Legal Question in Credit and Debt Law in Tennessee

healthcare provider failed to file claim by deadline

My husband was involved in a car accident that was not his fault. He was injured and received services from a chiropractor. The chiropractor agreed to file the insurance claim. He did communicate and update the insurance company on a regular basis, but he did not turn in the final claim/release report to the insurance on time. My husband was released from care in Dec 2006 at which time the doctor agreed to file that final claim. 30 days before the deadline of May 16, 2007 (one year from the date of the accident) we reminded the doctor to file the claim. His office said ''OK, we will do it.'' They didn't. We called again, one week before the deadline to remind them to file the last paperwork. Again, the office person said they would remind the doctor to fill out the paperwork. He didn't do it on time. The insurance company received the final claim/release/paperwork the day after it was due. They say they are not legally responsible. Now the irresponsible chiropractor expects us to pay his $4000 bill. Are we liable for this bill? What should we do? Shouldn't the doctor eat all or most of the bill since he failed to file the claim? Thank you


Asked on 7/13/07, 6:53 pm

1 Answer from Attorneys
KJW Firm PLC

Re: healthcare provider failed to file claim by deadline

First, I would follow up with the insurance company to try to get them to pay. Did they have notice that they were going to be asked to pay for this? Second, I would look at any papers that describe your relationship with your doctor. Does anything say that you are responsible for the filing of the claim? If anything says that he is responsible, then you may have a claim for breach of contract - you might also have one based on an oral agreement but that might be harder to prove. Since it is a large bill, I would talk to a lawyer in person. My office and others will usually provide a free consultation and give you an idea where to go from here. Thanks,

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Answered on 7/14/07, 11:59 am


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