Case Studies: Small Claims Trials Against Dentists

Oct 18, 2021

MLMIC Insurance Company has seen small claims suits filed against our insured dentists throughout the state. If you are being sued by a patient in small claims court, promptly call MLMIC Insurance Company. A determination will be made, based upon the allegations, whether to assign an attorney.

Resist the urge to handle the case yourself because it is in a small claims court. If nothing else, in many cases of negligence, when you are represented by legal counsel, a judge may grant professional courtesy and hear your case earlier than if you did not have an attorney. This may save you many hours away from the office, particularly when there is a crowded municipal court docket.

Below, read two case studies of small claims trials against dentists who were represented by MLMIC.

Case Study #1: Documentation for the Win

The patient in this case saw the MLMIC-insured dentist for implant restoration on teeth #29 and #30. Prior to her visit, she had had implants placed in Brazil, two at #29 and #30 and one at #19. The implant at #19 had failed prior to her visit with the dentist. The patient was interested in having the implants at #29 and #30 restored and provided the information on the implants necessary to order the parts. The dentist explained to the patient what her insurance would cover and then gave her an estimate of what she would be responsible for. She agreed, and the dentist ordered the parts for an impression. The patient returned for impressions and paid her full copay of $1,625. Prior to this appointment, the insured had sent a preauthorization for services, but the insurance carrier requested additional information.

The patient’s dental insurance carrier subsequently downgraded the approval from implant to partial denture when it learned that tooth #19 was missing. The patient was made aware of this and refused to pay the added cost associated with placement. She subsequently had new crowns placed in Brazil and demanded the return of her $1,625. As the insured already paid for the impression and lab parts, as well as the two crowns, the dentist offered a nominal refund, which was refused.

At the small claims trial, the dentist made an excellent witness. His attorney was able to produce office policy and consent forms signed by the patient that stated she was responsible for payment. It was demonstrated that the insured was paid only for the work performed and was not responsible for the failure of the patient’s insurance carrier to cover the remaining costs associated with the placement of crowns in Brazil. The judge reserved decision initially and dismissed the case the following day.

Case Study #2: The Need for Expert Testimony

The patient in this case sought treatment from a MLMIC-insured dentist for the replacement of crowns. Once these crowns were placed, the patient expressed dissatisfaction with their color, saying they were too dark. The dentist agreed to replace these crowns. After replacing the first round of crowns with a lighter shade, the patient gave the green light, and they were permanently cemented in.

Almost a year later, the patient returned to the dentist, again dissatisfied with the color of the crowns, and eventually brought a small claims suit requesting $5,000. The court informed her that she would need an expert and the patient stated that she would retain one for the trial. On the day of trial, the dentist and his attorney appeared and were told by the court that the plaintiff had submitted a letter withdrawing the case as she was unable to find an expert to testify.

These case studies were originally printed in our Third Quarter 2021 issue of The Scope: Dental Edition. Read more articles from the publication here, visit our blog for more articles and case studies and follow us on Twitter and LinkedIn for frequent updates.