What can I do about doctor’s office taking me to court foroutstanding medical bills when I am still waiting on my insurer to pay?

UPDATED: Dec 14, 2010

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What can I do about doctor’s office taking me to court foroutstanding medical bills when I am still waiting on my insurer to pay?

I had surgery done 06/10. Received notice today 12/14/10 to appear in Court ina month for a $5000 bill. I have received several letters from my insurance company not to pay the bill because they are waiting on paperwork from the doctor’s office before they pay them.

Asked on December 14, 2010 under Bankruptcy Law, Illinois


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 12 years ago | Contributor

Your insurer is putting you in a bad spot. When you get medical treatment, you agree to pay the doctor. If the insurer does not pay for any reason, including a lack of paperwork, you are obligated to pay yourself and the doctor can sue you to force payment--if the insurer was wrong to not pay, you should later be able to get reimbursement and possibly other compensation from them, but you are still yourself obligated to pay. If the doctor does not cooperate with your insurer and provide the paperwork you need for insurance coverage, it's possible you may have a cause of action against the doctor--but if sued for  nonpayment the doctor, unless you defend yourself correctly, he may still win and get a judgment against you. Caught between a doctor and the insurer, you should retain an attorney to advise and represent you. If you don't want to get one immediatlely, try first letting the insurer know that if they don't resolve this with the doctor and you are sued, you will expect them to pay our attorney fees...and forward to the doctor the correspondence from the insurer about the doctor's failure to provide paperwork and let the doctor know that if have to go to court under this circumstance, you will file an ethical complaint against the doctor and consider a countersuit. Send your letters in some way you can prove delivery; be professional in tone; and offer to both parties to assist them in resolving the dispute. You want to give them pause, by letting them know they may incur liability; you want to motivate them to resovle this; and you want to establish a paper trial that you are doing your part. You may, though, if this moves forward, need to retain a lawyer, though.

IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although AttorneyPages.com has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

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