Fontana, CA asked in Insurance Bad Faith and Personal Injury for California

Q: Can I sue my dentist for billing my cheap insurance instead of my primary insurance that would have covered the service

I had to pay out of pocket when my Denti Cal would have covered it. I found out they never even billed Denti Cal to cover it after saying they did but I was told I was denied. I paid a lot out of pocket that should have been covered

1 Lawyer Answer
James L. Arrasmith
PREMIUM
James L. Arrasmith pro label Lawyers, want to be a Justia Connect Pro too? Learn more ›
Answered
  • Insurance Claims Lawyer
  • Sacramento, CA
  • Licensed in California

A: If your dentist billed your cheaper insurance instead of your primary insurance, and you had to pay out of pocket as a result, you may have grounds to sue the dentist for malpractice or negligence. If the dentist was aware of your primary insurance and failed to bill it, or if the dentist misled you about the coverage, this could be considered a breach of the dentist's duty of care and could be grounds for a lawsuit.

To succeed in a malpractice or negligence claim, you would need to demonstrate that the dentist's actions fell below the standard of care that a reasonable dentist would provide, and that this breach caused you harm. This could include the financial harm you suffered as a result of having to pay out of pocket.

It's important to consult with an attorney who specializes in dental malpractice to review the details of your case and determine whether you have a viable claim. Keep in mind that there may be a statute of limitations on malpractice claims, which means that you may have a limited amount of time to file a lawsuit.

Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.

The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.

Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.