Auto Insurance Claims: Partial Medical Bill Payment Liability, insurance check, chiropractic doctor


Question
Bills were submitted to insurance by the chiropractic doctor totaling about $4000 for medical care following the auto accident. Prior to that incident we had paid him cash for regular treatments in advance. These same treatments would have only cost us about $1500.

The insurance company also thought his rates a little high and submitted remittance to them in total about $3000.  Now he is pursuing us for the balance (about $1000.)  Do they have a legal right to pursue the patient for the balance?

Note: We have already paid for all treatments beyond the scope of dates submitted to and remitted by insurance. The question is specifically about pursing the patient when the insurance makes a short payment of a long charge.

In the case of general medical insurance (such as dental) the doctor has agreed to accept the amount insurance submits as remittance. If the chiropractic doctor cashes the insurance check showing partial payments for the period from xxx to yyy can they pursue the patient for the "unpaid balance?"  

Answer
Hi Ethan.  This places you in a tough spot.  Yes, the chiro can do this and they normally make you sign something in advance of the treatment that allows this.

However, the insurance company should be able to provide some protection to you.  Call the adjuster and explain the problem and ask what they will do to help you.  If you do not like thier answer, ask for the supervisor.  They may be correct that the charges are not reasonable, but they need to prove this to the chiro and defend their position in court if necessary.