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Benefits Terminated Before I Was Told They Would Be South Carolina

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  • Benefits Terminated Before I Was Told They Would Be South Carolina

    I asked my previous employer if my benefits would go to the end of the month or end on my last day of work, and I was told that they would goto the end of the month. I gave my 2 week notice later that day, and was released the next day.

    The following week, of the same month as my notice date, I had surgery scheduled. The day before my surgery I called to confirm that I still had benefits. I was told that they ended on my last day of work.

    I had to cancel my surgery because I could not get proof of COBRA insurance in time for the surgery.

    So, basically, my employer gave me misinformation, which caused me to have to cancel my surgery.

    Is there any legal action possible here?

  • #2
    Sorry but no there isn't. Other than finding out a week later than you would have liked, you would still have had to cancel your surgery if the surgeon would not accept your claim that you would sign up for COBRA.

    I'm not sure why you didn't have the surgery anyway then just submit the bill to the carrier once you were enrolled on COBRA.
    I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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    • #3
      Possible? Sure, anything is possible. You are probably talking about "detrimental reliance". But that is a hard legal theory. You will have to be able to show actual damages incurred and a few other things. It is also IMO something beyond the capacity of an internet board to advise you on. This sort of thing is very technical, very detail specific and very state law specific.

      http://en.wikipedia.org/wiki/Estoppel
      "Reality is that which, when you stop believing in it, doesn't go away".
      Philip K. **** (1928-1982)

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      • #4
        Originally posted by DAW View Post
        Possible? Sure, anything is possible. You are probably talking about "detrimental reliance". But that is a hard legal theory. You will have to be able to show actual damages incurred and a few other things. It is also IMO something beyond the capacity of an internet board to advise you on. This sort of thing is very technical, very detail specific and very state law specific.

        http://en.wikipedia.org/wiki/Estoppel
        Ya, I was trying to get some guidance before I paid a $175 consultation fee. I don't really have that, so I wanted to make sure it was something worth pursuing before I did.

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        • #5
          Not my place to say yes or no, but detrimental reliance or promissory estoppal claims (sort of the same thing) are sort of like getting hit by lightning as far as the employer is concerned. They happen once in a great while but do not suceed all that often. When they do occur they tend to be very narrowly decided. An example often cited in law books is Grouse v (some pharmacy who shall remain nameless). Grouse not only interviewed but was told that he was hired and to report to work in a few weeks. Based on this, Grouse quit his existing job, but when he showed up to work some week later was told that his new employer had changed their mind, not that they bothered telling him that. Grouse sued and won.

          This was legally a rather shocking decision at the time because under Employment-At-Will there is generally no right to one's existing job, much less a new job. This was a CA decision and generally considered "way out there" by other courts. And it was actually a very narrow decision. The court did not say that Grouse had any right to the new job but rather had right to damages for quitting his old job. The new employer making no effort what-so-ever in letting Grouse know what happened and this hurt them badly in court. It showed a lack of any effort to mitigate the damages by the new employer.

          If you are really serious, this is a tough, technical argument to make. You need to not only prove actual damages but you have to basically be able to prove that your old employer behaved irresponsibly under whatever legal rules your state uses. Based on what you have said, your employer could argue a simple mistake on their part, and depending on your state laws, what judge you get, and maybe the phases of the moon, that might be enough to decide the case against you.
          "Reality is that which, when you stop believing in it, doesn't go away".
          Philip K. **** (1928-1982)

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          • #6
            Originally posted by ElleMD View Post
            I'm not sure why you didn't have the surgery anyway then just submit the bill to the carrier once you were enrolled on COBRA.
            This is what you should have done. Your COBRA coverage would be effective the date your group coverage lapsed once you enroll & pay the cost. (retroactive back to date of lapse of gr. health ins.)
            Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around. Leo Buscaglia

            Live in peace with animals. Animals bring love to our hearts and warmth to our souls.

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            • #7
              Originally posted by Betty3 View Post
              This is what you should have done. Your COBRA coverage would be effective the date your group coverage lapsed once you enroll & pay the cost. (retroactive back to date of lapse of gr. health ins.)
              I tried to do that, but they wouldn't accept my 'word' that I would enroll in COBRA.

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              • #8
                If you didn't enroll in COBRA then the cost would just be billed to you directly. In this case that is likely what would happen though once you got the bill, you would need to then submit it yourself to the carrier.
                I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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                • #9
                  The surgeon either required proof of insurance or the procedure to be paid in full. I didn't have either, so I had to cancel

                  Comment


                  • #10
                    That you would need to take up with the surgeon. Your surgeon's policies aren't the employer's fault.

                    Even if you had known the week before that your benefits would terminate with your last day you would still be in the same boat. Your employer doesn't even have to give you the COBRA election notice until 44 days after you lose coverage, so a week in either direction wouldn't have made any difference. You would still either have to pay out of pocket or cancel the procedure.
                    I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

                    Comment


                    • #11
                      I think you misunderstand the situation. I gave my notice the day I did BECAUSE I was told that the benefits went to the end of the month. Otherwise, I would've given my notice the day after my surgery.

                      Comment

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