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    Wednesday, March 27, 2019

    CA - Salvaged Title Vehicle rear ended and declared a total loss. I'm lost in the sauce here Insurance

    CA - Salvaged Title Vehicle rear ended and declared a total loss. I'm lost in the sauce here Insurance


    CA - Salvaged Title Vehicle rear ended and declared a total loss. I'm lost in the sauce here

    Posted: 26 Mar 2019 11:56 PM PDT

    California, 2013 Honda Fit, 30K miles, Salvaged Title

    My insurance: USAA, deductible $500

    At fault's insurance: State Farm

    I've read a bunch of posts in an attempt to do some research before creating this post. My head is spinning here with all of the insurance lingo. I'm lost in the sauce

    My wife was rear ended a month ago in Feb, not at fault. Car is completely drive-able (trunk lid is bent in), no weird noises when we're driving. The other party admitted fault, we decided to file a claim with the at fault's insurance company thinking it would be much easier. We took the vehicle to a repair shop recommended by State Farm. Car was dropped off, wife got a rental, and it's been a ball ache to get details about what's going on.

    Here are the facts:

    *Repair shop took their sweet time in uploading the car inspection details for review by State Farm.

    *State farm was told by the repair shop that the car was fixed, unlikely to be a total loss.

    *Fast forward 1 week, State Farm changes their story and now says car is most likely going to be a total loss and the car is not fixed.

    * No offer has been made yet for the ACV minus scrap value, ect.

    * Vehicle is still at the repair shop (1 month and counting)

    * Wife is still driving rental vehicle (paid for by at fault's insurance)

    End state: Wife wants to have the car fixed. What are our best options?

    Negotiate the payout to keep the car and find a cheaper repair facility?

    Can we take the insurance payout from State Farm and file a claim with my insurance company, USAA, paying the $500 deductible and pocketing the rest of the State Farm Payout? (is this even possible?)

    Just say screw it, file the claim with my insurance company, USAA, and let USAA go after State Farm to reimburse me for the deductable and get the car fixed?

    Thank you in advance!

    submitted by /u/nin10dough
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    Same Med, Different Strengths, Insurance Covering One However Not The Other

    Posted: 27 Mar 2019 01:52 AM PDT

    TIA

    I've been using Retin-A as a spot treatment for my acne for the last six years. The last time I filled it, I had MassHealth, since I was 17 and homeless. It takes me a while to use up a whole tube (My acne is mostly stress-related, and I use Retin-A as a last resort) so this is the first time I've had to fill it under my new plan. I generally use two different strengths - 0.025% on my face, neck, and chest, and .1% on my back, arms, thighs, and calves (thicker skin + longer use in that area)

    My insurance is covering the 0.025% tube with a copay of $50, however it won't cover the .1% tube, leaving the price at $185. Can anyone tell me why?

    submitted by /u/FallOnTheStars
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    Switching careers from claims to underwriting

    Posted: 26 Mar 2019 12:32 PM PDT

    As the title says, I'm eyeing a position that opened up in my company for a underwriter trainee position for business insurance. I'm leaving claims because I have a tendency to take my work home with me and I just get pretty stressed out from all the work that piles up the next day. Would a transition into underwriting be something worth doing or, are people prone to thinking about work while at home in this career as well?

    Thanks

    submitted by /u/joetjen
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    (CA) At fault drivers insurer delaying reimbursement costs.

    Posted: 27 Mar 2019 03:12 AM PDT

    I was in an accident 6 months ago in which I was rear ended and my car was totaled. Due to the severity of the hit, 3 other cars were involved as well and we were deemed not at fault. My insurance company immediately covered the costs but said I was not eligible for rental car reimbursement and would have to claim it from the at fault drivers insurance company.

    As soon as I rented the vehicle (just for 2 days) I sent the receipt to the at fault insurance. I'm not exactly sure how long these things usually take but I feel as though I am purposely being stalled and delayed. As I said before, it's been 6 months and every time I contact them, I sometimes get a response and sometimes don't. The agent tries to sidetrack me when I bring it up and is claiming that he cannot pay me until every driver in the accident has sent him their bills.

    I've tried asking my insurance company for help and they claim to have reached out but I still have heard nothing from them or the other insurer. Is there anything I can do or am I just going to have to wait? It just feels like an unreasonable amount of time to settle a claim. Also, due to financial constraints at the time, I had paid for the rental with a credit card and have been accruing interest as I have not been able to fully pay it off. Is this something I can claim as well?

    Sorry for the long post and thanks in advance.

    submitted by /u/kdee1377
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    Looking for advice: hospital (ICU) discharge against medical advice to transfer to another hospital’s emergency room

    Posted: 27 Mar 2019 02:45 AM PDT

    Family is frustrated with the quality of care my brother is receiving at "hospital A". Long story short he has stage IV cancer with lots of other medical problems. It's getting no where and they're basically writing him off. We have requested multiple time to transfer him to a nearby "hospital B" with better reputation and specialists. They resisted despite our family and brother's wishes.

    Unless we transfer him to "hospital B", we feel he will have very low fighting chance. What are our options??

    We are seriously considering discharge him ourself "against medical advice", put him on an ambulance to get him to the emergency room at "hospital B". I know by law they will have to take him in the emergency room.

    Is this even possible and what are the insurance ramifications? Right now we're just want to save his life!

    submitted by /u/imagin8zn
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    I have to pay over $3,000 because the insurance doesn't cover TMJ problems. What should I do to appeal my claims?

    Posted: 26 Mar 2019 05:23 PM PDT

    I've had TMJ since the beginning of the year. One day my jaw pain got so bad that I couldn't even talk, so I paid a visit to my PCP, who referred me to a pain doctor, who ordered me an MRI and physical therapy.

    For the past two years that I've had this insurance, I only need to pay a small portion of the fee even before the deductible because of my health plan discount. LITTLE DID I KNOW, I have to pay FULL AMOUNT for all of my doctor's visit including the MRI. It's over $3,000 in total.

    When I called the insurance, they told me my plan does not cover TMJ, and they said ONLY they know that TMJ is an exception under my plan. It is not written in ANYWHERE on the benefits which are listed on the website. Basically, the only possible way for me to avoid this payment in the first place is to call them before I visited the doctor, but how could anyone possibly know that something is not covered if they didn't even bother to write it down on the explanation of benefits?

    I am planning to appeal this claim, but I have no idea what to do. What should I write? Is there anything I can do to win this case?

    submitted by /u/awgong
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    Do I really need workers compensation for a bunch of sitting employees in a chill environment?

    Posted: 26 Mar 2019 11:10 AM PDT

    My wife owns a business where we offer tutoring to kids. We pay college tutors hourly rates, part time. There is 0 to little risk of someone getting hurt. Do I really need to pay 43 dollars extra every month for that? Is the Farmers agent just trying to make an extra buck of comission?

    Thanks!

    submitted by /u/slumdogbillionaire
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    Alternatives (short-term) to health insurance

    Posted: 26 Mar 2019 06:40 PM PDT

    I am currently out of work, and my health insurance was terminated when I stopped being an employee (of course). I'm still within the 60 day opening to look at the Marketplace, but only just. I have received a job offer and will be returning to work in a month's time, with that company's health benefits kicking in after 10 weeks.

    Currently, my spouse and I's income is reduced, due to me not working a regular 9-5, and we really don't want to throw ~$350 a month at insurance for a short period before I qualify for the my future employer's plan. I am in my early 30's, healthy and take no medications besides birth control (which is easily affordable out-of-pocket).

    As the federal penalties for not having coverage go away this year, that's not a concern either. It's very unlikely I'll have a major health event in the next couple months, but accidents are a bit more of a concern, as if course, you can only prepare for an accident but so much.

    Would taking out accident insurance be worth it, in place of a health plan? Would disability or life insurance make more sense - again, in place of (for a couple months, anyway) a health plan? (I already looked in to short-term health insurance and those policies don't appear to be worth the paper they're printed on.)

    Many thanks for your help!

    (Also posted on r/personalfinance)

    submitted by /u/DietChickenBars
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    Should I pay for car insurance for a car that will essentially sit in my driveway for 5 months while I'm away?

    Posted: 26 Mar 2019 08:44 AM PDT

    Had ICL (eye) surgery a few months ago and was looking at buying travel insurance? Recommendations

    Posted: 26 Mar 2019 09:33 PM PDT

    I am heading to Florida for 7 days but recently had ICL eye surgery back in January. Was looking at buying travel insurance. I am taking eye drops for pressure, would that count as a pre existing under insurance? The condition is called Ocular hypertension. Would I be covered still and what insurance would you recommend? I am in Canada as well if that helps. Would any insurance cover if I needed to get my eyes checked in the States for any reason?

    Thanks for your help

    submitted by /u/FriendsFan30
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    Do People Change / Considering Changing Fire Insurance after They Had Fire?

    Posted: 26 Mar 2019 09:10 PM PDT

    Just wondering what happens after people had fire .. what do they do with their existing insurance? Do they often change it (if they found them to be unsatistactory)? Do insurance people actually target owners of fire damaged property owners in their marketing?

    submitted by /u/taewoo
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    Should I call my insurance company if someone wants to settle it without insurance?

    Posted: 26 Mar 2019 11:43 AM PDT

    Minnesotan here. About two weeks ago I was involved in an accident in Minneapolis. I was backing out of a driveway and could not see the road well because there were cars parked very closely on both sides of the driveway. As I was backing out someone shot by me and my bumper scraped their door. They probably couldn't see me either and I think they were speeding.

    At the time the damage didn't look too bad. My car just had a small scratch on the bumper that I am not worried about. Their back passenger door is scratched and dented. We agreed to work it out without insurance as I thought it would be a cheap fix.

    A week later she sends me a quote for $3,400 with some problems listed that I know our accident did not cause. The pictures that I took would verify that. I told her that I would have to go through insurance and she told me that she would settle for a $500 check.

    I would much rather just give her $500 than risk my insurance company finding me at fault. My concern is that this is some sort of scam. I don't want to give her $500 and end up getting hit with a claim after. I am still on my parents' insurance and my dad told me I should call the insurance company and see what they think.

    What should I do? Should I call my insurance company for advice? Should I just send her the money? Do I need some type of legal documentation if we have both agreed to settle without insurance?

    submitted by /u/Admiral_Firebeard
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    [IL] Doctor's office falsely claimed they were in-network, but they aren't and want to charge me full price

    Posted: 26 Mar 2019 05:12 AM PDT

    Pretty much as the title suggests, this is in Illinois. I called a doctor's office to make sure they were in-network with Aetna and they said they were. I get my notice from Aetna saying they aren't and I owe the doctor the full list price for services. I emailed the doctor's office a full explanation including the belief that they at least owe me a discounted price of in-network pricing but haven't heard back in a week.

    submitted by /u/speak2easy
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    Got new orthopedic braces. The shop billed my primary but not my secondary. Have had multiple conference calls I'm still out my deductible and coinsurance

    Posted: 26 Mar 2019 07:33 PM PDT

    I got new orthopedic braces June 2017 when I had insurance through work (Cigna) and Medicare Advantage plan (Florida Blue Cross) as a backup as a former Disability recipient, I could pay for medicare out of pocket.

    The provider who built the braces (Hanger Orthotics) copied both insurance cards and only billed my Cigna Insurance. So I paid a $500 deductable and 20% co-insurance. My medicare plan covers durable medical equipment 100% so they should have picked up the deductible and co-insurance, but were never billed.

    I've had multiple conference calls with Hanger and Blue Cross- something gets lost in translation. Hanger claims to have sent BCBS the paperwork 7 times in total, to several different addresses provided by BCBS.

    The $685 I spent would be very useful for other things. How do I go about getting reimbursed for this screw up?

    submitted by /u/nobodytrickedme
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    Can my Fiancee be added on my health insurance?

    Posted: 26 Mar 2019 07:01 PM PDT

    Hi Reddit,

    My fiancee is losing coverage from her mom's health insurance and will be uninsured soon. We currently live together and plan on getting married in March of 2020.

    Can she be added to my current health insurance though work or would she need her own policy? At work I have the option to sign up for a family plan. Also would this be a qualifying event to change coverage and would this differ from company to company or is it a law?

    I would like to get some insight before going to HR to ask questions.

    Thank you for your help.

    submitted by /u/Fernweh5717
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    P&C license vs broker

    Posted: 26 Mar 2019 05:24 PM PDT

    Hey all I'm pretty new to the sub but I feel like this is the best way of getting an answer. So I currently have a P&C license in PA but I was wondering if getting a broker's license would provide me any advantages. I pretty much only deal with personal lines brokering but I know other types of positions on job postings mention having a broker's license. For some background I work at an exclusive agency so all of our appointments are sub-direct (ie not an independent agency, but not captive). Thanks in advance!

    submitted by /u/am19208
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    Drunk driver drove to my house,total my cars and garage, Their Insurance Can't get Ahold of Them

    Posted: 26 Mar 2019 05:16 PM PDT

    Drunk neighbor, who is 2 block away from my house. He drove all the way to the garage and total all 3 of my cars. Police show up make report and handcuff him. I only have liability so my insurance wont cover damage of my car and my garage. I contact the drunk driver insurance, file a claim on the same day. 2 weeks past and the adjuster said he cant contact him to get statement, so he cant make decision. I have to pay from my pocket for car rental so i can go to work. anyone know whats the chance that his insurance will deny the claim ? and whats the option do i have ?

    submitted by /u/renovatio617
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    Health Insurance for baby

    Posted: 26 Mar 2019 04:37 PM PDT

    I'm in Washington state. Wife and I are expecting in July. Basically want to know if I have any options other than what I am aware of. I have insurance through work and it would be over $300/month to add the baby to my coverage. My wife is still on her parents plan since her coverage offered through work is expensive and doesn't cover much of anything. From what I understand, since we are married we make to much to qualify for Apple Care. We make around $75k combined. The qualifications for state assistance are just crazy. If we weren't married it would only be based off of one income. If I have to put him on my coverage that would take up pretty much all of our extra income along with all the other baby stuff (diapers, clothes, formula). Do I have any other options here? WAhealthplanfinder has not been helpful at all.

    submitted by /u/ThurmanMerman19
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    CA, US: 3 points on record in last 12 months. Parents dropping me from insurance. Need advice on getting new insurance.

    Posted: 26 Mar 2019 03:36 PM PDT

    First time posting here.

    Background:

    I'm 23 years old, a graduate student, and working part-time as an engineer (just background info, as I don't know how these posts work).

    Up until yesterday, I had 2 points on my record. Both of these points were for not stopping completely at a red light on a right turn. Both incidents happened at the same intersection, taken by the same red light camera, and occurred in the same week. I had just moved area and did not know how strict the right turn policy was (my fault I know, but I'm used to slowing down but not completely stopping at an empty intersection). I didn't even I was getting tickets until both of them came in at the same time about a month later. These incidents happened in October 2018. I failed to do traffic school when I had the chance to (I paid and everything, but school and work were stressful and it slipped, my fault).

    This morning I got my third point. I got a ticket for going 65 miles per hour on a 50 mile per hour highway. This is normal for traffic on most days, but it had just showered, and there were plenty of CHP officers. I should've been more careful. The officer was nice and wrote me up for driving 60 instead of 65.

    I am currently on my parents' insurance. I called my dad and let him know that I got a ticket. This would increase our insurance and he and I decided it that it was best for me to be removed from the insurance, as to not be a liability to the rest of my family.

    Question:

    I need advice on choosing car insurance for my situation. To summarize, I have 3 points on my record (2 from same red light camera on a right turn at the same intersection on the same week, and 1 for driving 10 mph over the speed limit). I work part-time as an engineer but as of now all that money and my savings is going into paying for school and rent with a little set aside for food and gas, i.e. I don't have a lot of money. What are my options for car insurance?

    TL;DR: I'm 23. Made several stupid mistakes, ended up with 3 points on my record. Dropped from parents' insurance, and looking for new car insurance. Help?

    submitted by /u/BananaSloots
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    Tricky situation

    Posted: 26 Mar 2019 03:34 PM PDT

    My brother (18) got into a car accident yesterday. Driver failed to stop at a four way stop sign so our front bumper got damaged. Now the first mistake he made was not calling me immediately as I would have been able to avoid the mess. Apparently the at fault lady apologized to him and admitted that was her fault on the scene. However when they called the cops (Fort Worth, TX), they said they wouldn't come because there was no injury 1) mistake #2 , he had the other driver call the cops. So there's no way for sure to know if they said that 2) mistake #3, he failed to take the lady license, but he took the husband who arrived later on the scene So now we're trying to get the car fixed, we called Nationwide (the other driver insurance) to submit the claim only to tell us their client told them she wasn't at fault, so they deny liability. We haven't been able to get a hold of our own insurance adjuster for our claim either. Not sure how to proceed.

    submitted by /u/lepetitprince16
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    Medical Insurance Paid Medical Company But Company Says No Payment Was Received

    Posted: 26 Mar 2019 03:16 PM PDT

    TL;DR: United Healthcare is saying they sent a claim adjustment payment to an ambulance billing company on 3/2/2019. The ambulance billing company is saying they haven't received a payment and I'm still responsible for the entire billed amount. Late fees are accruing.

    In mid-October 2018, I rode in an ambulance and was charged accordingly. I added my insurance information (United Healthcare) to the bill sent to me from the ambulance billing company.

    United Healthcare billed in-network, the ambulance company did not recognize UHC as in-network and adjust my payment with a 'plan discount;' as a result, the amount I paid did not change from the original bill.

    I called UHC and they said they would adjust and bill out-of-network accordingly. According to my UHC claim summary, they paid the ambulance billing company an additional amount on 3/2/2019 and my UHC "amount I may owe" was updated.

    I called the ambulance billing company and they have not updated the bill with that UHC payment. I called them today 3/26/2019 and they said they have not received it. They want me to send my EOB by mail to verify the payment.

    I called UHC and they said they sent the payment. I am trying to get them on the phone with myself, UHC, and the ambulance billing company. What do I do if UHC says they paid but the ambulance billing company says they haven't? I don't want to be responsible for the money UHC says they paid.

    EDIT: This has urgency because the insurance and medical company are moving at snail speed while late fees are accruing for this bill. Is there any way I can speed up this process so I don't have to pay to wait for them? I've been calling UHC and the ambulance company every other week for updates.

    submitted by /u/hammiecat
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    Looking for advice: at-fault auto insurance is trying to convince my friend into taking a total loss

    Posted: 26 Mar 2019 02:26 PM PDT

    I am posting this on behalf of my friend. His car was worth $5000 (based on KBB and private listings) before his parked car was hit by another car.

    He filed a claim for the at-fault driver's insurance company, but talks have been sporadic over the past few months. It doesn't help that the company has a very low repution in the US.

    The repairs by the designated body shop is estimated to be $3000 and the claims adjuster is treating it as a total loss with the ACV at $3500. No negotiation has been possible despite sending documentation and proof that the car is valued significantly higher than assessed.

    He has a few options:

    1. Take the total loss pay, give car to insurance

    2. Take partial total loss pay and keep the car

    3. Somehow take some pay to cover repairs

    4. Walk away, take no pay

    While the damage is significant, it is primarily cosmetic. He still wants to keep the car. So, #1 is not an option. Also, he does not want a title change or total loss to be on the vehicle history due to effects on resale value. I have a buddy who is able to repair the damage completely for a few hundred dollars, so getting full compensation would be awesome but not a must.

    What should he do to keep his car and avoid changes to the title or vehicle history?

    How can he maximize compensation without affecting title or vehicle history?

    submitted by /u/runintotheground
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    Do agents from the same insurance company work together in harmony and joy?

    Posted: 26 Mar 2019 02:01 PM PDT

    Background: https://www.reddit.com/r/Insurance/comments/b5iees/condo_remodeling_punctured_a_pipe_before_i/

    Hi all,

    There was water damage from my unit to the common area of my building (5 units). My HOA and I both are using AllState. I was wondering if I should except a smoother process because we're using the same insurance company or if the agents are working in a "free for all" mode?

    Since AllState as an entity will be the one paying anyways, it would make sense that they would coordinate internally and split the work/repairs between them.

    Thanks!

    submitted by /u/k6box
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    OAP vs HDHP OAP?

    Posted: 26 Mar 2019 07:53 AM PDT

    Hi Insurance,

    I'm quite new to the world of insurance but I have recently started my first job out of college and I have an employee sponsored health insurance. I currently have two plans which are OAP and HDHP OAP. The OAP is (deductible: 1500, out of pocket max: 3000, per pay period: $44.72, prescriptions: $10-170 depending on the tier, Emergency room services: $250 copay, Urgent care: $75 copay). On the other hand, the HDHP plan is (deductible: 3000, out of pocket max: 5000, per pay period: $1.94, prescription: 20% after deductible, Emergency room services: 20% after deductible, Urgent Care: $100 copay + 20% after deductible). I am a fairly healthy young individual (23 years old) and do not normally go to the doctor for much. However, I do plan on doing martial arts over the years (jiu jitsu). Which plan do you guys suggest? I know most people recommend the HDHP for healthy young people but I know plans differ from provider so I just wanted to see what your input was regarding my situation. Thank you.

    submitted by /u/DudeGuyBroPalBuddie
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    Hit a pothole in my truck, now insurance wants to total my truck.

    Posted: 26 Mar 2019 01:46 PM PDT

    Sunday I hit a pothole going about 65mph. About 20 minutes later, "smoke" started to come out of my A/C vents. I called my insurance to make a claim, they reviewed my case and want to total it. It's a 2000 Dodge Dakota and said since it's an old vehicle, they'd rather just total my truck rather than fix it. I haven't taken it to a mechanic at all yet. They want to give me $2,000 for it but I still owe $6,000. What is the best route to take with this?

    submitted by /u/_skoden
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