Are US doctors allowed to charge insured clients more than uninsured clients? Is a U.S. doctor allowed to charge a client with insurance more than a client without insurance? I was told the cost for my visit was $40 if no insurance but $60 co-pay if I have insurance. I called my insurance but was told to ask a lawyer.
In the US, people are generally allowed to charge arbitrary amounts for services, as long as they do not violate various anti-discrimination laws in doing for. For example it would be illegal to charge people of one race less than they charge people of another race, because of federal and state anti-discrimination laws. Three primary factors govern the legality of a particular form of discrimination. One is the type of interaction, for example "voting rights", "public accommodation", "employment", "housing" – medical treatment would generally fall under "public accommodation". The second is jurisdiction – there can be federal, state, and municipal laws governing a particular kind of discrimination (the lower in the hierarchy you go, the stricter the laws tend to be). Finally there is the "protected class", that is, the basis for discrimination. Protected class is extremely variable, given the preceding two factors. Age discrimination is legal in ways that race discrimination is not. "Has insurance" is not a protected class anywhere, so this does not violate any discrimination laws (per se). There are numerous legal forms of discrimination which are analogous, for example to shop at Costco at all, you have to be a member; there are numerous businesses that offer "member discounts"; some doctors work on a "subscription" basis where they don't treat you unless you are a (paid) service subscriber. The idea that a service has to treat all comers identically is legally incorrect. Co-pay rates are dictated by insurance companies, and can vary depending on the specific insurance carrier that you have. To the extent that there are no specific laws saying otherwise, a service provider is legally entitled to charge less to a person who does not make a claims for coverage by medical insurance – or they could charge more. Indeed, the "without insurance" cost of medical services is typically higher, and the insurance company insists on doctors accepting lower compensation. A "practical" but somewhat risky solution is that if you know that the copay is higher than the street price, you can simply not reveal that you have insurance. However, sometimes an office visit results in a finding that some treatment is needed, and the street price for that treatment may be substantially higher than the insured price. At any rate, contractually-determined co-pays are legal. I should mention a remote possibility for applying anti-discrimination laws, owing to sec. 1557 of ACA. See this article on health care discrimination litigation, where the law enabled "private right of action for disparate impact claims opens the door to class-based claims challenging facially neutral health care policies, treatment decisions, and insurance coverage on the basis that they disproportionately affect members of protected classes". Under this regime, if a policy effectively discriminates on the basis of a protected class, without explicitly mentioning the class, the policy could still be found illegal. If there is a strong enough correlation between race and having health insurance, then "having health insurance" could be found to be a substitute for discrimination on prohibited grounds. There isn't enough case law on this issue, that we can clearly say that such an argument would or would not work.
You will almost certainly be sued For a small amount like this they would use junior lawyers and while the suit may take a while I’d be surprised if a lawyer spent a week all up on such a simple case. Say 40h at $200 = $8,000 which, when they win, you have to pay. Bargain.
Your personal liability depends on your state law regarding the family car doctrine, so the answer there is "maybe" (Texas is not a state with that doctrine, so simple ownership of the car does not confer liability). You would be liable if your supervision of the child was negligent, which means approximately that you knew or should have known that she was a bad driver and would cause damage. Still, the insurance company is suppose to indemnify you (plural) against such loses, as long as they are legally required to do so. That would include many considerations, such as whether the driver was covered under the policy, whether the car was being used contrary to the terms of the policy (being used commercially), and so on. The insurance company is entitled to make a reasonable determination of whether they are responsible for the loss (and if so, to what extent). If they actually decline to cover the loss, you would need to sue them to make them comply with the terms of the policy (and your lawyer would give you a detailed explanation of why they are not liable, in case they aren't). The plaintiff works with his insurance company to recover his insured losses, and with his lawyer to recover any uninsured losses. His insurance company works with your insurance company, up to a point, and then the lawyers get involved. Your daughter does not work with his insurance company, and your insurance company probably has said something along the line "only talk to us". The insurance that a driver typically has may cover some of their own medical costs, but does not provide a payment for "pain and suffering": that is an uninsured loss. It is not generally required that drivers carry insurance to cover their own medical expenses – it is required that they insure against damages, in general, suffered by other parties (if the defendant is at fault). So there is probably nothing for the plaintiff to work out with his insurance company. In Texas, if the defendant is entirely at fault, defendant will be liable for 100% of plaintiff's damages. If defendant is 90% at fault, defendant will be liable for 90% of plaintiff's damages. If defendant is 49% at fault, defendant is not liable. Defendant can, in any event, also sue for damages, so if defendant is 49% at fault, defendant can recover 49% of her damages. The insurance companies might be able to talk it out and reach a clear resolution of the matter, but it could be more in their interest to throw the dice and work it out in court. One can always sue at the very start, and drop the suit if it becomes advantageous.
Yes, there is a reasonableness limit, and this is especially true in consumer transactions. If you were given an estimate and the final bill is a lot more than what you were expecting, you can dispute it. The final price should be ‘reasonable’. The law doesn’t say what counts as reasonable, so you’ll have to agree it between you. You should consider: the estimate you agreed to [if there was one] any changes, and why they happened anything that happened that was beyond the control of the trader, like bad weather or the cost of materials going up https://www.citizensadvice.org.uk/consumer/getting-home-improvements-done/problem-with-home-improvements/ When it comes to work itself, the act states that a tradesman or professional has a 'duty of care' towards you and your property. Any standard or price you agree must be honoured. But if it isn't agreed in advance the work must be done to a reasonable standard, at a reasonable cost, and within a reasonable time. So if you haven't fixed a price, you don't have to pay a ridiculously high bill. All you have to pay is what you consider 'reasonable' and invite them to sue you for the rest. Be careful though, in some circumstances when you are withholding payment you may have a claim made against you by a supplier if you are in breach of contract. What's a reasonable amount would be what similar tradesmen would have charged for the job. So get a few quotations. https://www.bbc.co.uk/programmes/articles/1fdlwC9xzyxjCpWMlsCGG3j/supply-of-services NB that article refers to The Supply of Goods &amp; Services Act 1982, which was partially superseded by the Consumer Rights Act 2015.
Now I'm having another conversation with a lawyer and I'm not particularly happy (not to say outraged) that to answer a simple question they require £95 + VAT for 30 minutes Skype session. Maybe it is a common practice in law industry - in my industry (web development) we share our knowledge in an open-source manner. The rate you were charged is actually reasonable for such a limited engagement. Few lawyers are willing to even consider providing any advice on such a limited basis. Most would try to limit their clients to cases generating thousands of pounds in an in person visit. Lawyers are in the business of selling knowledge and time, not documents and results. An open-source approach would undermine their business model just as much as it would for the movie industry or the recording industry. While I appreciate professional legal advice (I know it is required) I have a belief that by obtaining some knowledge first I'll be in a position to ask better questions. This belief is not necessarily very well founded in this context. The reality of information about the law is that the raw data has limited usefulness. One of the main things that a legal education provides is an ability to "issue spot" so that you know what points need to be researched and where to look for them. Without the overall context that a legal education provides, knowing what issues you should be looking for is difficult or impossible, and this is particular true in Anglo-American common law systems, where the law is embedded in an opaque network of appellate cases rather than laid out more or less completely in a carefully organized statute. Also, you are almost completely unqualified to distinguish between a simple question and a hard one. Just as it is difficult for a non-expert to know what is difficult or impossible for a computer to do (e.g. turning raw image input in the models of reality is very hard for computers but easy for people, while intense calculations are simple for computers but hard for people), it is often very difficult for a non-lawyer to know what is an easy or hard legal question. For example, the rights of neighboring home owners when trees start to grow across property lines seem like simple questions but are actually extremely complex legally, as is another simple question such as explaining what a book means in IP terms as a book migrates to a new platform. But, some seemingly complex points (e.g. detailed questions of tax law or civil procedure) can have very simple and clear answers. Finally, keep in mind that in a situation like spousal alimony, if you've done as much research as you state, it is very likely that a definitive answer that you are looking for simply does not exist. There a lots of legal questions that do not have clear objective answers. This is because trial judges in family law matters have wide discretion in a lot of the fine points of alimony decisions, much of it exercised at the trial court level that does not generate binding legal precedents and is not widely available to researchers. Therefore, there is really no substitute in evaluating how judges will exercise that discretion for the collective experience of an attorney who has been through the process many, many times before the particular group of judges who are likely to handle your individual case. In sum, while I understand your frustration, a lot of it is rooted in common, but inaccurate assumptions about how the legal system works.
You're thinking of &quot;unconscionability.&quot; In the United States, the general rule is that a contract provision will not be deemed unenforceable for unconscionability unless it is both procedurally and substantively unfair. A provision is considered procedurally unfair if it results from some sort of unfair asymmetry in bargaining positions. This could include situations where a party was acting under duress, had a diminished mental capacity, or unequal experience in the . A provision may be considered substantively unfair if it imposes disproportinately unfavorable terms on one party, perhaps by imposing costs far out of line with market prices, or by allocating all risk to that party. If the agreement is not both procedurally and substantively unconscionable, it won't be voided. So the Google TOS may be procedurally unfair because Google's market position gives it disproportionate bargaining power, but because they don't really impose any serious costs on you, they aren't unconscionable. Similarly, a contract provision requiring you to give me your house if you ever forget to turn off the porch lights at night wouldn't be unconscionable if it was agreed to after lengthy negotiations between our lawyers.
As a lawsuit, it doesn't make sense in U.S. law unless you have suffered significant injuries. Your damages are likely to be, at most, nominal ($1) if you discovered it before you were hurt, so you'd only lose the money spent replacing the jar of peanut butter with a non-defective one and the nominal $1 damages. You would not generally have a right to any of your attorneys' fees and personal time spent on a lawsuit like that which would likely cost tens or hundreds of thousands of dollars on an hourly basis (no attorney would take a case like that on a contingency basis), and would take hundreds of hours of your own personal time.
If he is still pressuring you for the money even after filing insurance, talk to your city or county prosecutor's office. If you call the police, they may say they're too busy to deal with it and that it's a "he said-she said" situation anyway. But if you go to the local prosecutor, they should be more interested, as this could be a felony, considering the amount of money demanded, and they can instruct the police to help investigate.