Legal Question in Consumer Law in New Jersey
dental work
where it says I will pay what insurance does not I croosed that out before signing. Then I was given an estimate after the in-network insurance came back my dentist said i owed almost twice the amount due to what insurance did not cover. Are dentist the same as other estimates and they can only charge so much more? What is my legal responsibility?
1 Answer from Attorneys
Re: dental work
The law is fairly straightforward on these issues. Since you modified the written contract and the dentist obviously didn't agree, a court would likely find that there was no contract to pay for more than what the insurance company would pay. The dentist can't recover against you on a contract theory.
However, that does not end the issue. Since you accepted the services of the dentist for which he obviously expected to be paid, you are obligated to pay the fair value of those services or at least for the cost that the practice incurred in rendering them. Which it is depends on the specifics of the case. The advantage to you is that the burden now shifts to the dentist to show that the bill is reasonable. If it is greatly in excess of the amount that the industry-standard insurer would pay, that might be a difficult burden.
Unless the amount is large, it is unlikely that it will come to trial. However, either way, you have a lot of room for a negotiated settlement.
See also: http://info.corbettlaw.net/lawguru.htm
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