Legal Question in Health Care Law in Tennessee

Insurance Fruad

I was sick over the weekend and went to a Dr office that is not my PCP. Because they were not my PCP they refused to see me saying that if they took my money it would be insurance fruad. I wanted to pay out of my pocket for the visit because I felt horrible and I knew that my Husband would be going back to work the next day and I have 2 kids to take care of. Every one I have spoken to says this is not true. Is it worth looking into farther and who would I contact?


Asked on 1/29/03, 1:56 pm

1 Answer from Attorneys

Anthony DeWitt Bartimus, Frickleton Robertson & Gorny, PC

Re: Insurance Fruad

Whether it would be insurance fraud is a question that depends on the language of your policy and the specifics of Tennessee law of which I am unfamiliar. I can tell you that I find their refusal to provide care for this reason unpersuasive. I would report this physician to the TN Medical Society as you had insurance, had a willingness to pay, and were refused care and treatment when you were in need thereof.

Although I doubt you have a serious claim for medical negligence, I would urge you to report the behavior of the clinic to the proper medical authorities.

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Answered on 1/29/03, 3:20 pm


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