Legal Question in Insurance Law in Georgia

My girlfriend and her sister were recently scheduled to have breast reduction surgeries. They both went to the same doctor, and are both on the same insurance plan. They both were told that they were responsible for 20% of the cost of the procedure, and the other 80% would be covered by insurance. So my girlfriend's sister gets her surgery, and pays the copay. Then a few weeks later she gets another bill from the anethesiologist and other hospital expenses saying she still owes $900. Now, since the bill is going to be more than twice what they were originally told it would be, my girlfriend had to cancel her surgery. My question is, is this legal? Is it legal for the insurance company to do this, or should the additional costs be covered as well? Did someone at the company make a mistake? Thanks for your time.


Asked on 6/15/10, 3:31 pm

1 Answer from Attorneys
Scott Riddle Law Office of Scott B. Riddle, LLC

No one here has the policies. Your friends should read their policies and call the insurer with questions. They should also consider that the doctor likely did not speak for the hospital and other providers. Obviously they are going to bill for their services.

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Answered on 6/15/10, 6:54 pm


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