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    Friday, January 3, 2020

    Flying ice from my car cracked a windshield. Should I file a claim? Insurance

    Flying ice from my car cracked a windshield. Should I file a claim? Insurance


    Flying ice from my car cracked a windshield. Should I file a claim?

    Posted: 02 Jan 2020 03:05 PM PST

    Thanks everyone.

    I was driving down the highway today and then another driver that had been driving behind me flagged me down. They had a big smashed section of windshield that they said was from ice flying off my car. I'm not 100% sure that I'm not being scammed, but I think it is definitely possible that I cracked their windshield with a chunk of flying ice. There was a bunch of ice on my roof that I failed to clear, minus a big chunk in the middle that was missing. I know it's my responsibility to clear my roof.

    I just got a call from an auto glass service. Showed up as auto glass based on caller ID and I checked that they're a real shop. They were checking with me because they said the person with the cracked windshield said I would pay for it. They said it would be $320.

    I'm trying to figure out if I'm better off paying for that directly, or filing a liability claim through my auto insurance (Geico). I figure that a rate increase could end up costing me more in the long run. I'm not 100% sure that I actually cracked their windshield, but I think it's very possible that I did and I want to do the right thing.

    submitted by /u/warpigz
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    Got rear-ended yesterday stuck in traffic. Do i file the claim through my carrier or directly to the carrier of he person who hit me?

    Posted: 03 Jan 2020 03:35 AM PST

    State is PA. I have a headache and am going to the ER for a check-out as well. Thanks!

    submitted by /u/press_F_topayrespect
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    Avoiding surprise “preventive” medical bills. *Warning, long read*

    Posted: 02 Jan 2020 06:48 PM PST

    Figured I'd share a post with you all from one of my LinkedIn connections.

    Have you ever received a statement following a preventative visit and thought, "Shouldn't this be covered at 100%?" If so, you're not alone. Many health insurance plans follow the guidelines of the U.S. Preventive Services Task Force (USPSTF). And although sharing nearly the same acronym as our post office, this group does not deliver mail. Due to the ACA mandate to provide preventive services with no patient cost, we now rely on the USPSTF to determine if healthcare services are recommended as "A" or "B" graded preventive services, which most plans pay at 100%.

    So, what's the problem?

    Well, if your doctor orders tests, or provides services outside of this list, your health plan will likely apply patient responsibility in the form of copay or deductible. Whether you agree with your doctor's order or the "Task Force" recommendation, your plan document is the trump card when confirming who pays for these services.

    So, what should you do?

    Step 1:

    Know the tests your doctor plans to order for your annual check-up.

    Step 2:

    Ask your doctor if the "Preventive Task Force recommends the test."

    If yes, your health plan will likely pay for it.

    If the answer is no, ask what condition or risk factor leads the doctor to believe the test is necessary. Then ask how much it costs.

    If your copay covers all services at an office visit, ask your provider to perform the test in-house, and bill as a separate office visit. (BCBSM Community Blue and some self-funded plans have these "all-in" copays).

    If your copay only covers the office visit charges, or you have an HSA, your deductible will likely apply for these services (BCBSM Simply Blue, BCN HMO, most Priority plans, and most self-funded plans have these "restrictive" copays).

    If the blood draw or test is performed before the office visit (usually the case) and it is not an "A/B recommended" test, you'll either pay a lab copay or pay for the entire service (as deductible applies). Click here to know what you should pay for lab tests.

    Step 3:

    Print this list, and bring it to your first visit. Most physicians have no idea how the finance side of their practice works. The list of "A/B" services is in alphabetical order, so your doctor or lab tech can quickly identify if your health plan covers the service (or test) at 100%.

    Step 4:

    Lastly, if you don't agree with a bill: CALL! High volume services, like office visits, are mis-billed quite often. So, call your doctor's office before paying the bill. Or, use your healthcare concierge (if your employer provides).

    submitted by /u/jrock1986
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    After I get a work comp settlement, does my normal insurance kick in after that?

    Posted: 03 Jan 2020 02:06 AM PST

    Does normal insurance pay for old work comp injuries after settlement?

    Or do I no longer have healthcare anymore.

    submitted by /u/Yossi25
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    parked car slid down frozen road by itself with nobody inside and hit tree... GEICO paid almost $3000 in repairs to the bodyshop. are such claims going to count against me when at policy renewal time?

    Posted: 02 Jan 2020 09:17 PM PST

    parked car slid down frozen road by itself with nobody inside and hit tree... I watched it happen from the inside of my office. When I walked towards it, I fell and slid almost 30 feet down the same icy road on my butt and ended up next to my car.

    GEICO paid almost $3000 in repairs to the bodyshop. that's after my standard $1000 deductible. damages were the bumper and right fender.

    are such claims going to count against me when at policy renewal time?

    submitted by /u/OnePlinko
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    I’m Alberta resident but moving to Ontario temporarily for school

    Posted: 02 Jan 2020 09:03 PM PST

    Can I use my Alberta auto insurance in Ontario, I'm living in Ontario temporary Sep-May, I'm Alberta resident lived there almost my whole life

    These past 3 years I've been commuting to work and school using uber $300-$500 monthly -

    This Upcoming year Fall 2020 my commuting will be much higher & Im wondering if I can bring my Alberta registered vehicle to Ontario for only 8~ months

    Is it legal to drive Alberta registered vehicle on Ontario?

    Do I gotta pay $$ when bringing car over?

    Anything I should keep in mind?

    How much more is my Alberta insurance gonna increase?

    TIPS AND ADVICE are HIGHLY APPRECIATED

    Thank you

    submitted by /u/mxorep
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    How much time does car insurance give for non renewal

    Posted: 02 Jan 2020 08:48 PM PST

    Always freaking out about my insurance (USAA & CA) non renewing. Just my anxiety over doing it. Haven't had any accidents in this policy period just 1 glass chip claim.

    submitted by /u/megazord26
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    Had a sinus infection. Doc looked in my nose with a scope and I got a $150 co-pay for "surgery" . . .

    Posted: 02 Jan 2020 07:06 AM PST

    Is there anything I can do about the way this was coded? The doctor's office is unwilling to change this.

    Will the insurance company do anything about it?

    Is poking a scope up my nose and looking around actually surgery?

    edit

    OK, I guess I'm screwed. Fool me once, shame on me, etc.

    I'll pay them but they just lost a 20 year patient. Doing something that costs me an extra $150 without asking is unconscionable.

    submitted by /u/Edward_Morbius
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    Insurance won't cover my medical bills

    Posted: 02 Jan 2020 08:00 PM PST

    Hello all, On November 2019 I broke my hand because I punched my floor. I was frustrated, had a bad day and I wasn't thinking about what would happen. In my attempt to let off some steam I hit my floor which broke a bone and dislocated another. Again I wasn't thinking and I didn't know this would happen. I was stupid and hitting the floor was just an accident that happen in the spur of the moment. My insurance sent me a letter asking for details on what happened. They only gave me a small section to write on so I sent them basically the same thing as above. A couple weeks later I received a letter from them showing the cost of all the stuff and their explanation for rejecting it all is that it's a self inflicted injury and they are a plan exclusion. The bill is close to 20k. They gave me an appeal procedure and I would need to write a letter to them. Is there anything I could say or do that could change their minds and accept my request to be covered? Some additional information. I'm 24 and the accident took place at my home. My hand has healed nicely. It needed surgery to place a pin in my hand. I went to the ER on a Saturday. Any information is appreciated and even if it's some bad news, thank you for reading my post.

    submitted by /u/NaClyGengar
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    Just Started An Insurance Shopping Sub

    Posted: 02 Jan 2020 11:24 PM PST

    Hey guys, I have really only been on reddit to read posts and comments for the past couple years. I had an idea for a reddit to simplify shopping for insurance. I could use the help of someone who is more experienced with reddit to help me with this sub.

    submitted by /u/Dodgerzfan
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    Normal Business Insurance?

    Posted: 02 Jan 2020 06:44 PM PST

    Hi. I'm looking to purchase an existing business. This will be a very large investment of money, time etc. I know of what I call normal business insurance; liability, worker's compensation etc.

    Is there such thing as insurance to protect against this business venture not going well? Having to sell the business at a loss etc? Not making as much money as I projected etc?

    Thanks in advance

    submitted by /u/Tigasco
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    Water Damage - Statement of Loss - Please help explain

    Posted: 02 Jan 2020 06:00 PM PST

    I live in a condo, the upstairs unit had a 100 gallon fish tank fail to hold water. The water ended up across two rooms in my unit, plus in the walls. I had a remediation team in ASAP to dry things out and mitigate the damage, so no collapse. I just had water in the light fixtures/smoke detectors and in the drywall across the living and dining rooms.

    I spent a lot of time trying to get the insurance company to put out a reasonable sum of money for this. Between the remediation and mold testing, I've spent about $3000. A contractor came to cut a hole to see what was above the ceiling (insulation? electrical? who knows?) and I haven't been able to find a contractor who was willing to do the work for the amount the insurance company is offering, so there's been a hole in my ceiling for about a year.

    This is the final offer from the insurance company. The claim is going through the master policy. My unit's insurance kicked in for the deductible, and I'm still trying to find a contractor who can even just patch the hole, kilz, repaint and reinstall the fan (itself costing about $400) for what's left over. I found someone who will do it for about $3000 or so, who's actually bonded and insured, but it's a whole other thing to get them to make time in their schedule for this very small project.

    Most contractors refused the work, knowing that the condo association couldn't bridge the gap between what they would charge to do the work right and what I had to work with.

    Can someone tell me what these numbers really mean? I'm sick of fighting, but I also don't really know what this means.

    https://imgur.com/a/02fIdGz

    submitted by /u/orxhidblack
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    Cracked paint

    Posted: 02 Jan 2020 05:57 PM PST

    The paint on my fender on my classic Camaro cracked (maybe 4" long) from a parking lot door ding that rusted over a few months. Is this something I could file a claim for as it will be quite expensive to have repaired? What types of paint damage are typically covered and what aren't? Does it matter if an accident happened?

    Thanks

    submitted by /u/hodorr1234
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    Health Insurance Question

    Posted: 02 Jan 2020 04:41 PM PST

    I'm currently 24 years old. I'm marrying my fiancée in August who is also 24 years old. It's my understanding that we can stay on our parent's health insurance plans until we're 26 years old, even if we're married.

    After she changes her legal name, can she still maintain coverage under her parent's health insurance until 26 years old?

    submitted by /u/23BP2019
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    I'm confused about how claims work

    Posted: 02 Jan 2020 04:40 PM PST

    So I'm about to turn 18 really soon and I know i have claims from Geico. Like I have the claim number, the amount, the receipt, and the bank where the money is at. All I know is that I have to be 18 to get it. That's why it's been in the bank for a while since my accident in 2015. And the claim money thing is with interest for 24month period.

    So my question is how do I get that money? Is it like they send me a check from the bank? Or is it court issued? Or do I call Geico when I turn 18 or even now??

    Yeah I tried asking parents but they don't know either. Hope someone can help!!

    submitted by /u/yxjinin
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    Auto Claim

    Posted: 02 Jan 2020 03:59 PM PST

    I was hit head on by a drunk driver who was going excessively fast in the opposite direction and came into my lane. My car was totaled (my auto insurance will cover it) and my auto insurance will cover medical expenses. I hit my head and have had headaches and hurt my back which I am seeing a chiropractor for. So, nothing major. This accident occurred in NY which is a no fault state. Am I going to paid any further compensation from the other persons insurance? Does the other persons insurance settle with me? Should I sue? I never been in a collision and i just don't know what to expect.

    submitted by /u/tmf211
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    Gap- Can someone explain this to me?

    Posted: 02 Jan 2020 03:59 PM PST

    This is what the gap insurance that I purchased with a new car recently reads. I'm trying to figure out how this coverage compares to, say, Progressive's "gap" coverage that is much cheaper. I can offer specifics to my car/case, but I'm curious in general about how to understand this and if getting gap at the dealer is...in general...not worth it.

    "Maximum Liability: If the amount financed or lease cap cost exceeds 150% of the lowest of (a) the vehicle purchase price as shown on the Financial Agreement, (b) MSRP, or (c) NADA or equivalent retail book value, the settlement will be reduced in proportion to the amount that exceeds the stated limit of 150%. In no event will this GAP Addendum waive any amount in excess of fifty-thousand dollars ($50,000)."

    As an example, the numbers that apply to me would be: New car had MSRP of 26k, loan is 35k (still owed some on previous car).

    submitted by /u/Tiny-Sundae
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    Auto accident, Tricare, and medical bills

    Posted: 02 Jan 2020 03:34 PM PST

    I was involved in a minor accident a little over a month ago and was seen by my primary care doctor a few days later. I was seen at a military hospital, and Tricare is seeking reimbursement per the Federal Medical Care Recovery Act.

    I've been contacted by the other driver's insurance company, wanting to discuss settlement of an injury claim with them accepting 60% of the blame. (My insurance company says the claim is going to arbitration.) I did not intentionally start a personal injury claim, so is this the result of the medical bill? Their adjustor had initially specified a cash amount as well as their percentage of payment of the medical bills. I was not willing to discuss this yet, I didn't know if speaking about it at the time meant that I agreed with them accepting 60% of the blame and didn't want to screw anything up. I'm not sure if this is something I should discuss with them now, or after the arbitration. The representative at my insurance company couldn't give anything that might be legal advice regarding the claim, which I understand however I'm at a bit of a loss.

    They are also requesting blanket release of all my past, present, or future physical, behavioral, and mental health records. I'm not pursuing a cash settlement, Tricare just wants their reimbursement, and I'm not willing to give up my complete medical privacy. If I provide the records of the visit for which Tricare is seeking reimbursement (only one visit), would this be reasonable?

    eta: This occurred in Washington state.

    submitted by /u/RedMorrigan
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    USPS Rear ended me. Need help filing SF-95.

    Posted: 02 Jan 2020 03:30 PM PST

    Long story short, police determined USPS driver 100% at fault. I have minor damage to my tail light housing, bumper and quarter panel. I filed a claim to my insurance and also told my insurance to "take care of it". They said they filed to USPS but now need me to fill out a Federal Tort claim or SF-95. I later received it in the mail along with a letter. The letter stayed it needed SF-95 completed along with proof of ownership of property, and 2 estimates from a reliable body shop firm. So I got my 2 estimates from two shops. Maaco, and Carl's Body shop.

    As I'm filling out SF-95, I read that you must have a "sum" of total amount in damages or risk getting your case thrown out. Then after that, it says that you're signature will set the final amount of payout for your damages.

    Here's the problem, the letter asks for 2 estimates but the form asks for a set amount. What if the body shop determines there needs to be additional work, am I going to have to pay for that because I set a max amount on the SF-95?

    SF-95 also says that if the insurance has paid for it, to send the receipt to them and put that amount on the form. But the insurance company I'm with, (Progressive) I only have liability. So Progressive isn't going to pay for the damages then sue USPS to get their money back. So I can't do that either.

    So what are my options? Can I just ask the body shop to make a higher fake estimate just in case? And where do I file for diminished value? Who do I call for that?

    For the curious: both shops estimated the repair cost around $1,100.

    submitted by /u/Emmanuel-Gonzalez
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    Auto accident, does reimbursing medical bills mean an injury claim?

    Posted: 02 Jan 2020 03:21 PM PST

    I was involved in a minor accident a little over a month ago and was seen by my primary care doctor a few days later. I was seen at a military hospital, and Tricare is seeking reimbursement per the Federal Medical Care Recovery Act.

    I've been contacted by the other driver's insurance company, wanting to discuss settlement of an injury claim with them accepting 60% of the blame. (My insurance company says the claim is going to arbitration.) Is this injury claim how the medical bills are handled? Their adjustor had initially specified a cash amount as well as their percentage of payment of the medical bills. I was not willing to discuss this yet, I didn't know if speaking about it at the time meant that I agreed with them accepting 60% of the blame and didn't want to screw anything up. I'm not sure if this is something I should discuss with them now, or after the arbitration. The representative at my insurance company couldn't give anything that might be legal advice regarding the claim, which I understand however I'm at a bit of a loss.

    They are also requesting blanket release of all my past, present, or future physical, behavioral, and mental health records. I'm not pursuing a cash settlement, Tricare just wants their reimbursement, and I'm not willing to give up my complete medical privacy. If I provide the records of the visit for which Tricare is seeking reimbursement (only one visit), would this be reasonable?

    submitted by /u/AnonySquirrelMouse
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    AAA Claims - Taking Car before paying

    Posted: 02 Jan 2020 02:33 PM PST

    Hey guys. First time reddit user. So, Back in October, someone wrecked into my car and the claim has YET to be settled. We are finally entering the final steps of the process and they are coming to take the my car that was in the wreck. They are taking it before they pay me my settlement. This seems strange from what I have heard other insurance companies do. Is this normal?

    submitted by /u/SirCharles1719
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    Why do I have to pay A deductible if I got hit?

    Posted: 02 Jan 2020 02:28 PM PST

    Earlier today I got hit in my Mazda Miata. Anyone would be able to tell it was his fault judging by where the damage is on his car and mine. We exchanged insurance information but the cops weren't called since it wasn't a major accident. No airbags went off and both cars could still drive. I had someone in the car with me that also thinks it was the other guys fault. I just made a claim and they said I have to pay a $500 deductible to the repair facility. I'm just wondering why I'd have to pay a deductible if it wasn't my fault at all. Thanks

    submitted by /u/rwhite02
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    PIP Claim or work health insurance?

    Posted: 02 Jan 2020 01:56 PM PST

    I have asked this before but did not get much insight so trying again. I was involved in an at-fault accident in Washington state (in Spokane, WA if that matters).

    I have minor backache/neck pain that I would like to get checked out. I don't anticipate anything major (hopefully) but I do want to get it checked out. I'm debating whether I should file PIP (that allows me to claim up to $10,000 from my insurance) or just go for physio using my health insurance (have to pay out of pocket until I hit my deductible).

    What are your thoughts? Does it make sense to file for PIP and risk increasing my car insurance premiums significantly given that I'll probably only go for a few physiotheraphy/chiropractor appoinments and not really use up the whole 10,000.

    More info - I was at-fault and need to file an insurance claim for my own car regardless. The damage was around $5000 to my car. Almost 0 damage to the other car.

    Thanks!

    submitted by /u/lifeisandroid
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    UHC and CPT add-on codes

    Posted: 02 Jan 2020 10:02 AM PST

    I have a United Healthcare plan with fairly good out-of-network benefits, and I see a psychiatrist who is out of network. I pay out of pocket and at the end of each month I get an invoice for the weekly sessions. There are two line items for each weekly session, 99213 (E/M) and 90836 (psychotherapy). Based on my plan documents, I think this is pretty firmly covered.

    When I submitted the claim online, it was "partially denied" - all of the 99213 entries paid out, but none of the 90836. When I called UHC and asked, they said that each of these codes is supposed to represent a separate 45-minute procedure and prior authorization would have been needed for a 90-minute appointment. However, the actual appointment is only 45 minutes long.

    When I asked my doctor, I was told that the 90836 is a CPT "add-on code" and needs to be indicated as such when making the claim. However, there's no way to enter add-on codes on the UHC online claim form, and their paper claim form is so complex that I can't figure out exactly what to write on it. I made my best effort (example form I found online modified with where I wrote the add-on code in blue) and sent it in about 3 weeks ago, but I'm still waiting for it to be processed and have no idea i I did this correctly.

    Mt doctor advised me to fill out only the identifying information portion of the claim form (name, address, policy number, etc) and then attach the invoice, but I'm concerned that they will see that the two codes are entered as separate line items with no indication that one of them is an add-on code.

    TL;DR-- How to correctly enter add-on codes for an out-of-network UHC claim, and how to correctly revise the previous claims which were partially denied?

    submitted by /u/ilikecameras1010
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