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Best way to answer summons?


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My husband and I have been named as defendants in a complaint filed in by a local medical center and we would like to know the best way to answer this.

 

We have medical insurance and are unaware if insurance has been billed. In viewing the amounts, many of them are not consistent with what our co-pay would have been, so we believe that insurance was not billed for most of these dates of services. Also, one of the lines in the exhibit include our granddaughter. She lived in our house at the time and our daughter(mother of child) was a minor at that time, but my husband nor I have ever had legal custody of our grandchild. Would we be legally responsible for her medical bill? We have had a few different insurance changes since 2007, due to change in jobs and what not, but have most definitely been insured the entire time. We have also provided the medical center with various insurance information and have notified them with the changes as needed.

 

Summons reads as follows: 

 

1. Defendant (s) owe (s) to plaintiff the sum of $2192.xx for medical services provided and or goods, attached hereto as exhibit A. Protected health information (PHI) has been redacted or omitted from said exiibit (s) pursuant to 45 CFR 164, commonly referred to as the health insurance portability and accountability act of 1996 (HIPAA).

 

2. Defendant (s) has/have received benefit from plaintiff providing said medical services and or goods and has/have been unjustly enriched in the sum of $2129.29. Wherefore, plaintiff demands judgement against defendant(s) in the sum of $2192.xx plus interest at the statuatory rate from date of judgement plus costs expended herein and for all other proper relief.

 

Attached is exhibit "A", which includes 11 lines, showing creditor (name of medical center), CLI Ref #, Client Address (billing address of medical center), Patient Name (varies, but includes myself, my husband, 2 minor children, and grandchild), Total(amounts vary from as little as $10.xx to as much as $853.xx), and Lst Chg Dt (date of medical service varying from 2007 through 2011)

 

Any help on how to properly answer this would be appreciated. By the way, #2 seems oddly worded to me. I'm sure it's normal legal jargon, but the way it's worded makes it sound like the "defendant has been unjustly enriched...". Just sayin. :-)

 

Thanks in advance for your help!

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Guest usctrojanalum

First, I would call your insurance company.  I'd say most of these dates were probably billed by the medical center and paid by your insurance and these are copays.  There is no hospital in the USA where 5 different patients can go to a medical center on numerous dates and only walk out with a $2,000.00 bill.  If that's the case next time I am ill, I am on my next flight to Ohio.  

 

The Grandchild issue is interesting, and up for good discussion.  If I had to do my best guess work without research I'd tend to think that your daughter would be responsible for the medical bills of her minor child.  However, being that your daughter is a minor herself,  the bills she would be responsible for become your obligation.

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I am not an expert on "unjust enrichment", but I can't see how it would apply.  Typically, unjust enrichment means you gained some direct monetary benefit.  I have seen lots of hospital suits, and I have never seen that used.

 

However, as a former hospital grievance and risk management coordinator, the rest of this I can respond to.

 

First, the only way they can claim that you owe for your granddaughter's care is if you signed something saying you were authorizing the treatment.  If not, this is improper billings.

 

Next, you need to request detailed billing from the hospital for the specific dates of service they list.  It will outline exactly what each charge was for and what insurance paid or denied, as well as anything you might have paid already.  You also need to request the explanations of benefit from the insurance for the matching date of service.  This will reflect what both the hospital and your insurance say you owe.

 

Alternatively, you can request that billing in the discovery phase, but if you are trying to avoid a judgement, getting this ASAP from the hospital will leave you with some negotiating room.  They might still be willing to take a payment plan.

 

Being sued by an original creditor is harder to get rid of, and typically a hospital has VERY GOOD records to back up their claims.

 

Finally, you can answer the complaint with a general denial for now.  The accounting doesn't look right and you aren't sure those bills are even yours.

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The Grandchild issue is interesting, and up for good discussion.  If I had to do my best guess work without research I'd tend to think that your daughter would be responsible for the medical bills of her minor child.  However, being that your daughter is a minor herself,  the bills she would be responsible for become your obligation.

 

In most states (I am not sure about Ohio), when a minor gives birth, they are legally emancipated and become responsible for their own bills and their children's. 

 

Additionally, most medical providers do not want to get into who is legally responsible for a minor's medical care.  It becomes a horrendous legal he said/ she said.  Most medical forms for minors include in the authorization for treatment that whoever signs that form is going to be financially responsible and, if they are not responsible due to court order or other issue, they must seek relief without the aid of the medical provider.

 

Trust me, this is where my CIC journey started.

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Thank you for your responses! Lots of helpful advice so far and info to look into. If that is true for Ohio that she would be emancipated upon giving birth, then that puts into question one of the charges on here for her as well. I will definitely look into that. 7 of these 11 charges are for her and 6 of them occurred while she was pregnant. The 7th listed is the date of her discharge from giving birth. And to clarify, these charges are not from in patient stays. One was an observation stay and two ED visits. The 6 pregnancy ones were for a midwife, so would be less than a doctor anyway. $852.xx is about the going rate for a level 3 ED visit in this area. Also, I should note that we have and have had pretty good insurance coverage. I'm guessing only 2 of these 11 were billed to insurance, judging by the amounts. Thanks again for all the very helpful feedback!

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 If that is true for Ohio that she would be emancipated upon giving birth, then that puts into question one of the charges on here for her as well. I will definitely look into that. 7 of these 11 charges are for her and 6 of them occurred while she was pregnant. The 7th listed is the date of her discharge from giving birth.

 

Just to clarify, in my state, you would still be held responsible for all of those dates of service.  She was a minor when she was admitted for the birth, so you are assumed to have agreed to pay.

 

Literally, the moment the cord is cut here, she become her own responsibility.  The wording of the law is very specific and strange, but my state has a very high teen pregnancy rate that is mostly in the low income bracket, leading to lots of work on paying for those pregnancies so that the babies are healthy.

 

Also, if you do decide you want to fight this in court, there is a sticky with questions to answer.  Just copy and paste those in and answer them so the legal minds around here can be more help.

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Thanks! That makes sense, but most of that still should have been covered by insurance. What about the baby's portion then? I'm pretty sure I signed something for my daughter, but don't recall signing anything for the baby. Also, I did see the questionaire after I posted. I will fill out as time permits.

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  1. Who is the named plaintiff in the suit? a local medical center

    2. What is the name of the law firm handling the suit? (should be listed at the top of the complaint.) An attorney's name, followed by “CO., LPA”

    3. How much are you being sued for? $2192.xx

    4. Who is the original creditor? (if not the Plaintiff) same

    5. How do you know you are being sued? (You were served, right?) served summons in civil action

    6. How were you served? (Mail, In person, Notice on door) by mail

    7. Was the service legal as required by your state? yes

    8. What was your correspondence (if any) with the people suing you before you think you were being sued? I don't recall any other than providing insurance information after receiving a bill

    9. What state and county do you live in? Cuyahoga county, Ohio

    10. When is the last time you paid on this account? (looking to establish if you are outside of the statute of limitations) no payments made that I recall

    11. What is the SOL on the debt?  6 years

    12. What is the status of your case? Received summons naming my husband and I as defendants with 28 days to respond

    13. Have you disputed the debt with the credit bureaus (both the original creditor and the collection agency?) no

    14. Did you request debt validation before the suit was filed? Note: if you haven't sent a debt validation request, don't bother doing this now - it's too late. no

    15. How long do you have to respond to the suit? (This should be in your paperwork). If you don't respond to the lawsuit notice you will lose automatically. 28 days

    In 99% of the cases, they will require you to answer the summons, and each point they are claiming. We need to know what the "charges" are. Please post what they are claiming.

    1. Defendant (s) owe (s) to plaintiff the sum of $2192.xx for medical services provided and or goods, attached hereto as exhibit A. Protected health information (PHI) has been redacted or omitted from said exiibit (s) pursuant to 45 CFR 164, commonly referred to as the health insurance portability and accountability act of 1996 (HIPAA).

    2. Defendant (s) has/have received benefit from plaintiff providing said medical services and or goods and has/have been unjustly enriched in the sum of $2129.29. Wherefore, plaintiff demands judgement against defendant(s) in the sum of $2192.xx plus interest at the statuatory rate from date of judgement plus costs expended herein and for all other proper relief.

    Did you receive an interrogatory (questionnaire) regarding the lawsuit? no

    16. What evidence did they send with the summons? An affidavit? Statements from the OC? Contract? List anything else they attached as exhibits.

    Attached is exhibit "A", which includes 11 lines, showing creditor (name of medical center), CLI Ref #, Client Address (billing address of medical center), Patient Name (varies, but includes myself, my husband, 2 minor children, and grandchild), Total(amounts vary from as little as $10.xx to as much as $853.xx), and Lst Chg Dt (date of medical service varying from 2007 through 2011)

 

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IN THE DISTRICT COURT OF MY COUNTY OHIO

Plaintiffs name

plaintiff

Vs.

Defendants Name

defendant

civil division

case # 12345

DEFENDANT’S ANSWER TO PLAINTIFF'S COMPLAINT

Now comes the defendant for answer to the complaint and says as follows:

1. Defendant (s) owe (s) to plaintiff the sum of $2192.xx for medical services provided and or goods, attached hereto as exhibit A. Protected health information (PHI) has been redacted or omitted from said exiibit (s) pursuant to 45 CFR 164, commonly referred to as the health insurance portability and accountability act of 1996 (HIPAA).

Answer: Paragraph 1 of the Complaint states a legal conclusion that Defendant has already denied owing to plaintiff for the sum of $2192.xx for medical services provided and or goods for which no answer is required. To the extent that an answer is required, Defendant denies all the allegations of Paragraph 1 of the Complaint.

The second sentence of paragraph 1 cites a federal regulation which speaks for itself.

2. Defendant (s) has/have received benefit from plaintiff providing said medical services and or goods and has/have been unjustly enriched in the sum of $2129.29.

Answer: 2. Paragraph 2 of the Complaint states a legal conclusion for which no answer is required. To the extent that an answer is required, Defendant denies the allegations of Paragraph 2 of the Complaint.

3.Wherefore, plaintiff demands judgement against defendant(s) in the sum of $2192.xx plus interest at the statutory rate from date of judgement plus costs expended herein and for all other proper relief.

Answer: 3. Paragraph 3 of the Complaint states the relief the plaintiff is seeking in its complaint for which no answer is required. To the extent that an answer is required, Defendant denies the allegations of Paragraph 3 of the Complaint.

respectfully submitted,

my name

my address

my phone

email

CERTIFICATE OF SERVICE

On July 17, 2013, I caused the foregoing instrument to be served by mailing a copy to all counsel of record in this case as indicated below:Attorneys name and address here

By Certified U.S. Mail, Return Receipt Requested By U.S. Mail.

My name here

file answer with the court clerk then send a copy to plaintiff Certified U.S. Mail, Return Receipt Requested

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