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    Tuesday, January 7, 2020

    Hospital insurance won't cover hospital fees. Yay. Insurance

    Hospital insurance won't cover hospital fees. Yay. Insurance


    Hospital insurance won't cover hospital fees. Yay.

    Posted: 06 Jan 2020 07:34 PM PST

    My husband needs a surgery (two, actually). It isn't life threatening, but it also is basically ruining our lives.

    Anyway.

    I found out that for outpatient surgery, the insurance will cover $1250 for the surgeon's fees, $500 for the facility fee, and $300 for anesthesia. Then, I called the doctor's scheduler who said the surgeries will cost $3,000. That, he said, is just for the surgeon, and we'll need to reach out to the hospital for the other figures. I asked him what the cash price would be on that, and he said $1200. Joyous news! Surgeon fees fully covered! I could pay out of pocket, and get reimbursed fully. I was happy for about 10 minutes.

    Next I called the hospital to ask about the fees. The incredibly unfriendly woman quoted me $7,000 for the facility (FOR ONE HOUR), and "about another $1,000" for anesthesia. No cash price.

    So, to clarify, the insurance we pay an extra $360 a month for, will cover the surgeon fees if I pay them out of pocket first, and then they'll cover $800 of the remaining $8,000- leaving us with a bill for $7,200.

    Joy is gone now.

    Called the doctor's office back, and found out that they can actually do it in the office, and all in cash price would then be a total of.... $1,400 bucks. The hospital insurance won't cover that.

    So having insurance is actually costing us more money. It's literally cheaper for us to not use it. What a joke.

    submitted by /u/Vmizzle
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    New insurance company just sent us a letter to replace our entire roof and I cannot afford to do it. What are my options?

    Posted: 06 Jan 2020 04:41 PM PST

    We closed on our first house last month and our insurance company sent someone to look at the house and he said the entire roof must be replaced because we are missing a few shingles. The roof is 9 years old and there are no leaks and we plan on getting shingles fixed this week. We cannot afford to replace entire roof. Can we switch insurance companies and get our money back from the currant company? We had to pay 1 year up front as part of the closing requirements. Any help please!

    submitted by /u/PRIVATE_THROW_AWAY1_
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    Turned 26 in November 2019, mom insisted I could stay on her insurance by turning in incapacitated form due to a pre-existing medical condition but that was denied, what can I do?

    Posted: 06 Jan 2020 09:11 PM PST

    Hello!

    I'm currently not covered by any insurance as of right now due to my mom being somewhat incompetent.

    Anyways, to make a long story short, I didn't have coverage at the end of the calendar year of 2019. What can I do? I'm really frustrated with my mom because I was going to join my job's health insurance plan during open enrollment, but I trusted my mom's judgement like an idiot. I've been reading in some places that I have 60 days after my birthday to sign up for insurance and in other places I had until 12/31/19. Any help would be appreciated. Thank you!

    submitted by /u/jjchantel
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    [RI] Recon company sent me $25,000 bill for work I never approved to be done. What can I do?

    Posted: 06 Jan 2020 05:53 PM PST

    Had a sewage backup at my property in mid 2019. I know that I have been dealing with a bad recon company but I had a contract for them to do the work so I had no way out of it. Found that out a few months into the issue.

    All along I have been saying how I want to keep all work completed within budget of only what Insurance is paying for, knowing they were going to try to come after me for the total. They had quoted $42,000 worth of work up front but Insurance only ever got up to as high as $30,000(after deductible & depreciation). I have never seen that quote and only my insurance company has received it supposedly way back.

    I specifically delayed months until Insurance agreed to pay as much as they did, but it looks like there is still another $25,000 the company expects.

    I plan to ask them for an itemized list tomorrow, but want to find out how I can better protect myself. I believe they are going to say all the labor and work they did is totalling near $42,000, and I have a contract that I will pay anything Insurance has not.

    My thing is that I have been adamant not to do anything that would cost more than insurance would be paying for.

    There is still a bit more work left to be done, as we are waiting on products to arrive and to finish off two more rooms.

    I have never seen a quote from the company or even a statement until just now, and it says I am over 90 days past due.

    What can I do to protect myself? I am sure they know loopholes in the law that is going to protect them, even though I never agreed to most of the work they planned to do.

    submitted by /u/zWeApOnz
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    Car Accident but no report

    Posted: 07 Jan 2020 12:41 AM PST

    Girlfriend rear ended another person. There was very minimal damage (scratches) on her car, and the other person had a small dent; so small you'd really have to look to see it. She apologized and they insisted that she had drank alcohol, but she did not touch any alcohol. She said she'd call the police but they told her not to multiple times and stated that they'd just take $350. They kept yelling at her as if she was drunk for some reason and to give them money. She stated she did not have $350 on the spot so they eventually settled on $200. They have each other's license plates and ID's but no other information. Should we be worried that the people may file any claims later?

    submitted by /u/Pylux
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    The hospital charged $3k for a nursery we didn't use.

    Posted: 06 Jan 2020 06:42 PM PST

    Our baby left our room once and that was for her hearing test. I'm absolutely floored that they charged us for a nursery we never used. How do I go about fighting it?

    submitted by /u/clearcasemoisture
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    PNC

    Posted: 07 Jan 2020 03:41 AM PST

    I have a buddy that's interested in purchasing a PNC book particularly from a newbie or someone with a small book. How does one go about searching for anyone selling there book?

    submitted by /u/Time2getcereal
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    ER Bill - total charge of $3,000 and I had to pay $2,000 up front?

    Posted: 06 Jan 2020 09:08 AM PST

    Sitting in the hospital bed, the registration lady said I owe $2,000 right there. Looking at the paperwork, this is a preliminary bill until the insurance/hospital looks at it and revised it? I was honestly shocked, my past bills have never been this high. The doctor didn't even do anything besides look in the my ears, I wasn't given anything. He just said I had bad vertigo and left.

    Am I going to get money back or did I really just burn $2,000.

    submitted by /u/ml-the-one
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    Geico in CA has only $100K as the maximum coverage for Property Damage Liability?

    Posted: 06 Jan 2020 11:02 PM PST

    My limits for Bodily Injury Liability is $1M/$M. But Property Damage Liability is only $100K. There's no more option above that $100K.

    Anyway I have an umbrella of addition $1M on top of this insurance, but looks like $100K limit seems too low these days.

    Is this Geico in CA's limitation or just my problem?

    submitted by /u/dexdump
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    Bumped into back of a semi. My car took all the damage and police weren't called - What are my options?

    Posted: 06 Jan 2020 03:40 PM PST

    A few weeks ago I was involved in a fender bender during bumper-to-bumper traffic. A semi was merging (left) into the middle lane at the same time I was merging (right). I gave a little gas and accidentally ran into the back of the semi.

    The truck and driver were totally fine but the front passenger-side of my car was crushed. Since there was no damage to his truck he offered to continue along without getting the police involved since I took all the damage and was clearly at fault, to which I agreed.

    The car still runs fine; the airbags didn't deploy and there doesn't appear to be any damage to the engine. I haven't gotten body repair estimates yet but I'm guessing it'll easily exceed $5,000.

    This is my first time dealing with insurance so I'm wondering:

    1. What's the best way to claim this incident with my insurance?
    2. Is it possible to "just talk" to my insurance without filing a claim, just to discuss options and see what the impact on my premiums might be?
    submitted by /u/myfault1920
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    Minor Fender Bender

    Posted: 06 Jan 2020 07:33 PM PST

    I recently got into a minor fender bender while trying to park my car in the parking lot. There was little damage on both vehicles and we decided to settle the cost of repairs without involving our insurance companies as it is less costly. The person who I crashed has got back to me saying it would cost $600 to repaint the scratches on his rear bumper. I don't think the repairs would be that expensive, I want to know if this price of repainting is normal or if he's simply overcharging me etc.

    This is a image of their car: 2017 Hyundai Veloster.

    submitted by /u/anneriea
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    How soon should you let your insurance company know you're switching carriers?

    Posted: 06 Jan 2020 05:32 PM PST

    Will your terminating carrier fight your corner if you're in an accident during the last days of your policy and they know you're switching?

    submitted by /u/plawwell
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    Insurance cost on a 1987 Porsche 924

    Posted: 06 Jan 2020 11:23 PM PST

    I wanted to know if anyone would happen to know at least an estimate of how much car insurance would be for a used 1987 Porsche 924 that has a clean title and has 134,000 miles on it some more background info is that the car is in Utah and it's a coupe so any help would be appreciated thanks also this is for a teenage driver

    submitted by /u/JesusHernandez28
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    Musical Instruments insured w/ homeowners policy question

    Posted: 06 Jan 2020 10:31 PM PST

    Hi,

    I have a nice musical instrument collection I have insured for a specific amount on my homeowners policy. Do I need to get them appraised to be sure I'm covered?

    submitted by /u/terriblespeller
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    TX auto insurance - both PIP and Med Pay?

    Posted: 06 Jan 2020 10:10 PM PST

    I live in Texas and I recently changed my car insurance (USAA) to include both Personal Injury Protection (PIP) and Medical Payments (Med Pay). I previously had PIP but not Med Pay. The USAA website let me make this change just fine. However, while looking up information about PIP and Med Pay, I found several websites (nearly all of them belonging to Texas attorneys) that claim that, in Texas, you can only have PIP or Med Pay but not both. I was unable to find any Texas state websites or laws to back up these claims. I would like to keep both but am now paranoid that I'm doing something illegal. Does anyone know for sure whether Texas allows you to have both PIP and Med Pay for auto insurance? Thanks in advance! References to state websites or laws would be much appreciated.

    submitted by /u/zero_gravity94
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    Not at fault claim, GEICO unwilling to cover total mechanical expense

    Posted: 06 Jan 2020 08:17 PM PST

    I was rear-ended a few weeks ago by an individual who has GEICO as an insurance company. The accident was minor, probably 15mph or so and cause ~$2k in damages. The police came, a report was filed and the individual was cited/deemed at fault. When I filed the claim, I was told I could visit one of their Direct Repair Program (DRP) shops or one of my own. During that conversation, I did not receive a disclosure there were limitations to expenses with the shop I choose.

    Overall the process has been relatively painless until today when I received a call from the dealership about a variance in the mechanical rate they charge and what GEICO is willing to cover. From my understanding, Honda requires a pre and post scan assessment when an accident occurs and the certified dealership charges $120/hr. The body shop informed GEICO, who agreed to the work but decided based on average rates in my area, that this was too high and they're only willing to cover $106/hr which leaves me to cover the difference. I have escalated the issue to the supervisor of the adjuster who stated they cannot budge on the amount as it's an "agreed upon rate". Furthermore, when speaking with the dealership, they stated only GIECO and one other company in the area are unwilling to meet this rate with GEICO being the lowest of the two. We're talking minimal damage to the bank account here, however the fact remains that I'm left not only inconvenienced from the accident, but also had to come out of pocket for something that should not have happened if their customer had been paying attention!

    Without filing a claim with my own insurance company, what course of action (if any) do I have?

    I have held integrity throughout this entire process by not running GEICO through the medical combine by racking up unnecessary medical expenses. I just want what's rightfully mine which I see as inconvenience of time, diminished value in the vehicle due to the accident and expenses I should not have to cover.

    submitted by /u/pho-natic
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    Is insurance only via employer?

    Posted: 06 Jan 2020 08:07 PM PST

    I am a student and I developed this awful condition called pudendal neuralgia due to sexual assault. I only have medi-cal but having medi-cal doesn't help seeing my pelvic physical therapist (which is super expensive) and also I can't even see a pain management doctor whenever I desperately need to for procedures.

    My question is, can I get a PPO insurance that most doctor offices accept without being employed? I had to take a break from nursing school due to this condition and not all doctors know how to treat it. I am so frustrated and suicidal due to pain and I am just so frustrated with insurance!! It makes me just want to give up on myself.

    submitted by /u/psoass
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    Equipment & "Forced Entry" Claims

    Posted: 06 Jan 2020 11:01 AM PST

    Hello - I've had my Camera stolen from my car a few months ago, and I'm looking to file a claim now for said camera. However, there is a "forced entry" clause in the policy which states that I need proof of forced entry, but I believe the theft was committed via Keyless Hijacking as my car was equipped with this system and has been locked with all windows shut at the time. Is there any way I can refute this or prove forced entry?

    (Located in Canada, equipment is leased with the insurance being provided by the leasing company)

    submitted by /u/drain-angel
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    Medical Insurance Denial - Provider states that they never recieved denial letter, insurance states they "always" send it

    Posted: 06 Jan 2020 05:48 PM PST

    Hi everyone. Thanks in advance for any help you can provide.

    So on 11/5 I fractured my foot and recieved an orthopedic walking boot from an in-network provider. The provider submitted a claim for the boot with a diagnosis code of foot fracture.

    My first EOB started that the provider's name was unknown and they wouldn't be able to process the claim without it. I provided the name (which was the same as the provider who submitted the claim and the provider is the only one in the practice) and they processed it. The processed claim was denied on the basis that the boot with the diagnosis code meant that the boot "not medically necessary,"

    I called them multiple times, spoke with the provider's insurance person, posted on my Facebook for advice, spoke with my distant cousin who used to be an insurance person and these are the responses I've gotten:

    • (insurance "personal guide") we still don't know what the provider's name is
    • (insurance "personal guide") you could've just bought the boot on amazon or you could've just stayed home instead of walking on your foot
    • (insurance "personal guide") you (as in me personally) have to submit a letter of medical necessity (as to what sort of information that I could provide as I'm not a doctor, they wouldn't say)
    • (distant cousin) you shouldn't be dealing with any of this, your provider should submit the letter of medical necessity and if they're in-network then you shouldn't be having to deal with denials or the insurance company refusing to pay for a treatment ordered by the in-network doctor. She then told me to go see the provider myself, so I went in-person to do so
    • (provider, when I brought the denial letter to them) we never recieved this letter and your insurance company is just trying not to pay
    • at this point, I went to the parking lot and called the insurance company
    • (insurance "personal guide") we always send them the same copy of the letter we send you (me: well why didn't they get it like I did) maybe they have a PO box and they don't check it every day also btw your claim was denied because this diagnosis code "proves that the boot was medically unnecessary"
    • I went back inside to ask them about their PO box and to let them know what the insurance company said
    • (provider) we check our PO box twice a day and we haven't gotten anything regarding this particular claim. In fact, we got information about subsequent claims (for follow up visits about my foot) but nothing about this particular claim
    • I went back to the parking lot to call the insurance
    • (insurance "personal guide") we always send out the letters (me: why didn't they get it, they've checked their PO box and they have gotten subsequent claim information but nothing about this one) well maybe it got lost in the mail (me: eye roll hard)
    • Then I started questioning them about what information they could see about the claim being denied
    • (insurance "personal guide") I see that the provider sent in an updated claim on january 2nd with more information and that it was denied because it was a duplicate
    • I went back into the provider's office (I've been in the parking lot now for 3 hrs) and they said they were closed on Jan 2nd and didn't send in any sort of corrected claim

    So I'm at a loss. Someone is lying to me I think and I don't know how I can fix this. The provider's office says they'll sort it out but this is stressing me out majorly. Honestly I cried after the personal guide told me I should've stayed home or bought the boot on amazon instead of getting it from the doctor. It's not even that the money would be that impossible to cover (it is over $700 though). I just don't feel like I can even go to the doctor for legitimate issues. I've had a ringing in my ear for a while now but I don't feel like I'm able to go to the doctor without it being denied (this isn't the only claim this month they've denied for being "not medically necessary"). I called the insurance today to tell them about the ear ringing issue and ask what I'm supposed to do about it because seems backwards to have an issue, go to the doctor, get diagnosed, and then have go argue about whether I was right to seek treatment for an issue. So I figured I'd go to them first and ask what I'm allowed to be treated for. They transferred me to a nurse who stated that I should go to an ENT specialist and that I needed to get preapproval for all procedures and tests they do (this is contrary to the paperwork I recieved that stated that only certain classes of tests and procedures required preapproval). Of course I'm not going to not allow the doctor to even touch me in the future without preapproval but for now I'm still having to deal with nearly $1500 of denied claims (the $700 for the boot and more for an unrelated issue that I haven't even begun to start fighting with them about).

    So does anyone have perspective on this? Tips on what to do next?

    One thing I'd like to do is complain to someone about them though I'm not sure who. I've taken all their surveys after the calls and expressed my distaste for how this process has proceeded. I'm also planning to find out who my employer insurance rep is and also complain to them. I also know I can somehow complain to the state insurance board? Anyone and everyone I can complain to, I'd like to. I started recording all my conversations with them after the amazon comments.

    Thanks so much for reading this far as well!

    submitted by /u/Magpie2018
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    Do I have to report my income change to Medi-Cal?

    Posted: 06 Jan 2020 05:17 PM PST

    So my income changed, from $0 to 380$ and I was wondering if I need to report it bc since it's lower than the household limit of one person? I also receive Cal-fresh benefits too

    submitted by /u/cupid31
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    Car Insurance Claim Question

    Posted: 06 Jan 2020 04:55 PM PST

    So, I just got hit by a semi that didn't take a turn wide enough (I was in inside turn lane and he was in outside turn lane). His trailer scraped the front of my pickup, my brush guard took almost all of the real damage.

    The responding officer said she couldn't determine fault because she couldn't know if I was behind the stop bar (I stopped at the yellow light about to go red and he continued thru and his trailer came into my lane).

    I have Progressive Auto Insurance.

    Repairs would include a new brush guard, mirror, and replacing and/or repainting fender (might even buff out). Not really too much.

    Am I better not claiming it on my insurance? My understanding is that since there was nobody found at fault that my insurance would have to fix my truck which probably wouldn't meet my deductable anyway.

    Any advice is appreciated, thanks.

    submitted by /u/NachoGrande
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    Is small claims court practical for my car's DOV case?

    Posted: 06 Jan 2020 04:33 PM PST

    I've been working with Esurance in Washington State for about a year now, specifically regarding the DOV of my car after an accident by their insured. Basically, I am continuously being offered low values for my DOV, compared to what I have been appraised and estimated for what my DOV should be for my vehicle.

    To give an idea, my car is a 2018 Civic Si, purchased for just under $28k. I had the car for 3 months, 6k miles, when the other driver collided into me, causing over $14k repairs. After repairs (which were satisfactory), I started to work on the DOV aspect of this claim to finish everything regarding this case.

    I was initially offered a DOV of $1k, then bumped up to $2k after I had a professional appraiser give me a value of $7800 of a DOV for my car. I then did my own work and went out to have my car appraised via a Kelly Blue Book certified dealership, to a value of about $17k. I compared that value to cars of the same trim and mileage, but with no accidents on their titles, of which the lowest price of those vehicles I found was over $4500 more in value than my car is (i.e. $22500 is the lowest valued car of those that I found).

    I brought this to the insurance company, of which they said that this won't help, but they will increase the DOV to $3800. But this time, they included the fact that I was considered 30% at fault during the accident (since both insurance companies nitpicked my dash cam footage and deduced this share of fault, despite the cop at the scene placing fault onto the other driver). So because of this, Esurance would give me about $2700 (70% of the $3800). They did not mention they would give me 70% of the DOV in the last two offers, but this time they did.

    They requested for me to provide evidence (e.g. screenshots of dealer values, etc.) of cars to prove what my DOV should be worth. And that is exactly what I did. But once I did that, they basically just said "nope, this doesn't help your case. But here's a new value". There has been no backing as to how they obtained these previous DOV, and if they did have evidence backing these offers up, they have not showed it to me.

    So here I am now, wondering if small claims court may be a practical route for me to take in order for me to get a fair/reasonable DOV back on my car. I am in no immediate rush for being reimbursed on my DOV, so I don't mind waiting for court things to take place. I just want a fair DOV, since I know I lost quite a chunk out of my car's value when it was so new.

    I have read that WA's small claims court is limited to $5000. I would consider just going for this amount as the amount Esurance would compensate to me for my DOV. From the past few months, I've accumulated what I consider as evidence/proof/hard numbers as to why my DOV should be at least $5000, namely the appraisal of my car vs other cars on sale, as well as the professional appraisal of DOV being done on my car as well. This, versus the insurance not providing me any proof to the values they get for their offers, makes me think that it isn't unreasonable to try small claims court for this case. Are there any thoughts you guys might have on this?

    TL;DR: Insurance company that I am working with is low balling me for DOV after an accident costing $14k on my $28k vehicle (TOL was 3 months/6k miles into owning the car brand new). Offers were $1k, then $2k, then $2.7k to be compensated to me. I think it is still an unfair DOV, given the severity of damages and the car being so new, so I am considering small claims court to get $5000 to be compensated (which is not quite up to what the value should be, but still better than the lower offers). Thoughts?

    submitted by /u/KevroniCoal
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    Accident insurance for roller derby.

    Posted: 06 Jan 2020 10:32 AM PST

    So my SO participates in roller derby and is required by the derby organization to purchase accident insurance in case she gets injured. The language of which is a bit unclear and I wanted to see if anyone else here has dealt with this.

    She has her own primary health insurance with BCBS with ~$6000 deductible. The accident insurance says.

    $2,500 deductible for skaters with primary insurance

    $7,500 deductible for skaters without primary insurance

    $10,000 maximum

    Does anyone know if the money received from this policy could be used to satisfy her primary insurance deductible? I'm guessing that the policy covers up to $10k in injuries, and for $75/year that seems reasonable. The provider is WFTDA and we are in Texas. There just isn't a lot of documentation provided before purchasing the policy with regards to what it covers.

    submitted by /u/Inkling2424
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    Auto Insurance Question

    Posted: 06 Jan 2020 03:42 PM PST

    Hi, I have Mercury insurance and ran over a median. Unfortunately, there was a big rock and it caused damage to my door. I took it to an independent shop and he said for $1,400 he can get it 90%, for $2,500 he can get it to 100% with a new door frame.

    It's a lease and we may want to buy the car, so I'd rather not have issues with the 90% method. I think it's best to report to insurance with a $500 deductible. Any ideas about how much rates would go up? I'm also assuming that the insurance price would be higher. Thanks!

    submitted by /u/SweepTheLeg_
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    Discrepancies Between Estimates for Car Insurance

    Posted: 06 Jan 2020 02:59 PM PST

    I was involved in a wreck shortly before Christmas that left my car, a 2012 Honda Accord, with a hefty amount of damage. We've since had repair estimates done by an insurance adjuster that visited us, a Honda Certified body shop in town, and now a partner shop. As per the initial adjuster and Honda Certified body shop, the car has frame damage done to the front of the car as well as slew of other repairs, including the replacement of the radiator, condenser, hood, seatbelt assemblies, and plenty more. The issue began when we received the estimate from the partner shop that currently has possession of the car. The estimate they provided either contradicts or leaves off items included by one or both of the other estimates we've received. For context, the preliminary estimate put all surface level damage of the car at around $4900, leaving off the cost of frame repair, and the Honda certified shop put it just under $6500 with all aftermarket parts and not including frame repair. The partner shop's estimate put the repair cost at $5400, but this does not include the issues I've mentioned and will be detailing next.

    For example, both other estimates include emblems, trim molding, and a few other repairs in the cost for the grille of the car, but the partner shop has entirely neglected to put these other items on their estimate. So, they're either not going to include the full grille restoration in their work, or have willingly left it off of the estimate. This is the most obvious example of leaving things off, but can also be seen in condenser repairs, which they will not be doing.

    Additionally, they've failed to put any mention of repairing the frame that both other estimates deemed necessary and have neglected to factor in costs of engine repair for the affected area. Needless to say, I'm a little puzzled at the fact that this car has not been totaled, and even more so that the fact that this Honda certified, insurance company partnered shop seems to be neglecting some of the most expensive repairs needed on the car, as well as additional repairs that would still tack on more money to the price tag.

    I'm seeking advice on what to do in this situation, if I have any options I can pursue to confirm or disprove my concerns, or am I simply helpless here as the shop is partnered with my insurance company and guaranteed the work. Any ideas?

    TL;DR: Crashed Honda has received three estimates, the final being from the body shop our insurance guarantees the work to. Their estimate directly contradicts the preliminary estimate and an estimate from a Honda certified body shop, consequently not totaling the car but also leaving off repair work. What do?

    submitted by /u/carinsurancebad
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