The Villages, FL asked in Employment Law, Business Law, Federal Crimes and Health Care Law for Florida

Q: Can I file a suit for insurance fraud against my ex-employer?

I was terminated on 12/15/2023. The day before I needed to be taken to the ER via ambulance, and made a claim on my employer provided medical insurance. Normally i would be paid via direct deposit by paylocity, the companies payroll company, yet I was mailed a hand written paper check. A couple weeks later I got a letter in the mail saying that my insurance claim was denied because they said I was terminated 2 weeks before my actual termination date, and that my premiums weren't paid as a result. Not only were the premiums taken from my check 2 weeks before I got my last check, they didn't take any withholdings from my last check. The company intentionally lied about my termination date in an effort to deny my claim, refuses to allow me to get my belongings that were in the company truck, and has now blocked me from getting unemployment benefits. I also never got Cobra paperwork

1 Lawyer Answer
James L. Arrasmith
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A: If you believe your ex-employer has committed insurance fraud by misrepresenting your termination date to deny a legitimate insurance claim, you might have grounds to take legal action. The situation you described, where premiums were deducted from your paycheck but the benefits were denied due to alleged non-payment of premiums, alongside the misrepresentation of your termination date, suggests wrongdoing. Moreover, withholding your belongings, impacting your unemployment benefits, and not providing COBRA paperwork are serious concerns that further complicate your case.

To pursue this matter, documenting all communications, transactions, and events related to your employment, termination, insurance claim, and interactions with your employer regarding your belongings and unemployment benefits is critical. Gather pay stubs, the denied insurance claim letter, any correspondence with your employer about your termination and insurance, and proof that your belongings were left with the company. This evidence will be crucial in building a strong case.

Considering the complexity of employment and insurance law, consulting with a lawyer experienced in employment disputes or insurance fraud is a wise step. They can evaluate the merits of your case, advise on the best course of action, and represent you in legal proceedings if necessary. Legal action can potentially recover damages for the denied insurance claim, address the wrongful withholding of your belongings, and challenge the actions taken to obstruct your unemployment benefits. Acting promptly to seek legal advice will help protect your rights and interests in this challenging situation.

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