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    Wednesday, June 10, 2020

    Insurance claim denial. Need help please! Insurance

    Insurance claim denial. Need help please! Insurance


    Insurance claim denial. Need help please!

    Posted: 09 Jun 2020 02:31 PM PDT

    Looking for advice. Last month I had a fire where my rental property burned down. Initially when I purchased a duplex I had lived on one side and rented the other. I had recently moved out into a new home. And kept the same insurance policy that I had when I bought the home not thinking that I needed to be updated (it was a homeowners policy). The insurance recently denied the claim stating that it was a residency issue. I have worked with both A private adjuster as well as a lawyer. And the end result is still the claim was denied.

    Currently I have a burnt home that's not livable and will cost between 100 and 200,000 to fix it. Any advice or do I have to foreclose or file for bankruptcy?

    This is in New York State

    submitted by /u/dbucklaew
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    If there is a two vehicle accident, and both parties have the same insurance company, how does the insurance company fight each other in court?

    Posted: 09 Jun 2020 10:44 PM PDT

    [New York] but asking for USA in general

    submitted by /u/Zoydberg_
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    Declaring future modifications... (UK)

    Posted: 10 Jun 2020 05:07 AM PDT

    If I buy a car with no modifications, but with a view to modifying in the future. Can I declare the modifications in advance of having them fitted?

    I know this will probably increase my premium, but I would rather declare them all straight away rather than having to amend my policy each and every time I fit a mod. (I'm based in the UK).

    submitted by /u/sammd3
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    Question about windshield damage

    Posted: 10 Jun 2020 04:52 AM PDT

    I got a damaged windshield sometime last year, and I filed a claim almost immediately. It was a small chip about the size of a dime, so GEICO sent out a safelite tech who "repaired" the windshield.

    A few days pass, and the crack gets even larger, and eventually spreads to the point where I can no longer ignore it.

    I opened a new claim, but never finished it because I realized my deductible was $1000 for glass.

    I adjusted my policy to have a lower deductible (this was sometime around November 2019). Looking at my claims page, they both state that they're closed, even though I never went through with arranging a glass repair or replace the second time.

    Will I have to pay out of pocket at this point? Or is it allowed to open a new claim with my lower deductible?

    submitted by /u/Kuja27
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    Just got married, does my name on my insurance card have to match?

    Posted: 10 Jun 2020 04:16 AM PDT

    So I got married a few weeks ago and I got my wife on my insurance. Her last name is still her maiden name since we are still going through the process of changing it however on her card it's my last name. Will this cause any issues? I work for the state so our open enrollment was in June so my benefits person said it'd be fine if it was my last name. She's going through something right now with the doctor so I'm really worried it's going to get denied or something. I'm in Wisconsin by the way

    submitted by /u/pr8457
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    Need JUST personal liability for an apartment. Not renters', JUST liability. Does this exist?

    Posted: 09 Jun 2020 04:40 PM PDT

    All of the websites say "But you MUST carry more than that or a disaster will happen!" The disaster is that after paying for one more expense, I won't have any money left over to buy groceries. Does anyone even sell JUST personal liability insurance? Is it legal in Massachusetts? Are there any companies who won't give me the upsell runaround?

    submitted by /u/redcolumbine
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    Regarding Geico's rental reimbursement

    Posted: 09 Jun 2020 12:32 PM PDT

    California

    So I was rear ended around last month. I filed a claim through Geico and they said they would give me a rental while my car was being repaired. Claims Department agent told me it would be covered. So I got my rental and all seems well.

    Today I get a letter from them saying that they would not be covering my rental past the 5th since the repair shop said the repairs would be done in an estimated 8 days from the 27th of May.

    So I have a couple questions and would like advice on how to approach Geico about this.

    1. Why didn't they send me the letter before the 5th so I could be notified that I would be paying a few days out of pocket before hand? Or I could at least receive a heads up so I could return the rental back sooner if I decided to?
    2. Because they notified me late and the agent never mentioned anything about this specific stipulation about the rental not being covered, would I be able to get them to extend their coverage of the rental?
    3. If I have a case, how do I go about approaching Geico about this? How would I get them toconcede?

    The letter does mention that "If you intend to keep the rental beyond 06/05/2020 you will need to contact your rental car company to make other arrangements." But I was just notified and if I had been notified beforehand, I would've had the ability to return the rental before then. The language also implies that the date is before that date yet the letter states it was sent today.

    submitted by /u/Themostepicguru
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    LONG POST AHEAD: can someone explain this insurance to me please

    Posted: 09 Jun 2020 09:14 PM PDT

    Deductible

    The amount of covered expenses that the insured must pay before a plan or insurance contract starts to pay.

    $1,000 $2,500 $5,000 $10,000 $12,500Deductible Type Per Cause Per TermCoinsurance (per term) 60/40Coinsurance Out-of-Pocket Maximum (per term) $10,000Days of CoverageStartand Limitations📷 Brochure: Plan Benefits, Exclusions, Limitations

    Standard Benefits

    UnderwriterGolden Rule Insurance CompanyLifetime Maximum$250,000 per covered person

    Physician Care Benefits (Illness & Injury)

    Office Visits (no primary care physician/specialist referrals required)Office Visit, History, and Exam onlyYou pay: 40% coinsurance after deductible

    Prescription Drug Benefits

    Prescription DrugsNot covered. Discount Card - Average savings of 20-25%. Discounts vary by pharmacy, geographic area and drug.

    Outpatient Expense Benefits

    X-ray and LabYou pay: 40% coinsurance after deductibleEmergency Room Fees - IllnessYou pay: $250 copay, then 40% coinsurance after deductibleEmergency Room Fees - InjuryYou pay: $250 copay, then 40% coinsurance after deductibleMental and Nervous Disorders (including substance abuse)Not covered

    Inpatient Expense Benefits

    Room and Board, Intensive Care Unit, Operating Room, Recovery Room, Prescription Drugs, Physician Visit, & Professional Fees of Doctors, Surgeons, NursesYou pay: 40% coinsurance after deductible

    Additional Information

    Application Fee$20 (one-time, non-refundable)

    Additional Benefits

    Supplemental Accident Benefit None ($0.00) $1,000 ($17.70) $2,500 ($22.20) $5,000 ($27.60) $10,000 ($33.00) $12,500 ($36.00)

    Total

    Estimated Monthly Premium$143.10

    This coverage is not required to comply with certain federal market requirements for health insurance, principally those contained in the Affordable Care Act. Be sure to check your certificate carefully to make sure you are aware of any exclusions or limitations regarding coverage of preexisting conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). Your certificate might also have lifetime and/or annual dollar limits on health benefits. If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage.

    Expenses for injuries are eligible for coverage as of your plan's effective date; expenses for illnesses are eligible for coverage beginning on the 6th day following the effective date.

    This screen is intended only as general information. It presents only a brief overview of some of the standard in-network benefits of the product(s) shown. Optional benefits may be available for additional premium.

    Before you apply, please use the link(s) provided to download and review the product information for a more complete explanation of benefits, exclusions (including any that may apply to preexisting conditions), limitations, terms under which the product(s) may not be renewed or benefits may be reduced, and any state variations applicable to any of these items.

    Not all plans are a substitute for the minimal essential coverage required by ACA, also known as Affordable Care Act, Patient Protection and Affordable Care Act, Obamacare, health care reform. See product brochure for details.

    You must meet our eligibility requirements in order to become insured, which may include medical underwriting. There is no coverage until we inform you in writing that your application has been processed and approved.

    To be considered for reimbursement, expenses must qualify as "covered expenses" under the policy, and are also subject to all other policy provisions, such as reasonable and customary or eligible expense limits, or whether or not they were medically necessary.

    Estimated Premium shown is based on the information you provided, and is subject to change based on the product(s) you select, optional benefits you select (if any), and other factors. We shall exclusively determine the premium actually required, and the effective date of any coverage issued.

    In several states, Short Term Medical plans are available only to members of the Federation of American Consumers and Travelers (FACT), an independent consumer organization. If you are not already a member of FACT, you must join in order to be eligible for these plans. Through a special agreement between FACT and Golden Rule, you can enroll in the association through Golden Rule. You will fill out the FACT enrollment form on this website prior to making application to Golden Rule for health insurance. For more information on the benefits of FACT membership, visit www.usafact.org/ (no need to enroll directly - Golden Rule will submit your dues to FACT). Estimated Premium does not include the mandatory $4 monthly dues for FACT membership. FACT membership is not required in every state. Please see the product information for details.

    Please note: If you use a provider outside our network for non-emergency care, you pay all charges above the eligible expense. Additionally, non-emergency non-network eligible expenses will be reduced by 25% and are subject to an additional deductible amount equal to the per person deductible with no out-of-pocket maximum.

    submitted by /u/justhelp17
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    Medical Bill yet to be Paid by other Insurance... since 2018

    Posted: 09 Jun 2020 08:04 PM PDT

    Hello everyone, I hope one of you might be able to help me with my situation.

    On February 15, 2018 I was in a car crash on my way to class (20 at the time in college). I was in stop and go traffic on i66 in Northern Virginia near Haymarket. A driver in the HOV lane fell asleep, crashed into my car at 70 mph, which caused my car to flip and be totaled.

    I was taken to the INOVA Fair Oaks Hospital in an ambulance and luckily didn't have any injuries other than some minor scratches and bruising. After talking to my insurance company at the time (SafeCo. We now have Statesfarm because of how poorly they were helping us with this) it seemed that I had nothing to worry about and that all bills should be sent to Geico (the other person's insurance). Surely enough, the bill for my visit to the hospital of $1511.00 arrived and I sent it to the other insurance. The same bill kept arriving to our house for a YEAR so I decided to call Geico to see wtf was happening. The insurance agent at Geico said they were going to make a promise to pay. They would pay the medical bills and include compensation for the injury itself. That was on September 25, 2019 when I last spoke to him. I never saw anymore bills come to my house, but I also never got the compensation.

    On December 2019, my credit score dropped from 789 to 667. I freaked out and went to equifax, experian, creditkarma, etc. to see why this happened. Apparently the collection agency responsible for receiving payment never got their money and the remaining balance of $1016 was under my name as a delinquency. I filed a dispute with both equifax and experian, and they both came back today saying it was correct.

    I am so frustrated, exhausted, and stressed about this whole ordeal and I really want that horrible day to be behind me. But because my credit score is low (758 with equifax but 623 with experian... wtf?!?!!) i'm scared of buying a car for my new job i started yesterday and doing adult stuff. If anyone can help me out, please... give me advice.

    submitted by /u/Kool_Kat_Guy
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    Random question about trees

    Posted: 09 Jun 2020 12:41 PM PDT

    This is pretty random as I do not have a claim and I don't anticipate having one... But we recently had an arborist come out and check out some trees on our property. I wanted to know how healthy they were and if I should start planting a new generation to prep for when the mature trees start dying. We found out that one tree that is very close to three important structures (wood burning furnace, garage, and house) is essentially hollow (guy looked through a knot in the trunk to the center). He recommended it be taken down.

    So my question is this- if it falls on any of the three structures before we have it removed, would insurance deny a claim because we were aware of the problem and let it be? I am thinking of the problem with water leakage... If it's a sudden leak you are generally covered but if you were aware of a slow leak and did nothing it isn't covered.

    Obviously trees are different from water pipes. Essentially I'm just curious about a hypothetical claim.

    ETA- located in Indiana

    submitted by /u/chelreyn
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    Roofing system collapsed with a storm; Question about insurance adjuster/engineer

    Posted: 09 Jun 2020 05:25 AM PDT

    Location: Indiana

    My boyfriend's construction company is rebuilding a roof with all new trusses. A storm hit our area and the truss system collapsed under heavy winds. The insurance adjuster is sending an engineer who wants to see if it was braced according to the truss diagram. However, all of the trusses hadn't been attached yet so only 3 of the 4 main braces were put up.

    He did brace the standing ones with extra bracing that wasn't on the truss diagram but is common in construction. The engineer is going to be checking things out soon and I'm wondering if the lack of 1 brace or the other bracing will be a problem. If there was a deviation from the diagram, could that affect the claim?

    Any help is appreciated!

    submitted by /u/trancelogix
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    Switching careers, don’t know what my insurance options are.

    Posted: 09 Jun 2020 02:21 PM PDT

    So I'm currently a union carpenter in Indiana. Our insurance is pretty good and "free", as long as we are working. We have to get 140/month to qualify for insurance. If we don't meet the required hours, it's $1,050/month out of pocket.

    During this pandemic I came to the realization that I do not want to do this job anymore. My quality of life has decreased drastically since starting this job 2 years ago. I honestly just hate doing it.

    The move I want to make is to work for a small company ran my by friends father in law. Right now they haven't offered insurance because the only other employee is the owner and my friend. My friend is on his wife's insurance. But my wife isn't offered insurance. So I wanted to talk to him about possibly offering me insurance or giving me a stipend to help me pay for my own.

    If he doesn't, what are my options? My wife is currently pregnant with our first kid and we are working on getting on Medicaid, but we will need something for me and for our family in the future. I know people get insurance all the time, I just don't know how it works or where to start looking.

    submitted by /u/buffdaddy77
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    [NOT OP] My car that’s been missing since Katrina was recovered in Minnesota last month and nobody wants it

    Posted: 09 Jun 2020 10:48 AM PDT

    Comp+Coll on Restored Salvage Vehicle ?

    Posted: 09 Jun 2020 04:08 PM PDT

    Hello my fellow insurance people i'm looking at options as the title suggests comp+collision for a salvage car i've already checked out Kemper,Geico and Progressive are there any other choices i should check out ? In Arizona

    submitted by /u/Jeif96
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    Car Insurance Repair Issues (2)

    Posted: 09 Jun 2020 03:40 PM PDT

    https://www.reddit.com/r/Insurance/comments/gzbqfc/car_insurance_repair_issues/ Prior Thread.

    So today the Insurance company basically came back with 5% of the supplement the body shop sent to them. The body shop responded saying this is simply impossible to make work with. The body shop is a dealership of my car manufacturer with on-site shop.

    The preferred insurance provider in area is literally a chop shop with 2 star reviews people saying work done is botched and spending days trying to get car fixed which never happens as they are given run around.

    Insurance is a big one, not some random unknown. So I guess I will have to front payment to current body shop for inspection and then move car to the 'preferred provider'. Or risk hauling car around from one place to another and having insurance company not agree with the shop on pricing.

    Repair car anywhere you want but unless its 'preferred' chances are the insurance wont agree to amount of repairs looks like?

    TX

    submitted by /u/PEROKETANO
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    Can I see a therapist under my parent’s insurance?

    Posted: 09 Jun 2020 03:19 PM PDT

    I currently have Molina and I'm 18. I also live in Federal Way, Washington. I'm not really sure how insurances work.

    Backstory: I used to be in therapy and had medication after persuading my parents for four years. I thought that through out everything, they'd finally understand why I'm going to therapy. But I had to stop because my parents hated me going there. They still thought that going to a therapist = asylum. Also, in my culture, seeking help about mental illness is still a taboo.

    I've been secretly meeting with school counselors since then. Now my college counselor has recommended me to see a therapist who specializes in OCD since she sees my OCD as something that can disrupt my life. She also doesn't specialize in OCD that's why she recommended me to see one.

    Is there anyway for me to seek a therapist without letting my parents know? I really want to get better.

    submitted by /u/chen3837
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    Not sure what to do with car insurance

    Posted: 09 Jun 2020 03:05 PM PDT

    So this is my first car I've ever owned. I'm currently 20 and still only have a provisional license. Is it worth getting the car insured for a year with my provisional license and when I pass change it to the full insurance? I'm really bad with this so not sure what to do

    submitted by /u/RedRaw1999
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    LexisNexis / Credit Report question

    Posted: 09 Jun 2020 03:01 PM PDT

    Hi all! I'm hoping to get some advice here. For security and privacy reasons, I've done a credit freeze at the 3 bureaus and also opted-out from several big data brokers (LexisNexis included). Now I'm wondering if that will cause me a problem...I live in Pennsylvania, and they cannot increase my rate due to something in a credit report (on a renewal only). So my plan was to lift the freeze once every year or two while I shop around. But I heard that LexisNexis is relied on heavily, and I have opted-out of that. What kind of problems, headaches, or punishments is this going to cause me?

    I appreciate anyone's advice!

    submitted by /u/mjdbb1
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    My car is registered in Pennsylvania. What state does my insurance need to be the through?

    Posted: 09 Jun 2020 02:51 PM PDT

    So my car is registered in Pennsylvania. I'm living in Connecticut because of the military. I don't plan on changing my registration. Which state does my insurance need to be through?

    submitted by /u/Banzett
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    Should I change?

    Posted: 09 Jun 2020 02:23 PM PDT

    I have a chance to change careers and work for a Allstate office. I would start as a CSR with little salary and little commission, however the agent will also pay for me to get licensed and will move me to a sales position after three months. The problem I am currently having is that I make 38,000 a year now with a good company that has decent benefits but really cares about it's employees. I am just worried the move is not worth it or will not work out. It is in Alabama.

    submitted by /u/9andunder
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    I got rear ended last week than rear ended someone yesterday. Can i still get insurance money now that my car is totaled?

    Posted: 09 Jun 2020 01:11 PM PDT

    When i originally got rear ended it took off the plastic bumper itself, and bent in the metal itself as well as the spare wear well. As well as pushing me into a another car and slightly damaging the front. (Its a 2008 Saab 9-3 6cyl Turbo)

    submitted by /u/Yowkati3
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    Sideswiped while standing

    Posted: 09 Jun 2020 12:31 PM PDT

    Hi all,

    I am a NY resident and was sideswiped while standing on a 2 way street this past weekend in CT. Though I was not right on the curb, I was pulled over and had my hazards on, and someone pulled up trying to park in front of me, but ended up hitting the front corner of my vehicle, and I have dashcam video of what happened.

    The damage appears to be just minor scrapes, scuffs, etc at the corner of my driver's side front fender where it meets the bumper, and no panels feel loose. The driver immediately said they wanted to deal with it outside of insurance, but I called the police because I wanted a report just in case they renege. (I was rear-ended years ago where the person begged me not to call police and promised to take care of it and later just went back on their word.)

    After exchanging information and talking to both of us and seeing my video, the officer told me, "while they hit you, where you were parked contributed to what happened." I replied telling him other cars passed me by fine without even stopping, and that I have video of those other cars doing so. He then said he thought the damage would only cost a few hundred dollars to fix, and advised us not to go through insurance because our rates would go up. (He also said I'd be better off going to a detailing shop to buff it out instead of an auto body place.)

    I have not yet contacted either of our insurance companies as I am currently in the process of getting estimates for the repairs. I understand that CT is an at-fault state; would I be partially at fault even if I was standing and stationary with my hazards on if I filed a third-party claim on their insurance? If I filed on the other party's insurance, would my rates likely go up? What would you guys suggest I do, try to deal with the party outside of insurance or just file a third-party claim?

    Thanks for any help!

    submitted by /u/md3027
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    Someone crashed through my fence last night - Questions

    Posted: 09 Jun 2020 06:32 AM PDT

    Location: Missouri, US

    I woke up this morning to leave for work at 3am and saw someone had crashed through two sides of my 6' chain link fence damaging several sections (we live on a corner). From the angle of the tire tracks, I was 99% sure it was my neighbors who I already am not a big fan of because they are super sketchy. I even found a taillight cover with the Ford logo stamped on it and a part number but didn't see the car I thought did the damage parked in their driveway. One of them drives a blue Ford SUV.

    I woke up my wife and we called the police to file a police report as well as taking a bunch of pictures. The police said an accident report was filed last night for my address and I could call records to ask about the police report once they opened at 6am - we were asleep and didn't hear it all and no, the police didn't knock on our door, but they did call me and leave a VM at 11:41pm last night.

    I just called records. The police report won't be ready for 5-10 business days but they could give me some basic info: they gave me names of the two owners of the vehicle (my neighbors), a number to contact the husband, and said there is no insurance information because the driver fled the scene. The husband was the witness - so it sounds like someone stole the car and in a panic, drove through my fence. Of course I called the number he gave the police just now and it's been disconnected. I suppose the officer could've taken the number down wrong as well.

    So here I am at this point with some questions and just want to make sure I'm covering all my bases. I was a homeowners insurance property claims adjuster for almost 4 years from 2011-2015 so I'm semi familiar but everything is a bit foggy.

    First off, we have renters insurance. The fence is portable fencing we put up to keep our dogs in when we signed the lease. It is something I will take with me when I leave and is thus, considered personal property. My real concern is subrogation. Typically when subrogation is possible, if there's a known responsible party and a police report on file, the insurance company will pay you everything less your deductible up front, then subrogate against the responsible party to recover your deductible for you. But I'm assuming even though it's his vehicle, my neighbor isn't going to be deemed responsible if someone stole his car and crashed it through my fence, correct?

    Obviously, I need more information and I'll get that today when I go knock on his door after I get off work. Then the next step will most likely be to file a homeowners claim since he probably isn't accepting responsibility. And who knows if going forward with the claim will even be worth it if I have to come out of pocket my $500 deductible. I just want to make sure I'm covering all my bases. Should I speak to my neighbor before filing the insurance claim? Is there anything I'm missing and need to make sure to do? Any advice is much appreciated!

    submitted by /u/KCtitleist11
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    Trimming Auto-Insurance Costs?

    Posted: 09 Jun 2020 12:14 PM PDT

    I'm a full-time graduate student, paying $725 bi-annually in car insurance in Michigan!

    I drive a new 2020 Toyota SUV worth ~$35,000. I already have full medical insurance with low deductible + AAA for car towing, so I suspect some sections of my policy can be cut out or at least reduced. I'll admit I do not fully understand the converge I currently have.

    Can people offer me any advice on what parts of my StateFarm policy I can cut out to reduce costs?

    Current policy includes:

    - Liability ~$100 bi-annually
    Bodily Injury 100,000/300,000
    Property Damage 100,000

    - Personal Injury Protection ~$320 bi-annually
    Coordinated Medical & Work Loss

    - Property Protection ~$10 bi-annually

    - Comprehensive ~$50 bi-annually

    - 500 J Deb Broadened Collision ~$200 bi-annually

    - Emergency Road Service ~$10 bi-annually

    - Uninsured Motor Vehicle ~$10 bi-annually
    Bodily Injury 100,000/300,000

    - Limited Property Damage ~$2 bi-annually

    Whenever I ask my insurance agent, they always answer "You should keep it, better safe than sorry".

    submitted by /u/Highland14
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    Employer medical insurance when starting new job

    Posted: 09 Jun 2020 12:06 PM PDT

    I will be transitioning from one job to another and they have informed me it will take 90 days of employment from my start date for my benefits to kick in. I've worked for 3 companies prior to this and have had insurance all on day one with them. Is this normal? Location is NYC area.

    submitted by /u/Chadmerica
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