BEFORE she even inititated ANY correspondence with me that she was not legally entitled to come to the U.S.A. under any kind of Visa, (Moral Turpitude …….. Child Abuse/Neglect) that she might as well find a "mark" to steal from. With this kind of deception in her mind she used a marriage to me to assist her in her efforts to STEAL ME BLIND!!

But does this "bogus marriage" (on her part), also constitute Insurance Fraud under my Health Insurance Policy?? I mean it is supposed to be for my wife and children, but if the authorities declare her actions to be "Marriage Fraud" doesn’t that mean that the insurance benefits she received were also obtained under "FALSE PRETENSES"………..and therefore criminal "Insurance Fraud"?
I mean she obtained insurance benefits through HER acts of DECEPTION and victimized not only me (thousands of dollars), but also my insurance company (also into the thousands of dollars)?

The place I work is a small office and does not currently offer health insurance. They told us that since they are an established company, the health insurance would be very expensive if they offered it now. They recently formed another corporation under the same umbrella as the first. They say that it is less expensive for them to roll us in as new employees under this new corporation one by one and have a health insurance plan then. Can they legally do this? What happens if the health insurance company finds out they did this, as we are not technically new employees?
I am just curious. I actually have insurance under my husband’s policy.

My brother is at the beginnings of a divorce and his lovely wife *sarcasim* opened over 4 credit cards in his name without his knowing. Among other acts of deception including marrying him for health insurance to take care of a pregnancy and a child that she lied and said was his and taking money to pay her bills and then never paying them and then he later would have to pay them again……..can he file for marriage fraud and identity theft?

My ex wife was given her maiden name back by court order during our divorce. Yet, two months after the divorce was finalized, she filed a claim on my Health Insurance using her former "married name" to receive health coverage.

Is this Insurance Fraud??

No insurance coverage was provided for in the divorce decree either.

Is it insurance fraud to list someone as your husband on your health insurance when you have been together for 9 yrs and have 3 children together? we just never got married and i do pay for it out of my check bi-weekly…

I live in New York and I don’t have health insurance.
about a month ago I had strep throat and a doctor I went to took a culture test and submitted it to a lab. I received a bill 2 weeks later for dollars and paid that off. the lab that preformed that culture was Quest Diagnostics.
about a week ago I had strep throat once again and went to my mothers doctor, he took that same culture test and submitted it to a different lab, (north shore medical lab). I received an invoice now for 0. it was the same exact test. these doctors and labs are trying to pull as much money as they can get and its just unfair and ridiculous. who can I complain to? we really need to put an end to this. these doctors and labs have no hearth for anymore. they are in it for the money and nothing else.

A co-worker of mine has had a tummy tuck paid fully by the our health insurance company and she was suppose to have only 4 weeks off. Now she gets 2 months off becuase her doctor won’t relase her. I think she’s suppose to stay home durring this time but last week i saw her at theme park and concert. Is there a number i can call to report health insurance fraud?

I have health insurance through my employment and another insurance through my mom’s. I just had a procedure earlier today and asked the registrar upfront before the procedure of they could co-bill both insurances at the same time, and she adviced not to, and adviced me to let all my doctors know that i have another insurance, and that i would be in big trouble. i really am confused on what’s going on. can anyone help me please? thanks
I appreciate all the info guys. the thing is that I use my mom’s insurance as my primary since all the facilities and providers I see and get my procedures done are under the same name, and my mom works in a hospital under the same name.
I guess what I really want to know is what I need to do at this point to avoid getting into trouble.
I remember giving BOTH insurance information in one procedure way back (blood draw) but still paid the same co-pay amount for my mom’s insurance.

My b/f has had his ex-wife on his health insurance for 5 years. He gave his employer 5 years ago the court order to pay child support but his employer never took his ex-wife off the insurance. Now since he’s going to marry me, he’s taken her off and will put me on once we marry. Now his employer is telling him he’s guilty of insurance fraud and if her bills are over 5K they will fire him and convict him of a felony. Can they do this?

Let's say a patient dies that has health insurance but another patient needs an expensive operation, otherwise they die, and doesn't have insurance. Is it common for the doc to use the deceased persons insurance to help out the non-insured person so that they can live? If so, does this happen often, or very little?

I really don't agree with either program unless they can be revamped and only go to those who truly need it but like any government program both are full of fraud and mishandling but I digress.

Anyway why would he cut one and increase the other? Could it have something to do with one is predominately single women with young children (Medicaid) and the other is predominately senior citizens (Medicare)?

What kind of message is this sending to the older generation?

Actually I am surprised that AARP is not all over this one, never mind, I forgot it is primarily a liberal organization.
I have seen people on medicaid that don't need it because there job offers health insurance but they don't want to spend any money on it so they oft for the free government assistance.

A History Lesson:

1. In 1913, thinking it was being overcharged by the steel companies for armor plate for warships, the federal government decided to build its own plant. It estimated that a plant with a 10,000-ton annual capacity could produce armor plate for only 70% of what the steel companies charged.

When the plant was finally finished, however — three years after World War I had ended — it was millions over budget and able to produce armor plate only at twice what the steel companies charged. It produced one batch and then shut down, never to reopen.

2. Or take Medicare. Other than the source of its premiums, Medicare is no different, economically, than a regular health-insurance company. But unlike, say, UnitedHealthcare, it is a bureaucracy-beclotted nightmare, riven with waste and fraud. Last year the Government Accountability Office estimated that no less than one-third of all Medicare disbursements for durable medical equipment, such as wheelchairs and hospital beds, were improper or fraudulent. Medicare was so lax in its oversight that it was approving orthopedic shoes for amputees.

3. When the federal government nationalized the phone system in 1917, justifying it as a wartime measure that would lower costs, it turned it over to the Post Office to run. (The process was called "postalization," a word that should send shivers down the back of any believer in free markets.) But despite the promise of lower prices, practically the first thing the Post Office did when it took over was . . . raise prices.

Hi everyone. I just need some advice about a legal situation. Please only answer if you are sure.

I know someone who is listed as an employee of a company that a family member owns. He/she does not actually render any services, but pays taxes on the income, and reports all wages to the federal government. He/she gives all money earned to his/her boss, who owns the business by himself.

The reason for this "employment" is medical insurance. The person involved would not have otherwise been able to afford prescription medications and surgery. So the family member offered to put him/her on payroll so that he/she would be covered under a cheaper health insurance policy.

Is this situation legal? Is his/her boss allowed to put him/her on the payroll without him/her rendering services? If word of this situation were to get out, who would get introuble — the employee or the employer, or both? Is it fraud, or just a loophole in the system?

To me it seems like a loophole.

Read the Intelligence Report in the 2-20-08 edition of Parade Magazine. Medicare's budget is 400 billion dollars. The article says 70 billion dollars were paid out in fraudulent claims. That's 17.5%. Do you still think government run health insurance is a good idea? If the US government ran a program for everyone, what would the budget be? two trillion?
What would be the amount of fraud? 350 billion dollars if the fraud rate stays the same.

This is bad, real bad for me I really need some advice from someone who is a medical professional in the area of pharmacy or dispensing of medications. I suffer from AADD and narcolepsy along with disassociates disorder (multiple personalities). I must take a rather high dose of Adderall each day in order to remain functional. I have been on this drug for almost ten years and in that time my dosage has been gradually increased to what it is now. Before Adderall,it was Dexedrine and I was on a very high dose of that also.All along in these many years my health insurance paid for my medication,no problem.Recently however,they are threatening my doctor with legal action if he doesn’t stop prescribing this medication for me.They have accused him of over prescribing and malpractice.They also said they were going to investigate him and have his licence to practice medicine revoked.They came just short of accusing him and ME of insurance fraud.

My husband has a seven year old son who lives part of the time with his mother and her live-in boyfriend. Her boyfriend is insisting on covering the minor on his group health insurance and he is also claiming the child on his taxes as a dependent and getting the child tax credit every year. My understanding is that a child can only be claimed as a dependent if it is a biological, adopted, step or foster child. What would this be classified as? Fraud? And how would my husband go about proving this to the IRS?

I have several folks that have told me that they are still allowing their kids tages 18 to 23, to ride on their health insurance even though they know their kid has either dropped out of high school or college. How does the Insurance Industry handle this type of fraud…??? the folks i spoke too did not have any special requirements from the insurance company. How do they check this for fraud? If they don't they should….I see no special requirements…..And this type of fraud will come out of the pockets of the tax payers…which is you and I.
In the State of NJ, which requires, secondary and college students over the age of 18 , to continue to be covered on the parents medical insurance until the age of 23.
What is the insurance industry's procedure for continued medical for kids over 18 and still in school?

Ex was ordered to provide health insurance for children…does so sporadically. Most recent policy sent via email (February) was a copy of cards front and back. This policy began Jan.1, 2008. According to BCBS in recent phone conversation (July) this policy was "set up" in computer system but never activated and terminated on the same day (Jan. 1)….claims will be retroactively terminated and I will be responsible party as I took children to office visits…

here's the kicker…this is the second time this has happened!

The first time (2006) cost me 00…six months of retroactive termination…..without going into all of the mind boggling absurdities of the Family Friendly Court system of Missouri- (ex also facing "prosecution" for failing to provide support ,000 arrears…able to pay just not frightened enough or morally motivated) my question is this…because these insurance policies were sent through mail (email) can this be considered mail fraud- who brings charges