Legal pointers: Unpaid hospital bills and debt collectors

In a recent interview Chapala attorney Spencer McMullen offered advice on how area residents can plan avoid insurance and hospital payment problems by carefully planning for an eventual illness or hospitalization.

In last week’ edition of the Reporter McMullen related vital checkpoints so that residents can check their health insurance policies to be certain they are fully aware of the benefits available to them and of costs for which they may find they are responsible.

Additionally, he ticked off a list of four Mexican and Jalisco governmental agencies which may come into play when problems arise due to over-billing or false billing following hospitalization. For example, if the hospital bill reveals double billing for certain items, or outrageous costs for simple items – as in one case, the equivalent of 20 dollars for an aspirin – patients and their families should leave the hospital without paying the bill and immediately file a complaint against the hospital with Mexico’s Federal Consumer Protection Agency (Profeco, There is a time limit of nine business days for filing a complaint.

McMullen pointed out in the first part of this article it is against the law for the hospital to refuse to allow a patient to leave the hospital before the bill is paid in full. This possibility strikes fear in the hearts of the hospitalized and their loved ones, who believe the convincingly presented threats. “This solution is simple,” he said. “If the hospital says the patient (and his or her friends) can not leave the building, immediately call the police and report that are you are being held hostage, in a kidnapping attempt. Then pick up any belongings and walk out the door. It is absolutely against the law for them to hold a patient, or the remains of the deceased until payment is made.”

We’ve known three widows who have been intimidated and threatened by representatives of the hospitals in which their husbands died. In one case, the widow was awaiting for the insurance company to send the funds with which to pay the hospital. The medical procedures performed to attempt to save the second woman’s husband exceeded the cap amount paid by their health insurance plan. The third widow had no insurance and no ability to pay the bill, which was slightly over 10,000 dollars. She had no option but to either await the visit from the court officer, translator and the collectors and then hand over her ancient car, microwave, TV and computer, or move away before the time for collection ran out.

McMullen has had a great deal of “eyes on” experience with the end results of collection efforts as an official translator for the court system. “I get the problem,” he said. “The hospitals want to be paid, and they’ve had enough experience with expats who simply left the country to avoid paying to make them pretty hard core about going straight into the collection process.”

There are a few things that foreigners need to know about court-ordered collection. If you have a debt that you cannot pay, the hospital can go to court and get an order to collect the amount owed in cash or in real property, if necessary. According to McMullen, most hospital admissions forms have a pagare (promissory note) written into the small print. Most often the space for the amount of the interest on this demand note is not filled in until after it is signed by the patient or the person who is willing to take responsibility for the patient and the debt about to be incurred. 

“Later,” said McMullen, “patients discover that the interest is 10 percent per month … that’s 120 percent a year. And interest like that makes a debt nearly impossible to repay.”

Often representatives of the hospital appear at the house and try to intimidate the patient or family members. They look and act tough and tell the residents they need to give them the money or property immediately or they’ll be in even worse straits. These men, quite frankly, are old-fashioned strong-arm collectors. They are window dressing and often succeed in frightening expats into handing over whatever money, jewelry, electronics and cars are at hand.

“The problem is that these advanced collectors aren’t part of the legal collection process. It’s easy for expats to know when the collection is being done through the court and is legal and official. A group of people probably will come to the house for a court-ordered collection. There will be a  secretary or other officer of the court, an official court-appointed translator and one or more collection agents representing the hospital.”

McMullen continued: “Lakeside foreigners should always ask all visitors of this type to show proper identification before discussing the issue at hand.”

He went on to outline the procedure of the official collection visit to the home, adding that it would be wise for the debtor to have his attorney on hand to represent him and to witness the event in case the collectors are not totally above board. First the court official is required to inform the debtor as to the amount they owe. Then they ask if the debtor can pay that amount at that time. If the debtor says no, the court official then asks the debtor to name the pieces of property that he is willing to allow them to take to settle the bill.

“That’s the point where so many of the foreigners become their own worst enemy,” said McMullen. Invariably instead of calmly listing things they don’t care about – an old sofa, the second refrigerator, an extra pump, the bed stored in the bodega, the TV in the guest room, and the old computer monitor, the foreigners argue and try to defend their case and to convince the collectors that they don’t owe the bill.

McMullen explained that by the time the collectors arrive at the house, the time to defend payment of the bill is over. The court has determined that the debtor must settle the bill with the hospital. If the debtor is arguing instead of naming items, the court officer will report that the debtor was not cooperative. That allows the collection guys representing the hospital to start picking what they want. They know what will resell easily to raise the funds needed. They’ll start with the car and the flat screen TV.

Homeowners should check with their attorney when they know that a bill is going to collection. The simplest and easiest way to resolve the issue might be to either borrow money with the house as security or prepare to offer the collectors a lien on the house.

“Something most folks don’t realize is that the Jalisco State Code of Civil Procedures, Section 529, lists the types of things exempt from embargo. Included in the list of goods the collectors cannot take or hold are: personal property, such as clothing, shoes, any equipment, tools or other goods used to conduct your business, and a number of other items. It’s very important for people to know they have these options.”

As always, it would seem the way to avoid these bill-paying issues, like most other problems, is to draw out a solid strategy in advance. Don’t put off reviewing your health insurance papers. Be frank with your doctor about your financial situation as you discuss which hospitals he might suggest you use in a variety of future situations. Make your family north of the border aware of your situation and review in advance how you will handle emergencies and possibly the need for more money than is available to you at the moment.