Legal Question in Medical Malpractice in California

DENTIST INSURANCE FRAUD?

Last year I went to a local dentist. My issues are as follows:

1) They billed my insurance company for between $500 and $1,000 for work that was never done, and the insurance company paid. I brought this to their attention, but to date it has not been resolved.

2) They told me when I had some teeth removed that I would have a "partial" put in. After removing the teeth, they then said this was not possible.

3) Much of the work they did do is now having to be re-done by another dentist....bonding on front tooth has broken off for the second time, they fixed it the first time, etc.

When I went to this dentist I signed a form stating by using their "in-house" dental plan, I would agree to "arbitration" should the need arise, however, since they have billed my own insurance (not their "plan") for things that never happened, what legal recourse, if any, do I have?

Thanks.


Asked on 4/21/00, 4:59 pm

1 Answer from Attorneys
Jeffrey Zinder Zinder & Koch

Re: DENTIST INSURANCE FRAUD?

Just as in Medical malpractice against a medical doctor the determination of your claim will require a dentist to review the records and be willing to give an opinion as to negligence. The "billing" issue may be fraud but also requires extensive review. Please note that any claim whether in arbitration or in a civil trial must be formally presented by either a demand letter or lawsuit within one year of the date that you became aware of the potential malpractice. If you are in the Greater Los Angeles area and would like further information I provide a free 1/2 hour in person consultation on these type of cases. You may reach me at 818-760-0100.

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Answered on 5/22/00, 8:58 am


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