Do I have to pay the dental bill that is much higher than estimate?

Thank you for your question. It is in Washington DC. The dentist is outside the network of my insurance. I usually pay in full, dental office submits the claim, then I get reimbursed from the insurance company. Can I ask the dentist to submit the claim first then I pay the reminding portion (patient's responsibility) later? This way, I may be able to involve the insurance company in negotiation.

2 Answers 2

The dentist wrote to me that he would remake the crown free of charge. After starting the remaking process, he said his time was free but material was not. He estimated the additional fee to be around $400. But the final fee was more than $1000.

An estimate is normally merely a guess, not a binding quotation of a price, so the fact that he estimated the price to be $400 and that it actually turned out to be $1000 is not itself improper.

If he told you that you were being charged for materials and not time, and then he charged you for both materials and time, the amount he charged for time should not be allowed because he agreed on a price for his time ($0) for this task and oral agreements are still valid.

If you were charged for both, your position legally would be stronger if you paid for the material portion of the invoice but not the labor portion, although as a practical matter, it makes sense not to pay anything until the dentists agrees to accept the amount that you will pay as payment in full.

You could complain that the amount is much more than estimated and ask for a discount as a matter of professional courtesy and good business practices, but you don't have a right to a discount merely because the price ended up being more than the dentist estimated that it would be.

Arguably, the dentist said he would remake the crown free of charge, the dentist made a promise (and arguably this was to satisfy an implied warranty obligation for his work). But, when he told you that he would be charging you for materials before the crown was put in and you went ahead and had it put in anyway, this probably constituted a valid agreement to modify the terms of the arrangement.

You gave the dentist nothing in exchange for his promise to remake the crown free of charge so that promise would probably not be enforceable, even though it was in writing, because it was not supported by consideration (unless the dentist had, in fact, warrantied his work and broken the warranty, in which case it should be free).

In Germany some estimates ("Kostenvoranschlag") certainly have some binding effect. It's less than an offer but cannot be exceeded by more than a certain margin. I'm not sure whether there is some magic word that needs to appear in the estimate (like, "estimate") or whether it's simply any price quoted by the professional.

It depends on why you are having the crown remade: who is responsible for the resulting color, or the dissatisfaction with the color? If the lab did not construct the crown as specified, that is the lab's ultimate responsibility, and the dentist would be responsible for going after the lab. If the dentist used his own Crown-o-Mat and the machine malfunctioned, the dentist would have to go after the machine manufacturer. That covers "blame a third party cases". If the dentist entered incorrect color information on the order / in the machine, that is his responsibility and ha would have to eat the cost of materials. If the dentist made a plainly incorrect judgment of tooth color (and did correctly transmit that data to the maker), he would also be responsible -- that is, the dentist might have been negligent in determining or transmitting information about the color.

If the problem is that you are not satisfied with the color, we would need to know what your role was in selecting the color. For example, were you given an opportunity to choose between colors A and B? Did you have a chance to "sign off", by saying "yes, that is okay"? If so, you have contributed to the problem (perhaps you had a change of heart after the fact), so you would be partially to completely responsible for the expense of a replacement. If the correct answer is C and the dentist negligently only gave you the choice A vs. B, the dentist would be responsible. The underlying principle is, figure out who is responsible (who was negligent, or willful). If you are both at fault, then responsibility and cost are (generally) shared proportional to the degree of fault.

If you refuse to pay, the dentist will presumably submit the case to a collection agency, unless he knows that he is in fact responsible and he had just hoped that you would volunteer to cover his materials cost. Ultimately the matter might end up in court, and the court would look at all of the facts and determine who is responsible. You could simply ask him what he thinks his legal responsibility is when he makes an error – that assumes that the error was his (or the lab's).

A further complication would be that since we don't know your jurisdiction, we don't know whether dentistry is a government-controlled business: if that is the case, it's a question of what the regulations say.