[PA, NJ] wife’s health insurance keeps refusing to pay for cost of child birth. Insurance |
- [PA, NJ] wife’s health insurance keeps refusing to pay for cost of child birth.
- [NY] Trying to get Medicare
- homeowner insurance quote asking if I have pets
- Sewer pipe failed, insurance company denied claim due to the original issue happening months ago.
- CO - T-boned in intersection, insurance potentially playing hardball with me
- Should a contractor meet with my insurance adjuster? (Roof claim)
- [NH] Therapist only "just realized" she doesn't take my insurance
- Accident with Cyclist - Follow up Question
- Getting billed by an outside surgical pathologist I didn't know about
- Is there jail insurance
- Insuring deceased father's vehicle
- So I work for this company but I’m not legally on the paperwork , is it illegal for them to claim me on the insurance and give me a drug test without my information only my name?
- Issues with Auto Insurance.. Looks like Bodily Injury double on a 15 yr old truck?
- BCBS medical codes for lab work (WA)
- Water Damage Claim--3 Weeks & Insurance Still Won't Approve
- Mislead by Dental office to pay for cavities
- Individual and family deductibles
- Someone asked me if I have rental insurance?
- Had an extended power outage and food spoilage. USAA will pay me $240 with no deductible to replace refrigerated goods. Is this worth a claim, or is it going to cause more trouble than it's worth in terms of premiums, future policies, etc.? [TX]
- Called home insurance about a tree hanging over my house. They are ghosting me now.
- Quick Rideshare coverage question
- claims specialist? How social is the job
- Home over-insured for 10 years due to an incorrect inspection report Can I Sue? What to Do?
- How often to follow up with home claims adjuster?
- [FL] Had an accident in someone else's car, how does coverage work?
| [PA, NJ] wife’s health insurance keeps refusing to pay for cost of child birth. Posted: 11 Jun 2019 09:21 AM PDT Wife and I both work in PA and live in NJ. Child was born in NJ in August 2018. It was always our intention to have our child covered under my wife's plan. Child spent ten days in the NICU racking up some incredible hospital bills. She quickly added him after he was born. Hospital was never even given my insurance information. Cut to: A few months later, we're getting calls about owed medical bills. The hospital was saying that my wife's insurance was rejecting the claim. This is where we found out about the so-called "birthday rule". The hospital informed us that the law in NJ says the child must be on my insurance because my birthday comes first in the year. They ended up billing my insurance, who rejected some claims. Wife calls her insurance and lets them know that our son is simply not on my plan. We think this is an easy fix. However, her insurance suggests we back date him to my insurance for at least the first month of life to clear up confusion. This is when my instincts start to kick in. Since it is already December by this point, my insurance tells me they can't back date that far. And they could only go back to November. I explain to them the situation; and they don't understand what my wife's insurance is doing. If he's not on my plan then the birthday rule doesn't apply. This is also when I find out that this "rule" is not really a law but a only a standard business practice for dual insurance. I tell my insurance not to bother as we will just go with my wife's insurance. A conversation with my HR rep confirms my assumption. We get in touch with wife's insurance again and explain the situation. They seem to understand that they are in the wrong and we are given a personal assurance that they will take care of it. This process repeated more than once. Essentially having us go in circles: Saying EOBs from insurance will fix this issue, sending EOBs, getting a response agreeing with our position, getting another phone call from the hospital, which leads to us again calling insurance and essentially asking for the same information all over again. It is now June and we got another call from the hospital asking for payment or we will be sent to collections. We call my wife's insurance who said they will call the hospital to delay sending to collections. However, they keep saying that my insurance should be the one covering and it should be processed through them first. The final twist is it seems my insurance actually DID pay some of the bills during his hospital stay in August. We have no idea how that even happened. They also DID add him in my insurance for the month of November, when I asked if he could be back dated but ended up not going through with it. Since this time we have had doctor's visit and other treatments completely covered by my wife's insurance. How do we coordinate with all parties to finally get some closure? If my insurance did mistakenly pay for some hospital bills what are the implications of that? Wife has Aetna, I have Independence Keystone. [link] [comments]  |
| Posted: 11 Jun 2019 11:56 PM PDT I'm a US citizen with my wife whom I just got married. She will be receiving her green card in 7-11 months. I'm still finishing up college, so I essentially have 0 income. My family overseas is supporting us. Just figured out how insanely expensive private insurances are (I've been living overseas for many years), and I'm trying to get medicare. I have nothing to report to IRS, and my family would be sending money to my bank account. Would I still be eligible for medicare? Thanks. [link] [comments]  |
| homeowner insurance quote asking if I have pets Posted: 11 Jun 2019 01:36 PM PDT Hello. I will be a first time homeowner and I am in the process of getting quotes. It seems like every company I called so far is asking if I have pets. I do have a goldendoodle and was wondering if having a dog really makes a big difference in the cost. Thanks for any help. [link] [comments]  |
| Sewer pipe failed, insurance company denied claim due to the original issue happening months ago. Posted: 11 Jun 2019 10:06 PM PDT I live out of state from a home that we keep as a rental. Older home with older pipes. As a basement tenant was moving out they reported a leak. Plumber goes out and its a full blown active sewer leak. They have to excavate to repair an old clay failed sewer pipe. Starting bill is $5K for the plumber, no remediation or repairs yet. I call my insurance company, they check it out and say there is a foot of mold behind the walls, the lead has been going on for months and since it wasn't reported to them in time, there is no coverage:
As you can prolly imagine, I'm irate. Why didn't my property manager do something? They're telling me the tenant did report a few leaks but preferred to "clean it up themselves and dry it all up" since they had multiple pets in the property and did not want plumbers entering the home when they weren't there and they seemed to work all day. Seems like I'm gonna be stuck with a 5-figure remeditation and cleanup bill and have no idea why. This should have been reported when it happened and prevented. What are my rights here? How can I tell what is the responsibility of the tenant and the property manager? Anything I can do about the denied claim? [link] [comments]  |
| CO - T-boned in intersection, insurance potentially playing hardball with me Posted: 11 Jun 2019 03:15 PM PDT |
| Should a contractor meet with my insurance adjuster? (Roof claim) Posted: 11 Jun 2019 09:45 PM PDT Hello - quick question. We had a bad storm in my area last week, contractors have been knocking on all of the doors in my neighborhood wanting to inspect roofs for hail damage. I had one contractor on my roof and he said that there was enough evidence of damage to submit a claim. I plan on submitting and getting insurances opinion, but my question is should the contractor be present when the insurance adjuster comes out to look? I don't want to piss off the adjuster, but the contractor was pretty adamant that he wanted to be present to "advocate for me". Thoughts? [link] [comments]  |
| [NH] Therapist only "just realized" she doesn't take my insurance Posted: 11 Jun 2019 01:48 PM PDT New Hampshire Not sure if this is technically the right place to post this but it seems to fit as well as anywhere else. My daughter has been seeing a therapist for about a year. Our insurance switched on the first of the year to a provider she does not accept. However, here we are 6 months later and she is only telling us now that we owe her over $1200 because none of the appointments this year were covered. We have still been paying co-pays at every appointment. Are we on the hook for this? Is there no responsibility on the part of the therapist to have submitted claims more often? I'm just not sure what the next step is. It was suggested that I contact the NASW but that seems to be more gears toward helping the therapist. Thanks for any help. [link] [comments]  |
| Accident with Cyclist - Follow up Question Posted: 11 Jun 2019 07:10 PM PDT Follow up from this post We called the insurance company to make the incident report. Because it was a holiday weekend, we didn't speak with an agent or an adjuster, but someone who seemingly only 'takes notes'. We made it explicitly clear that we are not filing a claim, but making an incident report to demonstrate being proactive and establish a baseline for a consistent story. Over the last week, the insurance company called to get a recorded statement of the story (we assumed just because they want a verbal statement soon after the event in case the cyclist tries to sue later). They also sent and adjust to look at the car (we assumed maybe that's just standard protocol), who requested copies of the quotes we had already gotten for repairs. Again, we reiterated that no claim was being made every step of the way. Today we received a check from the insurance company, with a letter basically stating "Theres nothing more to do with your claim, but get your car repaired. Here's some money for the claim"... But we never made a claim! We explicity said we are not making a claim several times through each conversation. If they are just handing over money because my girlfriend wasn't at fault, and it isn't going to affect her premiums, awesome. But I seriously doubt thats the case. Is it possible to determine if the premiums are going to go up as a result of this? If so, can we tell them to cancel their check and strike the claim so as to not affect her premium? Thanks! [link] [comments]  |
| Getting billed by an outside surgical pathologist I didn't know about Posted: 11 Jun 2019 09:00 AM PDT Hi there! This all happened in FL. I just had a colonoscopy done last month. I've been on the fence about getting it done because of the expense, but a week before the procedure the hospital where I was to get it done (University research hospital) called and told me it would be $951 after insurance (Humana, $1500 deductible I hadn't yet touched). I figured, ok, I can afford that. They made me pay it all upfront on the day of the procedure, and then casually mentioned anethesia would be separate. Too late to cancel now, so I get it done. A couple weeks later, I'm getting a bill from some third party pathologist for over $400 (after a small Humana discount). I remember signing an authorization for anethesia, but don't remember anything about these guys. Am I liable for this? Feels shady that the physician can request services from a third party group and bill me without asking me first, but I guess the answer is always just "Merica." [link] [comments]  |
| Posted: 11 Jun 2019 09:06 PM PDT I've been listening to a lot of podcasts and I'm terribly concerned about wrongful imprisonment and how my family will be able to survive without my income. Is there an insurance for that? [link] [comments]  |
| Insuring deceased father's vehicle Posted: 11 Jun 2019 02:48 PM PDT My father passed in 2018 and his estate is being contested between myself and his ex-wife (who is not allowed back in the United States). I have been using his vehicle but his insurance expires in July. Is it possible to insure the vehicle with me as a covered party if it is registered in my father's name? [link] [comments]  |
| Posted: 11 Jun 2019 04:50 PM PDT Reason I ask is cuz something happened with my coworkers which the insurance technically has to help them but I wasn't working that day and they're trying to say I was , am I wrong or am I getting fucked right now? Illegally? [link] [comments]  |
| Issues with Auto Insurance.. Looks like Bodily Injury double on a 15 yr old truck? Posted: 11 Jun 2019 09:52 AM PDT Looks like when my policy renewed my Bodily Injury Insurance went from ~$600 for $100k to $1250 for $100k. I cant seem to figure this out, I have a clean driving record and talked to an agent and they said "Oh youre the perfect customer, we really want to keep you but cant do anything about this doubling. It must be the formula used for your state." I am in my early 30s and drive a 04 Tundra, why would my insurance for bodily injury go up this much in one year? My Insurance for this is over double what it cost me for insurance when I was 18 on my Mustang. Also, I am not seeing any shopping advice in the side bar here. Is there a basic guide for what insurance coverage I need for living in FL and/or a recommendation of how best to shop for insurance here? [link] [comments]  |
| BCBS medical codes for lab work (WA) Posted: 11 Jun 2019 01:46 PM PDT We have BCBS of Texas insurance. My husband is diabetic. After his most recent lab work - we received a bill from the lab (never have before). These labs are done every 3 months to make sure the Dr doesn't need to adjust medication. When I called the insurance company they said a "standard/diagnostic" code was used and not a "routine" code. With the "routine" code it is 100% covered. With the "Standard/diagnostic" code we were responsible as we have not met our deductible. In my mind it should be routine as the Dr needs this info to monitor his condition. The Drs office says they used the code they always use and don't have another. BCBS won't tell me what the code is that they are looking for and the Drs office doesn't seem to know it or can't find it. Does anyone know where this info could be found? Or perhaps have the code for routine lab work? thanks in advance [link] [comments]  |
| Water Damage Claim--3 Weeks & Insurance Still Won't Approve Posted: 11 Jun 2019 07:14 PM PDT Had a pipe leak under my pier and beam house. I immediately contacted insurance company, a restoration company, and a plumber. Plumber fixed leak after restoration company pumped out water. Fans, dehumidifiers and a heater are all under my house now for 3 weeks attempting to dry it out. It's working in some places, but my wood floors are SEVERELY buckled in places along how the joists run. Restoration company said that moisture is trapped between the joists and subfloor so they need to pull out all of my floors and dry from both top and bottom. Moisture readings are still really high in these areas. Insurance company agreed to having floors removed. This would include a full packout, storage of contents, and putting us up in a hotel. Insurance said fine, just send estimate for these services (last Thursday this exchange took place). Restoration company sent estimate for packout on Friday. Didn't hear anything back until noonish today from claims rep. She says the estimate is high and that she needed to forward it to her boss to review. That's fine. She also said they'd be sending an adjuster out to take samples of the wood floor so they know how much to allot for replacement. Adjuster called and said he could make it out next week sometime. Another week of nothing being done to fix this. Am I wrong for being concerned about my home's condition worsening? It's going on a month. I'm sure the restorations company price for fans, dehumidifiers, heaters, taking readings everyday etc isn't cheap and at this point we know none of that is working. The floors need to come up. I'm extremely concerned about the subfloor worsening. Not to mention living in a home that has hills and valleys on the floors and what sounds like a diesel engine running 24 hrs a day from all the fan, dehumidifier noise. I don't know what else to do. Any advice on how to get something done? It's extremely frustrating knowing that remediation efforts aren't currently working and floors are worsening, but insurance won't approve removal so we can fix this problem. [link] [comments]  |
| Mislead by Dental office to pay for cavities Posted: 11 Jun 2019 07:09 PM PDT Need help Reddit! I have Dental insurance with my employer, this year during open enrollment my employer defaulted my dental to a DMO without my full understanding. I went in to my same dentist as last year in March for a routine check up. They asked if anything changed, I said no. They did not take my ID or dental insurance card. The routine showed I needed 3 cavities filled. In May I went to the same dentist and got my 3 cavities filled. Less than a week later I get a voicemail from the office saying my claims were not processed and I'm to pay $1100+ for their services despite having dental insurance. I called Aetna and spoke with a representative and with some investigation she discovered that Aetna sent a message to the dentist that my routine in March was not covered. There are no records of the dentist calling and verifying with Aetna of why my claims weren't being approved. It wasn't until they needed me to satisfy the $850 bill for the 3 cavities did they call me and say I had to pay for the routine ($250+) and then for the 3 cavities ($850+). Obviously if I was informed my routine wasn't covered I wouldn't have gotten my cavities filled there. Aetna will only cover my routine claims saying "it's one time forgiven" but they cannot cover my cavity appointment. Help! It was wrong on both sides, now I know to always give them my dental insurance card but the dental office didn't process my claims until after the cavities were done. How do I prevent paying $850+ for cavities when I feel I was wronged?! [link] [comments]  |
| Individual and family deductibles Posted: 11 Jun 2019 03:02 PM PDT Hello, with a baby on the way my wife and I are comparing our policies against each other again. My health coverage document states that there is an individual deductible for $4,000 and a family deductible for $8,000. It also says in the footnotes: 1.The deductible that applies to the whole family must be met before the plan begins paying for a single member. The deductible can be paid by a single family member or several different members. Am I reading that right, that if you are on a family plan, you have to hit the $8,000 deductible before it covers costs? Even if all of the costs are associated with one individual? [link] [comments]  |
| Someone asked me if I have rental insurance? Posted: 11 Jun 2019 06:23 PM PDT I am selling my furniture and the individual (stranger) that is purchasing it just asked me via text if I have renters insurance and what type of insurance plan. I don't because in the words of John Mulaney, I'M JUST A CHILD. Kidding. I know I should get rental insurance. Google mentioned that rental insurance covers you if someone gets injured in your apartment. I might be over-analyzing this situation, but I feel like it is pretty weird for this stranger to ask me about rental insurance (it's not something that is super common in my area as far as I know). Should I be concerned about a potential "injury" that might occur while he moves furniture out of my apartment? Do you think I should sign up for rental insurance for only one month? I realize I'm probably being paranoid but I would honestly like to hear what you all think. [link] [comments]  |
| Posted: 11 Jun 2019 09:29 AM PDT I've never had any claims before but also only been a homeowner for 2 years. Am also a small-time real estate investor and sometimes need to add rental properties. Insurers always ask "have you had a property claim in the past 5 years." How should I be thinking about this? Is the underwriting process smart enough to establish that my having a weather-related power outage for 3 days is not necessarily indicative of my insured risk? Or am I going to end up spending more than this $240 due to having filed this claim? I receive a claims free discount of $312/year and USAA says this would not impact that. Appreciate any insight... Thanks. [link] [comments]  |
| Called home insurance about a tree hanging over my house. They are ghosting me now. Posted: 11 Jun 2019 10:04 AM PDT There is a huge tree in my neighbor's yard that leans over my house. My previous home insurance said that the tree over my house is ok. They said I'm covered. They were recently bought out by a bigger company, and I called them to discuss the tree. They said they would get right back to me as in a few minutes. It's been over a day now. They dodged my 2 calls. It seems very fishy, and I feel like I need to do something or I will get screwed. I have a feeling that they are scrambling to do something not so great for me. Anyone have any advice? Thanks for any help! [link] [comments]  |
| Quick Rideshare coverage question Posted: 11 Jun 2019 05:17 AM PDT Just a quick question to ensure I am thoroughly covered. I plan on driving for Uber/Lyft here in the coming weeks. I have Comp/Collision with un/underinsured and medical payments through SF with a rideshare endorsement. This should have all bases covered correct? [link] [comments]  |
| claims specialist? How social is the job Posted: 11 Jun 2019 12:22 PM PDT Is this position pretty much customer service in terms of level of customer interaction? [link] [comments]  |
| Home over-insured for 10 years due to an incorrect inspection report Can I Sue? What to Do? Posted: 11 Jun 2019 09:44 AM PDT While refinancing our home, I recently found out that my homeowner's policy was extremely high. In fact, it was the highest the mortgage person had seen in 40 years. She gave me a referral to Company B which had my replacement value at 600K and the premium 2400. Next, I phoned Company A explained the situation and they did a policy review over the phone. They confirmed that my replacement value should be approx 622K and my new premium would be approx 2400. At that point, I asked why my premium for the past 10 years was 6400; he said because my replacement value was 1.2. The $1.2 was based on an inspection report conducted in 2009. He sent a copy of the report and then said they would send another inspector out in the coming weeks. But in the interim, Company A would lower my premium to 2400. They sent an inspector/appraiser out and their report came back at about 850 for the replacement cost of my home. This amount is still 230K higher than their over the phone review. It actually came in higher than the market value appraisal we received for our re-finance. I phoned Company A and asked they return my premiums for the past 10 years because I was over insured and the inspection report was incorrect. They said no. I made a statement on Twitter and then I was contacted by their social media department. I shared the details then a few weeks later received a call from the Office of the CEO of Company A. Today, I received a call from an Advocacy Specialist in the Office of the CEO. On a recorded line we discussed the difference between replacement cost and market value. He took the time to explain that replacement costs go up each year due to inflation and that they will never go back to 2009 levels. Next, he explained that he compared the 2009 inspection vs the 2019 inspection and note that they were the same. Finally, he shared that insurance companies are highly regulated and that if they backdated my policy, the insurance commissioner would have to get involved, if the insurance commissioner got involved they may ask Company A to review all of their policies as they did in a Georgia case and it would cost them too much money. SO-- as much as they'd like to help they aren't going to return my money. I listened and only had a few questions for him. How does he know the numbers used to produce my inspection report are correct? We entered into a good faith contract based on those numbers. If those numbers were wrong, then we couldn't have had a contract. I asked why if replacement costs will never go down, why mine went down. He continued to say the report was correct because it was in front of him. I told him I'd have to figure out the numbers from 2009 and then he said they weren't available and Company A wouldn't help me get them. As for why my replacement costs went down almost 50% he blew me off. My questions? How do I sue company A? Does anyone know an insurance inspector who can give me an impartial report based on 2009 numbers? I will follow up with my insurance commissioner today. Any and all input would be greatly appreciated. PS This is my 1st post, if it's in the wrong group please suggest where it should be. Thanks again! [link] [comments]  |
| How often to follow up with home claims adjuster? Posted: 11 Jun 2019 03:41 PM PDT I just want to follow-up frequently enough to keep things moving, and not drag the home claim for months. But not too often I annoy the adjuster and get denied. What's that magic sweet spot? Thanks. [link] [comments]  |
| [FL] Had an accident in someone else's car, how does coverage work? Posted: 11 Jun 2019 10:59 AM PDT Last Friday my partner was driving our friend's car in the rain, he hydroplaned and hit a concrete barrier. No one else was involved, no one else was in the car. The police came and decided not to write an accident report since there was no damage to anything besides the car. We got the car home and called our insurance, and notified our friend. We are insured through USAA and our friend through Progressive. Here is where I get a little lost, I was always under the impression that in Florida insurance followed the car, not the driver, but when my partner was speaking to the adjuster he was told that it would be claimed under our insurance since they were considering him "at fault" for not maintaining control of the vehicle (this wasn't some light rain, it was very heavy rain and very sudden). Then he was told that our friends insurance would be the one issuing the rental car, sending an adjuster out, and taking care of the claim. How does this work? Are we responsible for the total cost of the damages through our insurance? Or should this be processed through the company that the car is insured with? I have heard the word "subrogation" thrown around about this, but I am not sure how that works? If the vehicle is a total loss, which is likely, and it is claimed under our property damage not our collision coverage we likely do not have enough to cover the cost of the vehicle. I'd assume this would result in us / him being sued and potentially losing his driver license (worst case scenario). I've never wrecked a car, let alone someone else's car, any help is appreciated. [link] [comments]  |
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