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    Wednesday, January 27, 2021

    Wait what? Is this how insurance works? Insurance

    Wait what? Is this how insurance works? Insurance


    Wait what? Is this how insurance works?

    Posted: 26 Jan 2021 07:22 PM PST

    Hello everyone,

    I am getting a very specialized foot surgery on February 11th from a doctor in Beverly Hills. I currently have United Health Care Select Plus PPO HDHP CA. The doctor's staff told me they only need me to pay my deductible of 3,000 and my insurance will cover the rest. After speaking with my insurance, they are only covering a certain percentage because this doctor is out of network (duh right?).

    I told this to my doctor's office staff and they said they (being the doctor's office) would not bill me for the remaining amount. In my head, that makes ZERO sense. It feels like a loop hole. I just want to make sure I am not responsible for the remaining amount that the insurance doesn't cover and therefore have crafted this email below to legally protect myself. I do not have any money to cover any extra fees outside of the 3,000, I will be in serious debt if they bill me for 20,000.

    Does anyone have any insight? Is this normal? Why would the doctor ever cover the remaining fees?

    The email draft:

    Dear Dr. XYZ:

    I wanted to thank you for taking me under your care for my feet. Your expertise is greatly respected and I am honored to have you perform my left foot surgery on xx. I also understand, the surgery for my right foot will be scheduled at a later date.

    I have spoken with xx and have gotten clarity on both surgery costs. I wanted to thank XX and your staff for those insights.

    I want to confirm my understanding as such: I will not be held liable for any out of pocket costs to my insurance company or your office once I have paid my $3,000.00 deductible to your office. This includes pre and post office appointments, x-rays, anesthesia, surgery center bills and any follow up bills in regards to both feet.

    Please confirm the above is correct at your earliest convenience.

    Thank you reddit!

    submitted by /u/SmoothieQueen20000
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    Being sued by safeco insurance

    Posted: 27 Jan 2021 12:52 AM PST

    I'm currently being sued for $3800 in car repairs due to an accident where at the time I had no insurance? Is there any next steps I can receive guidance in. The court date is not set until the end of august but is there anyway to have that adjourned at all? I also believe one of the claims was false stated that I "was negligently operated or maintained the vehicle to collide to the insured vehicle" on the road in which caused the accident, which in my case I believe I was not at-fault.

    submitted by /u/Hittworks
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    Independent Insurance Agent is asking for payment before detailed policy information

    Posted: 26 Jan 2021 10:43 AM PST

    Hi,

    In the past, I've always received policy documents before making premium payments. I've shopped around this time for a new home & auto insurance from a new independent agent who works with 200 different insurance company.

    He said he found an auto and home policy, gave me basic rundowns of the policy (like liability amount, etc.). I was happy with the coverage, and wanted to proceed to next steps, He sent me a link to make payments, and said he will release all the documents after payment has been made.

    Is this a normal practice? It's just a little different from what I've been used to. I've always received policy document first, then made payment. The company itself seems legit (tons of good reviews on google. http://www.everstoneinsurance.com/) but not many reviews on facebook/yelp (but still 5 stars)

    Thanks for your inputs.

    submitted by /u/NothingSlight822
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    My car got hit by a bunch of duct work fittings on the highway from a work truck and they say I need to pay my deductible

    Posted: 26 Jan 2021 11:40 PM PST

    I live in Ontario, I was driving behind a work truck and bunch of the sheet metal came flying out and beat up my car pretty good, I got the guys info call the cops did a report call my insurance and they said I need to pay my deductible.

    Is this normal?

    for something 100% out of my control and the other drivers fault, I could understand if it was hail but the weather didn't call for falling sheet metal.

    submitted by /u/NoSexAppealNeil
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    Confused about health insurance (Covered California and Medical)

    Posted: 27 Jan 2021 02:42 AM PST

    In a bit of a dilemma. I'm applying for Covered California, but I couldn't finish the application because they couldn't verify my identity online. I called the representative on the line since it said to call them if you want to upload documents (ID, Birth Certificate, etc.) they said they can't help me since I don't have an application active and that I can only do it by mail or fax since I'm not comfortable doing it in person due to COVID fears.

    They recommended since my income is low (no job, but I get small royalties from Twitch streaming every other month and I have a part-time job coming up) that I apply to Medical instead. I said thank you, they gave me a number to my local county's Medical service and recommended me to call tomorrow. Decided to see options online only to figure out that it's directing me BACK to Covered California's website to file online again which led me back to the identity roadblock, blocking me from proceeding further in the application.

    Before I go through the hoops of phone calls again, I figured I should ask for advice here since this is my first time signing up for health insurance on my own and I'm getting stressed out by it. I'm 28 and past health insurance was through my employer before I got laid off.

    1) Do I bite the bullet and use snail mail to either identify myself or print the 30+ page application to manually sign it?

    2) Are there alternate ways for me to apply for health insurance online without any in-person thing?

    3) I don't want to get penalized for not being on health insurance. I heard California penalizes you. The Open Enrollment Period ends on January 31st. I heard Medical is open all year. Am I screwed if I don't sign up by January 31st?

    submitted by /u/SilverSquare
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    Need to file a claim

    Posted: 27 Jan 2021 01:58 AM PST

    Hello I have a Aaa insurance, comprehensive. I need to file a claim but need it to be not considered a collision. My front bumper got scraped on the side of the road on the street that turns into a sidewalk. The 90 degree angel literally ate/scraped through the corner of my bumper. Any suggestions on how I can file the insurance claim without reporting it as a collision? Any help or advice would appreciated!

    submitted by /u/sassle180
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    Guidewire Question

    Posted: 26 Jan 2021 06:54 PM PST

    Anyone on this board have experience and expertise with Guidewire?

    I have a question regarding task failure alerts.

    submitted by /u/ImpressiveSuspect8
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    Full coverage on a rebuilt title

    Posted: 26 Jan 2021 11:17 PM PST

    Okay so I bought a 2016 bmw with a rebuilt title. I got full coverage which I pay 311$ a month. I can get liability for 100$. I was wondering if its worth it to keep the full coverage, I guess what I'm wondering is if my car was to be totalled or anything like that how much would they actually give me for my car?

    submitted by /u/JUNKINMYTRUMP2020
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    Do you think the Institutes will continue to have virtual exams for designations?

    Posted: 26 Jan 2021 08:44 AM PST

    The virtual exams are fantastic. No need to drive to a prometric center, and no need to meet with people face to face.

    The pandemic isn't going anywhere, and I personally prefer studying and taking the exams from the comfort of my own home.

    submitted by /u/beastofbang
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    Will I only get $3,500?

    Posted: 26 Jan 2021 09:50 PM PST

    My 2007 Toyota Corolla was hit the other night while parked. The other driver left and note and is insured. That's the good part. The bad part is that I think my car is totaled and I will only be offered $3,500 to replace it. This car might have a fair market value of $3500 but it's worth more than that to me. I was hoping to get another 100k miles out of it. I can't buy a car with the same utility for that amount. Especially when you include sales tax. Is there anything I can do get more than fair market value? If I accept a payment for a totaled car what happens to the car? Do they take it?

    I live in CA and have insurance in case it helps.

    submitted by /u/bukowski_knew
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    Crashed into again. Been paid the vehicle weite off fee. Can i hire a car and clain back whilst my injury claim is going through

    Posted: 26 Jan 2021 09:45 PM PST

    I was hit 20th december, whip lash, back is in bits, i already had a broken back

    Anyway, i have been paid out, now i am wondering if i am able to hire a vehicle against their insurance, i did have a courtesy car for the time i was waiting to be paid out for my cat c write off.

    I have to have a medical via online, any ideas about this? I was stationary and was hit from behind at 30mph

    submitted by /u/kopitesubuser
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    Looking for short term health insurance that covers multiple prescriptions.

    Posted: 26 Jan 2021 05:34 PM PST

    My significant other is a full time nursing student and needs to drop down to hourly at her work. This will remove her health insurance benefits. She is looking for short term coverage, approximately 4-6 months, that would cover her prescriptions, along with dental and vision. Any good company or plan recommendations? Thank you in advance.

    submitted by /u/dustyolefart
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    Is it possible to have an auto insurance plan hidden from my parents?

    Posted: 26 Jan 2021 09:07 PM PST

    Currently, I am an 18 year old living in Texas on my parents insurance plan for my car that I currently own, but some time next year I want to buy a motorcycle (with my own money) and I will obviously have to insure it. Since I need to hide the motorcycle from my parents, I was wondering if I would be able to get an insurance plan for the motorcycle on a separate plan while staying on my parents' insurance for my car. I know it'll be a little expensive, but I've thought this over and I really want this. Thanks for any replies!

    submitted by /u/aimonstertruck
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    Expected New Producer Revenue and Sales Goal

    Posted: 26 Jan 2021 02:38 PM PST

    Hey guys,

    I just finished up my first year as a P&C insurance producer and boy what it year it was to get started! Anyways my boss wants to have a meeting with me soon about what my sales goals are for my second year. With this being my second year I really have no idea what this number should be as I didn't really have one to start out with and when i was hired they told me my production wouldn't be reviewed until the end of my third year.

    For reference I have been specializing in Mid Stream Oil & Gas accounts as well as Trucking and generated about $77k in revenue for the agency in my first year. Being a new producer I'm grabbing everything I can though from contractors to monoline property.

    I've seen some stuff online about a 10-12% increase but I think I can go better. Would $100k in revenue be a good number to set?

    submitted by /u/7Vitro
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    *Crosspost* Maxed out on dental insurance

    Posted: 26 Jan 2021 08:03 PM PST

    Auto Insurance claim

    Posted: 26 Jan 2021 04:13 PM PST

    I had a car accident 7 years ago, dropped my car at a Toyota dealership, and they contacted State Farm to get the claim paid, so I only pay my deductible.

    I am currently with American Family insurance and they have the preferred shops list that are pre-approved.
    https://www.amfam.com/claims/car-repair If I choose a shop that's not in the list (e.g. Toyota dealership), then they'll have to review the estimate and photos before reimbursing. Since I wasn't involved in the State Farm claim process, I'm just curious whether the AmFam approach is typical or whether AmFam is pickier. I'm just worried I won't get reimbursed for the repair.

    The Toyota dealership seems to be able to fix my car this week, but the preferred shop isn't available til next week. When I called Toyota, the person who answer my call isn't the person dealing with insurance claim, so they couldn't provide the answer I needed.

    Hopefully, this is the correct place to ask.

    submitted by /u/qponrocks
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    Friend totaled her car with my things in it

    Posted: 26 Jan 2021 07:43 PM PST

    Friend totaled her car with my things in it and now she's in the hostpital. My ID is in her car and I'm flying out to Florida on Saturday. I called the people who have her car impounded and they said I can't get my things out only the owner. But she's in the hostpital!? Can anyone kin to her get my things out ? I'm freaking out!!!

    submitted by /u/Nanbxhd
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    Critical meds are covered by our insurance plan, but the pharmacy is trying to charge me over $1000 per dose. No one can tell me why and I can't switch pharmacies. Help!

    Posted: 26 Jan 2021 07:42 PM PST

    Hey y'all! I apologize if this isn't the right place for this question, but I'm at the end of my rope.

    My son is trans and has been on lupron for a little over a year. It's a hella expensive medication regardless, but initially the insurance + copay assist paid all but a $10 copay. Perfect. Better than I expected. Last year at some point it went from $10 to $100. I don't specifically know what happened, maybe the copay assistance ran out (it pays a total of $1300 per year), but that's still doable for us. But I went to fill it last week and they're telling me my out of pocket is over $1000 per dose. We can't just use another med, but we can't pay for it.

    I'm currently trying to track down wtf is even happening. My calls to insurance all end with them telling me it should be $100 not $1000 and they have no idea why it's doing that. At one point last night, the insurance rep tried a test file claim and initially it gave her the $1000 amount. She couldn't figure out why it would be like that because that's not how my plan is set up, but then when she ran it a "different way" it came back to be the $100. She told me something like they "reclassified" some expensive drugs or something and now people are running into issues. I was supposed to call the pharmacy and "tell them to run the claim properly." I asked if she could give me any instructions as to how to do that and she refused. Did...they do something shady so that the claims would come back funny? Is this a way to con their patients into not refilling?

    Every time I call, they're giving me some different explanation for why I owe this money and I'm no closer to a resolution after 20 hours of phone calls. And then randomly the amount that I owed went from $1100 to $1750. No one seemed to notice or have any idea why. I know my medical plan and I don't owe this money. I confirmed 5 times with insurance that I don't owe this money. But I can't convince CVS specialty pharmacy of this and I have CVS caremark insurance, so I literally cannot fill this prescription through any other pharmacy.

    I'm not making any progress and my kid needs these medications. What should I do? Would a lawyer or a disability advocate be able to help me? What would you do in this situation?

    submitted by /u/Hysterymystery
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    Annual maximum higher than lifetime maximum for dental insurance

    Posted: 26 Jan 2021 06:57 PM PST

    Hi everyone,

    I need to get my wisdom teeth removed and I was researching costs. I knew this surgery would need to happen this year, so I paid for the enhanced plan through our insurer (Delta Dental of PA).

    Here's where my confusion lies: my annual maximum is 2500; my lifetime maximum for oral surgery is 1500. Does this mean my insurance would only cover up to 1500 for the removal?

    Thanks!

    submitted by /u/mmw2848
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    Dental insurance is confusing, please help!!

    Posted: 26 Jan 2021 06:41 PM PST

    So, I currently am trying to pick my dental insurance. My first question is; Is it better to get a HMO or PPO? some of the insurances the HMO insurances are cheaper than PPO, but they have no maximum benefit, so wouldn't that make the HMO better than PPO especially if I wanted to get oral surgery ?

    Second question: How do I find out if oral surgery is covered by insurance? I want to get jaw surgery for my TMD, but I am having a hard time finding out if it's covered . I am looking into either getting Anthem($16.00 per month) , blue cross standard HMO ( 14.00 per month), or blue cross HMO( 24.30 per month). It states oral surgery is covered with only a $90-$70 copay (depending on which one I choose. So if I get jaw surgery, I would only have to pay $90?

    Last question: I am currently unemployed and looking to get insurance on my own. I ALWAYS do it through my job but is it better to wait until I get a job or pick my own?

    Thanks guys!!

    I am located in Los Angeles, Ca

    submitted by /u/TheYearOfTheKnife
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    View on State Farm

    Posted: 26 Jan 2021 06:28 PM PST

    How is State Farm compared to Travelers and GEICO for auto insurance in terms of fair assessment and timely settlement of claims?

    submitted by /u/first2015
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    Was it dumb for me to get Simplified Whole Life Insurance for our 3 children? (USAA)

    Posted: 26 Jan 2021 02:41 PM PST

    We used to put $100 each month in to an investment account for each one of our 3 children. When I was on the phone a few years ago with a USAA financial advisor, she was telling me I should move these to a Simplified Whole Life Plan for each child. Everything she said seemed to make sense to the point of why on earth would you not buy this plan.

    But recently I was reading a post on Dave Ramsey and he said buying this type of insurance isn't fruitful and you would do better by investing your money elsewhere. Now I'm second guessing if I did the right thing.

    As I understand it, we are to pay the policy's off after a predetermined time and then they grow cash value. When each child turns of age they can then use these policies for their own. I'll add the policy is called Whole Life Insurance - 20 Pay. We've been paying on these for almost 3 years now which at this point should start growing some cash value now.

    submitted by /u/Hotmoonsauce
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    Question on auto insurance rates

    Posted: 26 Jan 2021 05:25 PM PST

    So my sister got a DUI a long time ago, and when she switched insurance to Geico they gave her a good rate and never raised it.

    I want to insure my car with Geico, and provided all of my information on the web. They offered me a good quote. My question is, if I have no future incidents, my rates can't just skyrocket right? Or can they do a thorough lookup on my driving record and raise the rates because they didn't catch my record for this current quote? I ask because there is a careless driving incident and a couple speeding tickets that I don't think the current quote reflects.

    *Edit located in Minnesota

    Thanks!

    submitted by /u/RCpaddler
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    Renting a Ford F150 from Enterprise. Do I need to buy additional Insurance?

    Posted: 26 Jan 2021 01:33 PM PST

    I'm using my Delta Gold Amex Card. Reading my credit card terms pickup trucks look like they are covered. Only box trucks and trucks over 10k pounds are excluded. My personal car insurance is for my standard sedan.

    Should I buy insurance from enterprise when offered at the counter or will I be ok? I didn't consider this when booking a truck. I've never thought about buying rental insurance before when renting standard cars and midsize suvs.

    submitted by /u/cincyski15
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    Appraised Value vs. Insured Value

    Posted: 26 Jan 2021 04:23 PM PST

    I recently had an appraisal done as I am working on refinancing my home. The banker I was working on said that my insurance seemed really high, so I went out for homeowners quotes since I haven't shopped around since I purchased my house 8 years ago. I gave my agent the appraisal and when I received my quote they had the insured value at roughly 1.5 x the appraised value. I understand bumping the value up for inflation over time, but 1.5 x seem high. This didn't even include my other structures or content values. The quote was based on nearly 3 x the appraised value of my home once you added up insured value, other structures & contents. Does this sound normal?

    submitted by /u/BKuku
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