Dental insurance company in Florida is accused of fraud, misrepresenting coverage
A Dental Insurance company in Fort Lauderdale, Florida, is being sued by a patient who alleges that the company lied to her about her coverage, according to a lawsuit filed Thursday by her family.
The plaintiff, who is a Florida resident, was initially diagnosed with a rare bone cancer in February 2017.
She was told that her coverage would cover the cost of her treatment, but when she sought her insurance company’s help to find a provider, the company said that it would not pay for her care, according the lawsuit.
In her complaint, the woman says that in August 2017, her insurer called her at home to inquire about her medical condition.
She did not have any prior medical conditions that could be considered a concern, the lawsuit says.
The lawsuit says that when the woman returned to the office that day, her dentist told her that her dental plan would cover only the cost for her treatment and not any out-of-pocket costs.
She also received a bill for the first $250 of her dental treatment, the complaint says.
It is alleged that the dentist misrepresented to the woman that her treatment would not be covered by her dental insurance and that the woman was charged a $2,500 premium for her initial treatment.
The dentist’s practice was contacted by the insurance company after the patient requested a copy of her claim form, which was later found to be falsified, according a statement from the Fort Lauderdale Dental Medical Association.
“This is a troubling example of negligence and/or misconduct that should be investigated thoroughly,” the statement said.
The insurance company has not responded to ABC News’ requests for comment.
The woman has filed a class action lawsuit against Dental Associates, Inc. in Broward County Circuit Court.
She says that she is entitled to reimbursement for the out- of-pocket cost for the initial treatment and that she was also denied coverage for any other treatment that would be covered.
She is seeking punitive damages and court costs for the insurance companies negligence.
