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Im being sued by a doctor that failed to file a claim for

I'm being sued by a...
I'm being sued by a doctor that failed to file a claim for services provided for my wife in Jan 2007. My wife informed them that we changed insurance and they failed to follow up. The insurance company called the doctor and filled the claim but said it will probably be denied. Does the doctor have a leg to stand on, and how do I format a response letter to a civil suit? My friend is an attorney and he says just write a short letter stating the doctor failed to unite all involved parties, do you agree?
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Answered in 4 minutes by:
11/1/2008
Law Educator, Esq.
Category: Legal
Satisfied Customers: 121,077
Experience: JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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The advice of your attorney is correct. The insurer is liable to cover the bill for you and if the doctor agreed to submit or accept your insurance, then the doctor's negligence in doing so should bar his claim under the theory of "estoppel" which means that even if someone is entitled to something, if they are negligent in their actions they cannot make a claim. You also have a responsibility to pursue the claim with the insurer, and 2007 is not really that far beyond the time for making the claim and most insurers have a 1 year time frame for you to make your insurance claim. If he agreed to file the claim and failed to do so, then you claim that his suit is barred by the doctrine of estoppel and the doctrine of laches (similar to estoppel but says if he sat on his right to make the claim to your prejudice then it is his fault and his claim is barred). Title your "letter" as a "Motion to Dismiss" and state the reason as estoppel and laches and failure to attach an indispensible party and state the doctor agreed to file the claim and neglected to do so to your prejudice and your insurer is liable to pay the claim.

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Customer reply replied 9 years ago
The one issue I see with that is he did file a claim but with the wrong insurance company, and when it was denied he did not try to submit it to our insurance. They are stating that we did not notify them, but when I call the representative did note that my wife informed them that we switched carriers. When my insurance company called them they told them that we never notified them. So it sounds like it will be their word against ours.
If you provided him with the proper insurance information, it is still his error. If you did not, that is his problem. However, you also have an appeal with your insurer if you can prove the claim was submitted on time, but due to an error on the part of the doctor it was submitted to the wrong company. BotXXXXX XXXXXne is the doctor is still at fault for not informing you the wrong company was notified.
Law Educator, Esq.
Category: Legal
Satisfied Customers: 121,077
Experience: JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
Verified
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