HEALTH REIMBURSEMENT: DON’T FORGET TO SUBMIT YOUR RECEIPTS!

This is a guest post from Attorney Kevin Segler, also at Holmes, Diggs & Eames.  Thank you, Kevin, for the article!

THE ISSUE:

If the party who incurs an unreimbursed health care expense for a child fails to submit the bill/receipt to the other party for reimbursement within the time period specified in the order, is the other party still required to reimburse for those health care expenses for which they received untimely notice?

HYPOTHETICAL SCENARIO:

Mother and Father have one child and their Order in Suit Affecting the Parent-Child Relationship contains standard language regarding payment of unreimbursed health care expenses. The Order provides that “each party must pay 50 percent of the unreimbursed health care expenses. The party who incurs a health care expense on behalf of a child must submit to the other party all forms, receipts, bills, statements, and explanations of benefits reflecting the uninsured portion of the health care expenses within thirty (30) days after he or she receives them.”

The child is 15 at the time of the order. Five years later, Mother sends Father various bills and receipts for the child’s health care expenses she incurred when the child was 16. Father does not pay. A year after sending Father the bills, Mother files a Motion for Enforcement for a cumulative money judgment based on Father’s nonpayment of his 50% of the unreimbursed health care expenses for the child. Is Father still obligated to pay his 50% even though Mother did not submit the bills and receipts to him within 30 days after she received them?

Short Answer: It seems to be in the discretion of the trial court judge whether Father is obligated to pay.

THE STATUTE:

The Texas Family Code §154.183(c)(1)-(2) states:

(c) As additional child support, the court shall allocate between the parties, according to their circumstances:

  1. The reasonable and necessary health care expenses, including vision and dental expenses, of the child that are not reimbursed by health insurance or are not otherwise covered by the amount of cash medical support ordered under Section 154.182(b)(3); and

  2. Amounts paid by either party as deductibles or copayments in obtaining health care services for the child covered under a health insurance policy.”

Remember, obligations under this section are considered child support and are treated the same as periodic child support payments in that the penalties and limitations periods are the same for enforcement purposes.

THE CASE LAW:

While there are no Texas Supreme Court opinions on this issue, several appellate courts have addressed the topic.

In re A.C.B., 302 S.W.3d 560 (Tex.App.—Amarillo 2009, no pet.)

In 2009, the Amarillo Court of Appeals upheld a trial court ruling that allowed reimbursement for bills despite one party missing the deadline to submit receipts. The order in A.C.B. gave the paying party a ten-day window to provide bills/receipts to the other party. Mother testified that she provided one bill to father within the ten-day window required by the order but there were several bills that were not presented by the deadline.

Even though mother failed to provide the majority of the bills and receipts to father within the ten-day notice period provided in the order, the appellate court held that the trial court did not abuse its discretion in awarding mother 50 percent of unreimbursed medical expenses. The court reasoned that even if mother failed to provide copies of the medical bills within the ten-day deadline established by the modification order, each parent is obligated to support his or her child during the child’s minority and is liable to any other person, including the other parent, who provides necessities for that child.

In re L.L., 341 S.W.3d 22 (Tex.App.—San Antonio 2010, no pet.)

However, one year later the San Antonio Court of Appeals reached an opposite result. When the father in L.L. submitted receipts for his child’s oral surgery two months after the deadline specified in the final order, the appellate court determined the trial court’s denial of father’s request for reimbursement for the surgery was not an abuse of discretion because father failed to provide timely notice of the expense as required by the decree.

Father argued that mother was still responsible for reimbursement because she had a duty to support the children regardless of whether he provided notice pursuant to the decree, relying on In re A.C.B. (discussed above). The L.L. court disagreed, noting that because the trial court chose to enforce the notice requirement contained in the decree, the trial court never acted in an arbitrary manner or failed to follow guiding principles.

Herzfeld v. Herzfeld, 05-10-01298-CV, 2012 WL 6061772 (Tex. App.—Dallas Dec. 6, 2012, no. pet. h.) (NOT REPORTED IN S.W.3d (2012))

The Herzfeld court agreed with the San Antonio Court of Appeals in holding a trial court did not abuse its discretion in denying mother’s request for medical expense reimbursement. While there was evidence from mother that the children saw a psychologist, there was no evidence as to the number of appointments nor was there any definitive testimony regarding the amount owed to the doctor.

Mother testified from memory that both of the children saw a psychologist an average of twice a month, presumably every month from the time of the separation until they turned eighteen. She sought $200 per month pre-divorce and $100 a month post-divorce.

However, there was no evidence Wife timely notified Husband of the payments made and no evidence of the dates on which they were made. Furthermore, the trial court found evidence as to an actual amount was “speculative” because there were no records of visits by date or by child. Given the absence of any other proof to corroborate Wife’s testimony regarding the number of children’s visits, when they occurred, or the cost of each visit, the court upheld the trial court’s decision in concluding the amount was speculative.

CONCLUSION

The classic (and often frustrating) response to many legal questions is “it depends.” It appears that answer also applies here. The one consistency in all three of the above cases is each appellate court’s reluctance to overturn the lower court’s ruling. The trial court’s decision hinges on accepting the “each parent is obligated to support his or her child” argument versus the “strict adherence to the deadline” stance. Just to be on the safe side, one should always submit any health care bills or receipts to the other parent before the deadline passes.

About CJ.Harding
Chris believes one of the most important aspects of family law is seeing the 'big picture.' This means understanding the law, the facts of your case and the range of possible outcomes. Only after knowing each of those can an attorney convey the risks and potential results and guide you to make the right decision for your case, your life and your family. He understands every person and every case is unique. Chris will advocate for the very best possible result in your case. He has worked on a variety of family law cases, including tracing of assets, property division of estates worth more than one million dollars, international and interstate child custody issues, enforcement actions as well as pre-marital and post-marital agreements. Chris continues to be a student of the Law and helps to educate others by maintaining the "Hot Topics" section of the Firm web site, which features current issues in Texas family law. Topics have included how a bankruptcy can affect child support and the differences between alimony and court ordered spousal maintenance. Chris joined the firm after graduating cum laude from Southern Methodist University Dedman School of Law. During his time at SMU, Chris competed in numerous mock and moot competitions and placed nationally. Chris is a native Texan, growing up in the Houston area and completing his undergraduate studies at the University of Texas at Austin.

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