What recourse do I have when my doctor said my insurance would cover a surgery then after the surgery he said that the insurance changed their mind?

Prior to the surgery the doctor said all I need to do is cover the $40 co pay. After the process he billed me $1200 stating that my insurance has changed their mind and they would not cover the entire cost.

Asked on July 17, 2012 under Business Law, Texas


FreeAdvice Contributing Attorney / FreeAdvice Contributing Attorney

Answered 8 years ago | Contributor

If you relied on your doctor's representations to you that your surgery would only cost you $40 out of pocket but it turned out that that your health insurance carrier did not cover the costs of surgery, then under the concept of "detrimental reliance" you should only be responsible for paying the $40 under the law.

I would write the doctor a letter stating stating the above while keeping a copy for future need and use.

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