Legal Question in Legal Ethics in North Carolina

Re: Being sued by dentist

We need a lot more facts to answer this question. You should probably consult a lawyer to fully discuss this and provide him or her with all the facts, especially with an upcoming arbitration hearing. This inquiry raises a lot of complex questions, involving contracts, dentistry, arbitration, and insurance. We would need to know exactly what was said to you, and exactly what any written contracts and documents say. Assuming that the health care provider's agent said something to the effect of "we believe that your insurance will pay about $6,000 of the $8400 bill," and assuming that you relied on this statement (discussed infra), and assuming that there are no disclaimers in your written documents (e.g. stating that the health care provider makes no representation as to amounts paid by insurance), then you may have some claim, or defense, based on "negligent misrepresentation." The legalities, however, are quite murky here. (Another approach would be that the "contract" between you and the provider as that you would only be charged $2400 for you personally.) It is not clear what the provider's obligations are regarding insurance. (Unfortunately, as this claim involves "professional services," you probably cannot use the "unfair and deceptive" trade practice statutes.) You can attempt to make these arguments yourself, but I would advise you to retain a lawyer to assist you to research the legal issues and to explore the factual issues. Finally, it is not clear whether you "relied" on the estimate. If you would have had the procedure anyway, at the same price, then your case is weakened. As for your spouse, I do not see his exposure. (There is a doctrine called the "necessaries doctrine," which can result in a spouse's liability for the debt of their spouse, but I will not go into that here.)