Consumer complaint received 2020-10-13
Company: LEXISNEXIS
State: TX
Product: Debt collection
Sub-product: Medical debt
Issue: Attempts to collect debt not owed
Sub-issue: Debt was paid

Complaint:
XXXX XXXX XXXX XXXX XXXX XXXX XXXX, # XXXX XXXX XXXX, Texas XXXX XXXX ( XXXX ) XXXX | ( XXXX ) XXXX XXXX XXXX XX/XX/XXXX To : Consumer Financial Protection Bureau XXXX XXXX  XXXX XXXX, IA XXXX XXXX ( XXXX  ) XXXX XXXX XXXX XXXX XXXX XXXX  XXXX XXXX, XXXX XXXX XXXX XXXX, NV XXXX XXXX XXXX XXXX XXXX. XXXX XXXX XXXX, Pennsylvania. XXXX XXXX  XXXX XXXX XXXX XXXX. XXXX XXXX XXXX, Ga XXXX XXXX  XXXX XXXX. XXXX XXXX XXXX, Texas. XXXX XXXX  Member Id. XXXX Re : XXXX Account Number : XXXX CFPB Complaint Case # : XXXX Details : Complainant Date-of-Birth : XXXX Complainant Social Security No. XXXX Complaint In Rebuttal to XX/XX/XXXX Response of XXXX XXXX XXXX BEFORE THE CONSUMER FINANCIAL PROTECTION BUREAU : I, XXXX XXXX XXXX, Complainant herein, and In Complaint and Rebuttal to the XX/XX/XXXX correspondence of the XXXX XXXX XXXX ( " XXXX '' ) represent as follows : 1. I am not indebted to XXXX 'S client, XXXX XXXX XXXX XXXX XXXX ( " XXXX '' ) to the sum of {$220.00} for services rendered on XX/XX/XXXX. 

2. While the documentation provided may establish an outstanding balance, they do not, however, establish the validity of the alleged debt itself as said documentation only provides dates of service of XX/XX/XXXX and not a description of the services nor my signature acknowledging the services. 

2.1 To this date, XXXX has failed to perform its lawful obligation to mitigate any potential losses by failing to submit a bill to Louisiana XXXX. 

2.2 Pursuant to Title 8, section 91.001 : The general rule in Texas is that damages that may have been avoided or mitigated are not recoverable, and an injured party must use reasonable efforts to avoid or mitigate its losses. The standard is that of ordinary care, and what an ordinary prudent person would have done under the same or similar circumstances. And, while an injured party has a duty to minimize its damages, this duty arises only if the damages can be avoided or mitigated with only slight expense and reasonable effort. 

2.3 XXXX  was advised that all it had to do was request the issuance of a Louisiana XXXX Identification Number, an act that could have been, and can be still, accomplished with minimum effort. La. XXXX No. XXXX 3. For the reasons that follow, XXXX actually owes me money due to insurance overpayments for services rendered on XX/XX/XXXX : 3.1 As of XX/XX/XXXX, Complainants primary health insurer was XXXX XXXX XXXX ( XXXX ), XXXX, XXXX, XXXX  XXXX. Member Id. XXXX. 

3.2 Moreover, I had secondary health insurance with XXXX XXXX XXXX  XXXX XXXX XXXX XXXX ( XXXX  ) Health Maintenance Organization.

3.3 Primary insurance is the insurance that pays its portion medical claims first. Secondary Health insurance is the insurance that pays the remainder of the medical claim. Medical claims are submitted first to the primary insurer and that plan pays out the maximum amount an insured is allowed. After the primary insurer pays, then and insured 's secondary health insurer helps to cover the rest, including co-insurance. 

3.4 At all times pertinent, XXXX was a participating provider within the both the XXXX and XXXX networks, meaning that XXXX, XXXX, and XXXX  negotiated by contract the amount of payments that XXXX would receive from XXXX and XXXX for services provided ( less plan discounts ) including XXXX. 

3.5 For the XXXX services provided on XX/XX/XXXX, XXXX submitted a claim to XXXX to the sum of {$5600.00}. As per its contract with XXXX, the maximum amount XXXX allows for an XXXX is {$220.00}, which it paid, leaving Complainant with a co-insurance balance of {$200.00}. 

3.6 XXXX  also submitted the {$5600.00} claim to XXXX. Less, plan discounts negotiated between them, XXXX paid XXXX the sum {$860.00}, which more than satisfies the debt of {$220.00} allegedly owed for services provided on XX/XX/XXXX. 

3.7 Less the {$220.00} XXXX claims it is owed in the instant scenario, it still owes me the sum of {$640.00}. 

4. Notwithstanding that XXXX owes me money in excess of {$220.00}, XXXX 's collection efforts may be in conflict with a payment arrangement I have with XXXX 5. Additionally, XXXX  is lawfully obligated to cease and desist collection efforts on behalf of XXXX as XXXX  is not lawfully licensed as a Collection Agency in the State of Texas as it has not posted the requisite surety bond as required pursuant to Title 5 of the Texas Finance Code, section 392.001, which provides : BOND REQUIREMENT. ( a ) A third-party debt collector or credit bureau may not engage in debt collection unless the third-party debt collector or credit bureau has obtained a surety bond issued by a surety company authorized to do business in this state as prescribed by this section. A copy of the bond must be filed with the secretary of state.

( b ) The bond must be in favor of : ( 1 ) any person who is damaged by a violation of this chapter ; and ( 2 ) this state for the benefit of any person who is damaged by a violation of this chapter.

( c ) The bond must be in the amount of {$10000.00}.

6. The foregoing considered ; I respectfully request : 6.1 Reinvestigation to determine the veracity of the information subject to this dispute. 15 U.S.C.
1681i ( a ) ( 1 ) ( A ).

6.2 SUSPENSION of collection activities with respect to the alleged debt, pending final disposition upon re-investigation. 15 U.S.C. 1692g ( b ).

6.3 SUSPENSION of collection activities with respect to the alleged debt, pending final disposition upon re-investigation. 15 U.S.C. 1692g ( b ), as XXXX  has not satisfied the requirements of Title 5 of the Texas Finance Code, section 392.001 to lawfully operate as a third-party debt collector in the State of Texas. 

6.4 Payment from XXXX on behalf of its principal, XXXX, to the sum of {$640.00} for unjust enrichment for overpayment of monies not due. 
Sincerely, __________________________ XXXX XXXX XXXX

Company response to consumer: Closed with explanation