Dr. Wants Me to Pay Four Years Later, but Gave No Bill

[SunnyWilds]

After a car accident, I went to a chiropractor for help. i gave my insurance card, but when he found out that the other driver hit me and that we were going to court, he said he would wait and collect from the wreck. Well two years later when we finally went to trial, he got nothing. Now he is trying to make me pay what he claims the insurance would have paid. He only charges $40 per visit to patients, but charges the insurance companies $250 per visit. That is what he is trying to make me pay. I have never received a bill, he has never discussed charges with me. I only found out in court, because he says my medical bills are $21,000; and he had my ins. card and never filed then. They won't pay now, because his time is up. 1) Is it ins. fraud to be charging everyone $40 and ins. co. $250? 2) It's been over four years since I had care. Isn't statue of limitations in NC 3 years for a debt like this. 3) We still have never received a bill with charges or anything. Only an email saying we need to settle this account and it $21,000. Do I have to pay? Thanks

[Mr. Knowitall]

Why did you choose not to put the claim through your insurance? Even if you were trying to avoid copayments, you would be better off that way than paying the entire bill out of an eventual judgment or settlement.

If you made the choice not to submit your claims to your insurance, your insurance doesn't have to accept the submission of stale claims.

As for what he can bill you, if he participates in your insurance plan he would presumably be limited to billing you the amount that your insurance plan would authorize - the amount they would pay him and whatever your copay would have been. The fact that you would have paid a $40 copay had you chosen to submit the claim to your insurance does not mean that he charges only $40 for the treatment - it means that the copay is $40.

If you have not received any treatment from the chiropractor for more than four years, you have a plausible case that his claim is expired. But the statute of limitations would only prevent him from successfully suing you - he can still bill you. And if you only recently lost your case he might argue in response to your assertion of a statute of limitations defense that you promised to repay him when your case was over such that the limitations period only started to run at that time.

As we don't know the full story, you should discuss this claim with the lawyer who represented you in the injury case.

[LarryPSmithLaw]

Technically, if someone provided you service, you would owed them for the expense. However, from what you posted, I would say that you don't necessarily owe what he is asking. You have every right to dispute the charges, and that he would charge a lesser amount to an insurance company certainly is relevant. The first question is whether it is too late for him. There is a "statute of limitations" that applies to each debt. That is, the creditor only has so long to file a lawsuit claiming they are legally owed something. When that time expires, there is not a lot they can do to collect.

The next issue then would be what you should pay. Unless a court of law says that a certain amount is owed, then the amount owed is not certain, and can be negotiated. After all this time, it is likely the chiropractor will accept a settlement on the bill. Finally, no matter what, no collector has the right to harass or abuse you just because you owe a bill. There are legal protections for you under the Fair Debt Collection Practices Act.