Reimbursement for Child’s Health Insurance Premiums?

Texas child support orders often provide that the parent with visitation rights is ordered to provide a health insurance policy for the child.

However, what happens when the parent with visitation rights (NPC – non-possessory conservator) fails to obtain the health insurance policy when ordered to do so? If the possessory conservator (PC) then puts the child on the PC’s health insurance policy so that the child has health insurance, can the PC seek reimbursement of the child’s health insurance premium from the NCP? If the PC has a claim, how is this calculated?

In this example, the PC has a potential claim for reimbursement for premiums under Section 154.182 of the Texas Family Code. So, the Texas Family Code does allow the PC to seek reimbursement for the costs of insuring the child NPC failed to cover, if the NPC was ordered to obtain coverage and failed to do so.

Many times the parent stepping in to cover the child has an insurance plan that covers the entire family, regardless of how many children are covered by the policy. Does this have an effect on the PC’s potential claim? In this circumstance the PC may not have incurred any additional out of pocket expense to obtain the child’s health insurance coverage. Does the PC still have a claim for reimbursement in this situation?

In Bird v. O’Donnell, 03-04-00603, Austin 2006, the court of appeals ruled that the PC must show an increase in actual incurred cost due to adding the child to that insurance policy. The court held that there could be no reimbursement of the premiums in that case, because the premiums did not increase when the child was added to the policy. Because the premiums did not increase, there was no additional out of pocket expenses incurred by PC by adding the child to the policy.

Therefore, in these kinds of reimbursement cases under Bird v. O’Donnell, the PC has the additional burden to show that adding the child to the policy caused a specific increased out of pocket expense to the PC that was not present previously.

To speak with Diana Larson or Erik Larson about your case, call us at (713) 221-9088.

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