Criminal Law Questions? Ask a Criminal Lawyer.
Hello! I am a licensed attorney, admitted to practice in state and federal court. I have a nearly 100% satisfaction rating so all that means is that you can count on me to help today. I am very sorry to hear about your situation. This appears to be a violation of the implied covenant (promise) of good faith and fair dealing. Under the Uniform Commercial Code Section 1-304, every contract comes with implied promises from both parties that they are going to be acting fairly toward one another. The failure of one party to act fairly toward the other can result in a breach of contract. Specifically, insurance carriers are required to approve or deny claims in good faith. In your case, a lawyer should argue that it is entirely reasonable that you would take your child to the doctor with whom you worked, particularly if this was within the field of expertise of your employer. Just because the doctor did not dictate the exam does not mean it did not happen. Thus, it is not a reason to deny your claim. You may want to file a lawsuit against your insurance company and then compel your former employer to tell the truth under oath. To facilitate your situation, there’s a site that I’ve used in the past where you can find a good template for advising of a breach of contract (click here). It's a bit easier (and cheaper) than going through litigation and I have seen it be effective in the past. If you send this letter and they do not respond, then you may want to consider bringing a lawsuit after that because it will be clear they will not be willing to settle the issue.
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I understand your concern. Usually, an attorney will be able to work on contingency for matters like this. So, if you get paid a settlement for the claim, they may take 33%. however, it's not necessary to have one.
One of the hardest things to do sometimes is find a lawyer that you can trust. Google searches are a good place to start, but usually the lawyers who pay the most can get bumped up to be on the first page regardless of their quality. One thing I recommend is going through your state’s lawyer referral service (LRS). The LRS in each state typically requires the attorney to have several years of practice, be free of discipline, and have adequate staffing to assist people. Here is the link for the Maryland LRS click here.
Good question. Frankly, most of them are handled informally outside of court. However, you could bring a lawsuit in small claims (generally under $5,000) or in superior court (over $5,000). 99% of the time, cases like these are never filed. 99.9% of the time, if you file a lawsuit, you will end up settling the matter.
I can't imagine why they would do this. I'm very sorry. However, I think that you'll be in good shape:-)