Hi,
I recently broke a back molar tooth while eating a salad which contained a rock. The Insurer is being difficult. She has requested the past 4 years of all dental medical and My GP patient records - which I believe is extreme - and I won't do this.
My dentist has sent her a report saying that because the tooth is broken in half now, it will require a crown. Unfortunately, the insurer is trying to deem this as pre-existing and are refusing to progress the claim.
I had had a root canal last year and a filling - however, the molar was fine and the root canal was also fine at the time I bit the rock.
The insurer is saying that because the tooth had "previous work" it could be "weakened" and as the "root canal treatment is invasive" they want to refuse the claim.
What are my rights under insurance law in relation to the "eggshell plaintiff doctrine"? Am I in my right to claim this, as the issue only presented itself after I bit the rock?
The claim for the repair to the tooth is $1900 and seeking legal advice is going to cost me half of that.
Any help in dealing with this insurer and my rights would be greatly appreciated ...
Many thanks,
I recently broke a back molar tooth while eating a salad which contained a rock. The Insurer is being difficult. She has requested the past 4 years of all dental medical and My GP patient records - which I believe is extreme - and I won't do this.
My dentist has sent her a report saying that because the tooth is broken in half now, it will require a crown. Unfortunately, the insurer is trying to deem this as pre-existing and are refusing to progress the claim.
I had had a root canal last year and a filling - however, the molar was fine and the root canal was also fine at the time I bit the rock.
The insurer is saying that because the tooth had "previous work" it could be "weakened" and as the "root canal treatment is invasive" they want to refuse the claim.
What are my rights under insurance law in relation to the "eggshell plaintiff doctrine"? Am I in my right to claim this, as the issue only presented itself after I bit the rock?
The claim for the repair to the tooth is $1900 and seeking legal advice is going to cost me half of that.
Any help in dealing with this insurer and my rights would be greatly appreciated ...
Many thanks,