Health Insurance not paying bill they confirmed would be 100% covered without a copay. Not refusing to pay, just... Not paying. Insurance |
- Health Insurance not paying bill they confirmed would be 100% covered without a copay. Not refusing to pay, just... Not paying.
- s it better to use my insurance to repair my car even though my car is only $4000 and I have $2000 deductible?
- (Question) In general how many frames does insurance cover? Can I get more than one?
- Hail Claim on Multiple Vehicles
- Need advice: I got into a car accident and I think this women wants me to fix pre-existing issues
- How do insurance adjusters view MRI’s, X-Rays, etc?
- I dropped full cover my from financed car
- I am being scammed by a driver! [TX]
- Am i considered a secondary driver?
- Auto insurance being shady?
- Does PA state-mandated coverage apply if employer and insurer are based in PA, but I'm in DE?
- Medical Necessity
- I caused a minor scratch to another car. Should I provide my insurance info? They are asking for it, but it’s sooo minor!
- Thinking about Switching Auto Insurance
- Two questions as I go through home insurance adjuster issues- Hire public adjuster / find new company
- I got into a car accident and I’m not sure which option is better financially
- Marketplace denied coverage for maternal care, what next?
- Not my fault, but expired reg
- Recommended Recourse
- Real Estate Title Insurance and Revocable Living Trust
| Posted: 14 Jun 2019 04:59 PM PDT ***Posted in r/legaladvice and was encouraged to post my questions here, too. I am not sure what to do or who I could even escalate this to, but I am hoping I can get some advice on this issue with my health insurance. TL;DR -- Had surgery that was supposed to be covered at 100%. I keep getting bills for the surgery for over $6,000. Every time I talk to my insurance, they apologize and confirm that they absolutely are responsible for the bill and I'm correct that I should owe nothing. They then do/pay nothing and I keep getting bills. The bills I got today are "final notices" before they get sent to collections. Help. So, I got my tubes tied in January of this year. Before I scheduled the procedure, I called my health insurance (PreferredOne, through my job) and confirmed the policy stated online that sterilization procedures are covered at 100% with no copay, including any hospital/recovery/anesthesia fees. The woman I spoke with confirmed that yes, all of this was covered. So I scheduled the surgery, and after my pre-op appointment, my doctor faxed a pre-authorization letter in to the insurance company confirming the procedure and date it would take place. Obviously, the day of the surgery the surgery center made photocopies of my insurance information and ID. So, in a nutshell, since my surgery in January I have repeatedly gotten bills in the mail from the surgery center and the anesthesiologist separately. In total, I am being billed for over $6,000. Today I got a fourth round of bills, both marked that this is my final notice before the bills are sent to collections, which REALLY stresses me out. Basically, every time I call the insurance company (which I do multiple times, each time I have received a bill over the last few months), they confirm over the phone that I am 100% correct -- the surgery and surrounding care is covered at 100%, they do have my pre-authorization on file, all of my information like DOB, SSN, etc. are listed correctly. They confirm that there are no issues or discrepancies and it is absolutely clear-cut on their end that this bill should be fully covered. They then apologize profusely and say they will sort out payment to the surgery center and anesthesiologist right away. Then they do nothing, and a few weeks later I get another round of bills. I almost feel like I am being ghosted -- they confirm all of the above information, apologize, and then... Do nothing and don't pay or find any resolution for my bills. So my questions are:
I would really appreciate any and all advice... Thank you. [link] [comments]  |
| Posted: 15 Jun 2019 03:26 AM PDT Hello /r/insurance, I need your help because I don't have any friends or relatives in the US. Background: Last Monday I caused a collision which 2 cars involved and I am apparently the at-fault (I was making a left turn). Thankfully no one was injured. I have GEICO coverage that is 100k/300k/100k and $2000 deductible for both comprehensive and collision. It seems my claims adjuster is working for other driver's damage so I have to move on to my car's repair. My car is a 10-year-old compact car with 40000 miles which is about $4000 value in the market in my city. My car was had wheel damage and not drivable. It towed to my regular mechanic whom I trust right away and they estimate the repair would be $2000-$3000 (it can be more. I'd say $4000). Now my car is in my apartment parking so I have no fear of storage fee.
I haven't opted to use my insurance to repair my car yet. Because I am not sure about the impact on my insurance premium. I am the secondary policyholder and my husband is the primary (we are not living together currently). GEICO would declare a total-loss because my car is cheap. It is actually an unpopular shit car (I love it though). What is my best option? Let GEICO fix my car and pay the deductible? Or fix my car (or buy another) out from my pocket? Thank you for reading. [link] [comments]  |
| (Question) In general how many frames does insurance cover? Can I get more than one? Posted: 15 Jun 2019 02:25 AM PDT |
| Hail Claim on Multiple Vehicles Posted: 14 Jun 2019 11:53 PM PDT I live in Colorado and happened to be in a small area that suffered severe hail last weekend: well over 15 minutes, much of it between marble and golf ball size. Unfortunately we were doing a project in our garage, so all 3 vehicles were outside and hit by the storm. The vehicle I've been able to really evaluate has extensive paint damage. I suspect vehicle #2 will be similar. We'll likely ignore vehicle #3, unless there's literally no reason not to include its damage on the claim. If we file a claim for multiple vehicles damaged in one storm, would those typically be considered one claim, or multiple claims? I'm thinking about deductibles, and how many claims would go on our record. I realize comprehensive claims generally do not directly increase premiums, but we also had one at fault claim last year, so I want to be cautious, and give some thought to the trade-off on reporting the damage to each vehicle. I'd rather live with the damage than risk being dropped and have a bad clue report following us. [link] [comments]  |
| Need advice: I got into a car accident and I think this women wants me to fix pre-existing issues Posted: 14 Jun 2019 07:51 AM PDT I accidentally backed into a car in a waiting area for workers (while picking up my brother). A car was behind me and just left, and I saw my brother and decided to back out of my parking, and go to him. Suddenly, another car appeared that I backed into... I have a 2010 kio Rio, a small car for a young driver(myself) and the woman that I backed into had a 2004 Pontiac. The woman was out of her car screaming "F**CK" then smiles at me saying "I'll need your insurance". This was the first "collision" I have been in, and I had such a sigh of relief when I see the car and my own didn't have a scratch. The woman's mother comes out and she says it's fine, and the driver responds "My bumper is FALLING OFF". I didn't want to incite rage so I just shook my head, stayed silent and we exchanged insurance. The security of the parking lot takes photos and is laughing saying thank god there is no scratches or anything. The woman goes off again and everyone is silent... she insists she is going to the police so I just say keep me updated and left. I didn't hear anything from her for two days. She texts me this morning and says "I have a few estimates for repair but get underneath checked on Monday and let you know what you want to do" .... WTF I am confused as to how the heck she could have estimates if she hasn't gotten the underneath verified and I haven't even gone to my insurance pr heard anything. Also, they car looks completellllly fine. I didn't think of it until later that this woman likely has pre-existing damage that she may be wanting for me to get fixed. I cannot think of what damages underneath could be existing. I haven't spoken to my insurance at all or even heard from the police. I asked her to contact me the case number after she filed but have only received the above text. How do I move forward? I am willing to pay for the bumper fix but I don't think there would be anything other than maybe it fell out of it's brackets (I highly doubt the brackets would have broken as it looked the same when we left/when she drove off). I am a second driver on the insurance as I keep the car at my parents throughout the school year and will be moving out in two months... willing to just let her go through insurance and then just take myself off the insurance when I move out. [link] [comments]  |
| How do insurance adjusters view MRI’s, X-Rays, etc? Posted: 14 Jun 2019 03:40 PM PDT When reviewing claims and settlement demands how do the insurance adjusters value the claims when a MRI or X-ray bill is presented to them? Does it add value to the claim or can it hurt the claim? I'm in the middle of a personal injury claim right now after I got in a accident. Turns out my lower spine has some disc protrusion and herniation impinging on the thecal sac. Hoping the insurance adjuster doesn't try to deny adding this to my claim [link] [comments]  |
| I dropped full cover my from financed car Posted: 14 Jun 2019 09:26 PM PDT I was stupid enough to drop the full cover in a brand new car, then I got into a not-fault accident where I got payed 15k, and I owe 22k to my bank. In my case progressive never notified my bank that I have dropped the full cover from my car and they don't even know the car is totaled. Although I'm still planning to pay the debt no matter what. Question Am I in legal trouble? What if the bank finds out? What can I do for them not to find out? Can I still refinance with a credit union ? How f@ck am I ? Disclaimer: just another ignorant learning a hard lesson [link] [comments]  |
| I am being scammed by a driver! [TX] Posted: 14 Jun 2019 03:09 PM PDT I was driving behind a car whose rear bumper was already badly scratched up, dented and the undercarriage badly damaged and crumpled up. I was driving at least two car lengths away and I could see the damages from there, and I even remember thinking to myself that I should back up more because his bumper looks bad. We were going about 40-50mph (speed limit is 45). Suddenly this dude stops in the middle of the street! CRASH! I hit her car! This mf literally stopped in the middle of the road to scam me! The police are called, and the driver is erratic, screaming and crying and writhing in pain and I'm just standing there like "bruh". I told the police what happened, I mentioned how there was already damage to the car, how the undercarriage was already coming out etc. And they speak to the other person, who of course tells them I'm crazy, I just dont wanna pay up. They make no note about what I said. My question is 1) what can I do to prove my innocence?? 2) is there anyway my insurance company can look to see if they had any preexisting claims? 3) can I talk to their insurance to check if they had any preexisting claims? 4) can I talk to police to check if they're car had been in any accidents within the last few months?? [link] [comments]  |
| Am i considered a secondary driver? Posted: 14 Jun 2019 08:48 PM PDT So i live in Canada Ontario and just recently got my G2, and my mom doesn't let me drive the car alone because we do not have secondary driver insurance yet which i did look into but i do not know if i would even qualify as a secondary driver because i don't even drive the car more than 20% of the time it is on the road. Most websites say that the insurance policy applies to someone who borrows it twice a week or like say every friday tou know basically someone who consistently and often borrows it. But i do not so if i wanted to take the car every few weeks or even less would i still be considered secondary driver or do i not drive enough to be considered it yet? thanks in advanced. [link] [comments]  |
| Posted: 14 Jun 2019 08:47 PM PDT Hey guys, My car is now rendered inaccessible due to a crane falling on top of the parking garage. I called one of the agents who set me up with auto insurance and he basically said to go through my renters insurance. I called my renters insurance and they said it's covered by auto. Should I go directly with the auto insurance instead of the agent? The agent basically said if I file claim then it would make my premium go up. This doesn't sound right because it wasn't even my fault this happened. I'm new to this but would love hear y'all's thoughts on this. Also, my address on my insurance was my home address and not this new apartments address. I moved into it like two weeks ago. Would this cause problems? The agent is with like some no name insurance company but officially he set me up with Safeco. Edit: my car isn't damaged. It's just stuck in the garage for the time being. [link] [comments]  |
| Does PA state-mandated coverage apply if employer and insurer are based in PA, but I'm in DE? Posted: 14 Jun 2019 04:03 PM PDT Pennsylvania has state-mandated coverage for medical foods for the treatment of eosinophilic disorders. Delaware does not. If my employer and insurer (Cigna) are based in PA, but I'm in DE, does that mean the plan has to offer PA-mandated coverage? Or do they not have to offer that coverage to me since I live in a state without such mandated coverage? [link] [comments]  |
| Posted: 14 Jun 2019 03:37 PM PDT Hi, all! So I'm trying to get a surgery covered by my insurance (Quartz), and I just realized that in the private version of my plan — I work for the State of Wisconsin so I'm on the employee trust fund plan — covers this surgery as medically necessary, while my plan does not. Is this common? I know benefits change from plan to plan, but do definitions of medical necessity? I can go into more detail if that would help — thanks in advance! [link] [comments]  |
| Posted: 14 Jun 2019 02:38 PM PDT |
| Thinking about Switching Auto Insurance Posted: 14 Jun 2019 01:37 PM PDT Good Afternoon All, I have been a AAA customer for 16 years and have all of the discounts except the eye in the sky app. We have three cars in our names 1 of them is in our name and our sister's name and so we have 3 cars and 3 drivers on the policy. They quoted us $350 and then my auto pay did not change. So I call them today and they tell me oh the auto pay is actually $373. I realize it's not that big of a difference but I feel like they should honor the quote, I even gave them the old 16 year customer never had a complaint thing and all they said was well download the safe driver app and you can save 10%. Anyway is it worth changing auto insurance companies once you have achieved the longevity discount? I used Insurify to look at quotes for 3 cars and 3 drivers and it looks like several of them are over $100/month cheaper than AAA. We have had good service from AAA over the years, they hooked us up with a hotel for several days while our apartment flooded and I'd hate to leave. I don't think the customer service agent is going to change anything but she said she'd call back later. Thanks for any advice or thoughts! [link] [comments]  |
| Posted: 14 Jun 2019 05:45 AM PDT We experienced a main sewer line backup which flooded our lower level. Mitigation team came in and removed everything down to slab and wood frame. Our insurance adjuster is sticking to her Exactimate quote and saying that's that. Problem is, it's far lower than any contractor (other than the one that's part of the home insurance company "network") is estimating. Are there any downsides to hiring a public adjuster to come in and work to help get us a little more in the settlement? Ie- is this bad for our standing with the HI company going forward? Will they raise premiums to make us more-than-pay for it? How much power do I, as the customer and homeowner, have to say that I'm unhappy how this is handled and their lack of working with us to increase the settlement and say that when it's all over, we're definitely going to another HI company? I feel like we're being lowballed quite a bit and everyone says "you just have to keep calling you adjuster" - but we are...and just get "Exactimate says this is the amount..." over and over. Any help on how this goes would be appreciated [link] [comments]  |
| I got into a car accident and I’m not sure which option is better financially Posted: 14 Jun 2019 12:24 PM PDT I recently got into a car accident and it was my fault. I didn't injure anyone in the other vehicle but my fiancé did end up with a fracture in his hand. He doesn't have insurance . We share the bills and I was wondering which would be worse, paying off the hospital or filing a injury claim and paying off the settlement through my insurance. If someone could also explain how all of this works and how my insurance is going to work now that I don't have a car anymore (I ended up giving the title to the wrecker) that would be great. [link] [comments]  |
| Marketplace denied coverage for maternal care, what next? Posted: 14 Jun 2019 08:24 AM PDT Any insight on this situation is greatly appreciated. We live in Texas. My wife is pregnant (10 weeks); expected due date: mid- late January. She is CURRENTLY a dependent on her mother's BCBS marketplace health plan. According to her OB, her mother's BCBS insurance does not cover maternal care for dependents. So, rude awakening: none of our upcoming doctor visits regarding this pregnancy are covered. It is June. I have BCBS coverage for myself through my employer. Open enrollment is in November. My wife is unemployed. I don't THINK we qualify for any special enrollment offers (life changing situations). My wife was a student finishing her degree in Louisiana. She just moved to Texas where I reside now. She applied for Medicaid/CHIP but was denied due my income. She has not submitted her own marketplace application yet, but we're afraid she will get denied due to the fact that she technically "has coverage" and that she could have been added to mine last year. We have no idea where to go from here. We cannot really afford out of pocket costs for the birth of this child. Does anyone have advice for this mind racking situation? [link] [comments]  |
| Posted: 14 Jun 2019 11:03 AM PDT I was recently involved in a car accident. My vehicle was parked on the street, and an ice cream truck driver wound up scraping the side of my driver's side door, very deep gash. Fortunately he did not flee the scene, and all the information was collected. Obviously in the situation 100% fault is on him, and his insurance should be providing all of the repairs to the vehicle. Heres the catch. Unfortunately for me, my registration was expired by approximately 3 days when the incident happen without my knowing. I immediately renewed it. Does my registration being expired give the insurance company rights to deny me the repairs? [link] [comments]  |
| Posted: 14 Jun 2019 08:58 AM PDT Back in the olden days, I would initiate a complaint with the State Department of Insurance, and in most cases simply beginning that process would motivate the insurance company to take action because they were genuinely beholden to this regulatory body that was ostensibly created to protect consumers from exactly this kind of scenario. My doctor of 15 years' professional opinion & my 30+ years as a patient dealing with this chronic illness counts for absolutely nothing. Some insurance company stooge that's never met me or spent 2 minutes reviewing my file is now in charge of my medical care. This stranger somehow decided I must try 2 alternative (cheaper) medications first before they will agree to pay for the one my doctor & I decided I need. The fact that these 2 other medications are in a completely different class from the one I'm trying to get doesn't matter. The fact that each of these medications caused serious life-threatening reactions when I tried them 15 years ago apparently also has no bearing. The most infuriating part is the complete lack of any coherent process that injects common sense here or any way for a human being to make a decision. They just repeat the script like a robot - "Sir, your provider must initiate an appeal/peer review blah blah". They have no answer when I tell them exactly how that's going to go - my doctor's office will follow their intentionally vague process and call or fax whoever they tell me they're supposed to. I'll call in a week later for an update, and they'll tell me there's been no communication from the provider. Then 4 more calls may dig up a fax to the wrong department, I'll get transferred around, hung up on, etc. Eventually I'll wind up having to get the medication as an inpatient in the hospital, costing the company a heckuva lot more. The drug company can help if I'm under-insured or indigent, but the fact that the medication is actually supposed to be covered disqualifies me for any kind of assistance. Even if I were to produce a bag of money ($8400 for the 1st dose), they could not sell it to me directly, because that'd mean too many people would miss out on their kickbacks. In any other industry this would be called racketeering & the Justice Department & FTC would be investigating them constantly. I've spent the last year of my life suffering needlessly while I fight the insurance company tooth & nail for every service I try to obtain. In the meantime doctors are dropping support for my plan in droves because they can't get paid either. Is there any law firm or non-profit out there that I'm just not finding that could give me some advice regarding any legal recourse? I just don't have any fight left in me and I just don't know what else to do. In all seriousness, I'm at the point where it's starting to look like actually moving to another country is the best option for getting the medical care I need. If one more person tells me about how Canadians have to wait for care as a rebuttal for universal coverage in the US....these people obviously never had to deal with chronic illness in America today & don't understand just how broken our system is. [link] [comments]  |
| Real Estate Title Insurance and Revocable Living Trust Posted: 14 Jun 2019 04:33 AM PDT VA/USA - I'm establishing a revocable living trust in my name. I plan to transfer the deed to a rental property to the trust, but the title insurance issuer will only issue an owner's policy endorsement for the trust if it's my primary residence. Question - if I rely on the title insurance I have now and don't have it for the trust, what risk will I be taking? There are no liens, mortgages, or issues since I bought the property 14 years ago. Thanks! [link] [comments]  |
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