[US-NV] Secondary insurance denied benefit because primary insurance paid a small amount Insurance |
- [US-NV] Secondary insurance denied benefit because primary insurance paid a small amount
- windshield claims in California
- Health Care Providers Trying to Avoid Billing Insurance?
- How do I ensure I get insurance to pay
- Is a job in claims as bad as everyone... claims?
- Am I responsible for hit & run damage to my garage door?
- I have new employer insurance and chosen a Primary Care Physician (PCP) but when i called, they said they are not accepting new patients. Is this normal?
- Was hit in a parking lot 5 nights ago, not sure of next steps. (NY)
- Confused about short term insurance
- Short-term Disability, Pregnancy, and New Job
- I was rear ended and this is my first time dealing with insurance, I could just use some advice
- Unmarried couple homeowners insurance (USAA)
- Somehow there’s a crack in my bumper (that needs to be completely replaced) quoted $1800 by shop but thinking I should just file a claim? My deductible is $500.
- Wife is a terrible driver (literally)
- How do I get insured on the way home from a dealership when I purchase a new vehicle?
- How does an accident in my work vehicle, how does that affect my personal insurance?
- Vocational Evaluation Assessment Question
- My vehicle has just been written off. The insurance has given me a very good offer on the car. Iam wondering if the rule of never take the first offer still applies, in my opinion the offer is thousands above market value for the car.
- New grad buying first car
- Renters' Insurance and Electronics Coverage
- Car Warranty/Service Contract in Texas
- What am I supposed to do?
- [Canada] Can I submit a claim when spouse is provider?
- Insurance fraud?
- MAss health dental/ dentist ripped me off?
| [US-NV] Secondary insurance denied benefit because primary insurance paid a small amount Posted: 25 Feb 2021 04:07 PM PST I have primary insurance through my employer which is not very good, so I have also enrolled in a secondary policy through my wife's employer that is much better. Last year in August, my audiologist prescribed hearing aids to help with tinnitus and hyperacusis. I independently did what research I could into my policies, and their office did as well. I found that my primary insurance provided no hearing benefit at all, and the secondary covers 75%. The secondary said that after submitting to the primary, submit the rejection and balance to them and it should be covered. Well, in the end, my primary ended up paying 25% despite it sounding like they wouldn't cover anything. So when the balance got submitted to my secondary, they denied the claim completely because it was already partially covered by my primary! (edit - the claim actually shows as approved but they paid $0) Is this standard practice? I'm paying full price on the secondary policy and if it was my only policy it would have been covered. Maybe there is something buried in the fine print of the policy somewhere that explains this but on the surface I can't find anything. I do not yet have a copy of the denial from secondary. Is this something I should appeal? As is stands, this is costing me over $3000 out of pocket when it would have cost $1000 if covered only by secondary. Thank you! Edit: Primary paid 25%, not 20% EOB info from secondary:
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| windshield claims in California Posted: 26 Feb 2021 04:03 AM PST Hi, I purchased a 2020 Toyota Prius Prime In September 2019. That October the windshield cracked in half (from a pebble perhaps—We didn't hear anything). The cost to replace/calibrate out of pocket was over $1,200 so we filed a claim and paid the $500 deductible with StateFarm. Just weeks after total windshield replacement, the windshield cracked in half again(!) (another pebble?) and we reluctantly filed another claim to have it replaced using factory glass and a different glass company. Our insurance went up for the 2 claims and now almost a year later...our windshield is once again cracked in half. >_< I reached out to Toyota first because our State Farm rep previously told us, multiple claims for this matter seems to point to a flaw with the car. I own two older Toyota Prius cars that we switch off driving the prime with and have never needed to replace their windshields but this Prime is somethin' else. The Toyota rep claims nothing is wrong with the car and they won't help repair. I'm so Frustrated that we are safe drivers who leave plenty of room, no tickets or accidents but yet—these windshield Claims are costing so much money! Is there any insurance that offers more cost effective windshield replacement in California? Does State Farm ever waive deductibles? Should I pay out of pocket or just file the claim and switch to Cheaper insurance later? I Was looking to switch to aaa before this 3rd cracked showed up. This will Be the 3rd claim in 16 months of owning the car. Meanwhile, im planning ahead and bought some crack filler and plan to check for impact chips daily to stay on top of this bs. [link] [comments]  |
| Health Care Providers Trying to Avoid Billing Insurance? Posted: 25 Feb 2021 06:35 PM PST Location: USA WA Hello All, So I called my insurance provider because on an unrelated appointment a doctor asked me if I would like my skin tags removed. I declined not thinking they were a problem. Fast forward about 1 year. I have rubbing when I jog that irritates the hell out of my skin tags. I called my insurance provider to see if a skin tag removal procedure would be covered and they told me it was. They even told me it was covered without a referral. Not 100% but definitely a large part of it. So I set an appointment up with a dermatologist to have them removed. After dermatologist review, she said okay I can remove them. Then she tells me insurance is not going to cover it. I told her I called about this procedure I did not have a code but they ensured me the insurance does cover the removal of problematic skin tags. She says we typically don't get paid from insurance providers ever so we don't do the procedure because its never covered. I said okay but I definitely called my provider and they said its covered. She says okay I will give you a procedure code, and they are concluding the appointment as if the procedure is not happening now they said, you can get dressed. I said, I don't know how long you guys have... but I can have an answer under 15 minutes. Rang my provider up and they again ensure me we do cover the removal of skin tags but the procedure code she gave me is not a procedure code for skin tag (literally my provider is telling me the procedure code is not for the procedure in the appointment) removal it is for shaving. The doctors assistant tells me they send the shavings to the pathology center. So while I am on the phone my provider says if you would like I can get the phone number of the billing office and talk to them. I have yet to provide my provider with their billing phone number but this place feels scammy. Why would I get a procedure code that is not for skin tag removal? Why would they tell me insurance is not going to cover it? Shouldn't they bill the insurance companies and the insurer decide if they cover it? Anyone experience medical providers hesitant to move forward if they have to bill insurance? TLDR; Dermatologist did not remove skin tags, a procedure covered by my insurance because they would have to bill my insurance. [link] [comments]  |
| How do I ensure I get insurance to pay Posted: 25 Feb 2021 11:15 PM PST Hi, I was on my bike today when a car pulling out of a gas station plowed right into me and my bike. I fell down and bruised my hand(have a sprain as well but apart from that nothing serious) but unfortunately, my road bike was ruined. It's a 1500$ bike and the front part of the bike got smashed. The dude in the car, came out and gave me his insurance card which essentially had the policy number, make of his car etc. I filed a claim with his insurance company (progressive) and they told me that a claims examiner will call me by tomorrow for more details. How do I ensure I get reimbursed for the damage to my bike? What games might they try to play given the facts below? Lastly, should I mention the pain in my hand and would they reimburse me for that should I decide to visit a doctor? (Pain has gotten worse since the accident) Some more facts about the incident: - No, I did not file a police report as I had to head out for work - The driver of the car was clearly at fault cause there was a signal when exiting the gas station and it was red. He was essentially taking a right on red. The signal was white for me on the pedestrian crossing. He was half on the sidewalk and this is something common in Arizona. I thought he's gonna wait as he was looking elsewhere but before I knew it, he just turned right literally while looking left. - Place of accident is Arizona - No, I don't have any other information of the driver apart from his insurance card(which also contains details about his vehicle). Lastly, the intersection where this happened has cctv cameras (incase that helps) Thanks! [link] [comments]  |
| Is a job in claims as bad as everyone... claims? Posted: 25 Feb 2021 07:07 AM PST I've been stuck in sales and I'm ready to get out. I'm tired of not knowing what the future will look like and having minimal room to grow. I don't enjoy upselling customers and would rather be straightforward with people. I'm considering accepting an entry level claims adjuster position with a set salary. Again I'm good with people, good with managing my time, but I want consistency. However I've read that claims is a dying field with technological advancements filling the roles of actual people. I've also read that it's miserable and a ton of work, but here's the thing: I hate waiting around all day for customers. I like to stay busy but I don't want to work 70 hours a week. I can manage 50-55, and I've worked in car sales so I've worked ridiculous hours before. So my questions are: is it really a dying field? Is there room to grow and advance after a few years? And are the horror stories really as bad as people make them seem? Thanks in advance ! [link] [comments]  |
| Am I responsible for hit & run damage to my garage door? Posted: 25 Feb 2021 01:36 PM PST A few weeks ago, I woke up to discover that the two-car garage door of my SFH had been driven into by a vehicle. I found two small pieces of plastic trim and red paint on the white garage door. I contacted the police and the property manager. I filed a police report, then the property manager responded and told me that we were responsible for repairing the door back to the condition it was in when we moved in. It seems absolutely absurd to me that I should have to use my insurance to cover damage to the dwelling that I didn't cause in any way, shape, or form. I contacted my renter's insurance company and they were also unconvinced that this was something for which I was liable. Can anyone with professional experience in this area provide any guidance or assistance? I live in Kansas City, MO. [link] [comments]  |
| Posted: 25 Feb 2021 03:05 PM PST Hello, I am not here to complain or anything but just wanted to double check. Our company got a new health insurance (different provider) and i chose a new PCP using the provider's website (Anthem Blue Cross). Anyway, after choosing PCP few days ago, i called the number and try to schedule an appointment for preventive care + lower back exam but they said they are not accepting new patients... Is this normal or should i be considered an existing patient since he/she is my PCP? [link] [comments]  |
| Was hit in a parking lot 5 nights ago, not sure of next steps. (NY) Posted: 25 Feb 2021 10:14 PM PST Sunday night I was reversing out of a parking spot at my workplace & saw brake lights go on behind me. I was already out of the parking spot and laid on the horn while trying to pull forward but the kid across from me reversed out and backed into me. Unfortunately the kid who hit me is my coworker- I was flustered and we got out, looked at my car and did not see damage so I did not call the cops and unfortunately didn't ask for insurance, but I have his contact information. After salt was cleaned off my car today I see multiple scratches on the bumper, texted him to speak with his parents and see how they wanted to proceed but he hasn't gotten back in touch with me. The parking lot has camera footage but store says I need to file a police report to access it. Another coworker witnessed this and also asked the kid why he continued to back up when I was already pulled out and beeping the horn. Should I file a police report tomorrow and then ask him for insurance info? Or file through my insurance? It seems as if he still has not told his parents so I'm at a loss for next steps. Thank you in advance for any help! [link] [comments]  |
| Confused about short term insurance Posted: 25 Feb 2021 06:27 PM PST So I was fired in November, and I had insurance till Feb 25th(so today I have no insurance). I will start my next job on March 15th, and so was looking for some sort of coverage between now and till I start my job and get covered. I plan to travel a bit so it is kind of important that I have some sort of insurance(or is it safer to abandon all plans?) I was planning to get some sort of short term insurance, but here is my problem. I currently live in Seattle, WA and will stay here till around 5th March. Then I will spend around 7 days travelling in Orlando, FL. I will then go to Pennsylvania, where my workplace is, and I will start working on 15th(I assume this is when I will be able to get on whatever insurance my company provides). What state should I be looking at when I search insurance. I'm on my F1 visa, so is it possible for some "Short Term All over US" kind of insurance that I can use? [link] [comments]  |
| Short-term Disability, Pregnancy, and New Job Posted: 25 Feb 2021 09:54 PM PST My wife is changing jobs due to her group being bought out. She is on Aflac STD currently and will be switching to The Standard in July with the new employer. She is currently pregnant, but will not give birth until after the employer change. Would the maternity leave portion of STD be covered by The Standard once she switches plans, since she won't have been covered by The Standard for a year prior to the birth? We are in Oregon. If The Standard will cover it, do we need to remain on Aflac for STD needs until the change? [link] [comments]  |
| I was rear ended and this is my first time dealing with insurance, I could just use some advice Posted: 25 Feb 2021 06:04 PM PST So last week a car drove into me and then drove away, but was pulled over down the road so I was able to move forward with a claim. It's through his dads insurance because he was driving without a license in his dad's car. My car is totaled. It was older than me and had its quirks but it was my first and only car that I was able to get cheap from my grandparents. His insurance is reimbursing me for it but it's just nowhere near enough for me to get a new (new to me, used car), actually reliable car. I'm a broke college student and I have work and classes to drive to, and I now have 3 days to find a new car or until I have to start paying for my current rental. Basically, I'll probably have to empty my savings so I can get a car that will last me rather than getting a beater, I just wish I was more prepared than I am. I'm basically wondering if there's anything else I could be doing. My relatives act like I should barter over the value but it's worth what it's worth. The insurance agent asked if I want to move forward with bodily harm claim and I just am unsure of what that means. I was in pain (whiplash) for three days and I went to the doctor and got meds but insurance covered it, is it worth the hassle to do anything with that? Sorry for such a long post I'm just overwhelmed right now and thought Reddit might help. If this is the wrong sub just let me know. Edit: I'm in the US, DE [link] [comments]  |
| Unmarried couple homeowners insurance (USAA) Posted: 25 Feb 2021 05:49 PM PST Hi everyone! My partner and I are in the process of purchasing a townhome, and we need to start looking into home insurance. My dad is a veteran, so I currently have my renter's insurance and auto insurance through USAA. I have had great experiences with their service and their rates thus far. Can you explain, in simple terms, how homeowner's insurance works when two individuals own a property? Do we each have a separate policy, or do we have one policy for the house with both of our names on it? I know this is a very basic question but it's all new to me. As a follow up question, if it is one policy for the home, could I get a USAA policy (assuming rates are good) and add my partner to it since it is our home, even though we are not married? Thanks in advance! [link] [comments]  |
| Posted: 25 Feb 2021 08:08 PM PST I live in Wisconsin and the only thing I can think of happening is maybe me hitting some ice or snow. I have Progressive. $500 for both comprehensive and collision. Any advice helps. I would just gorilla glue it lol and I don't really want to spend $1800 on a little crack but I'm looking to sell the car. Any advice helps. I also don't want my insurance to go up. AHHH adulting. What should I do. 😠[link] [comments]  |
| Wife is a terrible driver (literally) Posted: 25 Feb 2021 04:18 PM PST Ok so super long story cut long. My wife has been in multiple (7) in the last 8 years. 4 in the last 8 months. All were a total loss btw. I have been involved in 2 accidents (1 hit and run and 1 at fault). I find out that her accidents are tied to my name as well as hers. So if I want to get my own policy, with her being excluded that the rate doesn't change. Is there any way to get her claims off of my name? [link] [comments]  |
| How do I get insured on the way home from a dealership when I purchase a new vehicle? Posted: 25 Feb 2021 08:49 AM PST SOLVED: Since I have the VIN I was able to compare quotes from a few places. Since I already have a quote from my desired insurer, I am able to just log in to their website and activate it if I do decide to purchase the vehicle. I don't currently have a car, but this next week I am driving around 2 hours to look at one, hopefully purchase one, and drive it back, woo! I've had cars in the past and know my way around basic auto insurance. But with cars in the past I would buy local and just drive home uninsured, and then leave it at home until I got auto insurance. On this occasion, I will have to drive 120ish miles, if I do purchase one, and would of course prefer to be insured. So, how can I have auto insurance as soon as I purchase a vehicle? EDIT: Location: AL, USA [link] [comments]  |
| How does an accident in my work vehicle, how does that affect my personal insurance? Posted: 25 Feb 2021 06:37 PM PST I live in Illinois, I got in an auto accident a few months back, I was at fault. I was driving my company vehicle in which they insure. I'm not sure if there was actually an insurance claim or if they paid out of pocket. I was issued a ticket, "Failure to reduce speed to avoid an accident" because of COVID, no court appearance required. Bad for me because the ticket has more potential to be on my record. To counter this I took the defensive driving course to get the moving violation off my record. How will this affect my personal insurance? I have an accodent from September 2018 still on my record. [link] [comments]  |
| Vocational Evaluation Assessment Question Posted: 25 Feb 2021 06:12 PM PST Hello, If I completed this vocational evaluation assessment requested of my attorney, are the results of said assessment between me and my attorney or does the insurance somehow get this information too? [link] [comments]  |
| Posted: 25 Feb 2021 06:09 PM PST Ontario Edit I've repainted the bumper and one door because they had scratches and I've recently tinted the windows total cost about 1500$ should I try to get this back? All done within a couple months [link] [comments]  |
| Posted: 25 Feb 2021 06:08 PM PST I had a car for like 3 months but never after that , recently I got a job and now I am on a lookout for a new car insurance What are my options and how can I choose them ? [link] [comments]  |
| Renters' Insurance and Electronics Coverage Posted: 25 Feb 2021 05:28 PM PST Hi all. So quick specs: I live in a small apartment in NYC. I don't have many valuables of worth except electronic devices, some furniture, etc. The devices alone however have made me want to consider renters' insurance which my friend told me can be quite cheap. I am curious to find out which insurance companies offer affordable yet comprehensive plans, especially when it comes to covering devices such as laptops and harddrives outside the home...suggestions with details or links regarding the prices and policies regarding electronics would be ideal. Thank you. [link] [comments]  |
| Car Warranty/Service Contract in Texas Posted: 25 Feb 2021 05:18 PM PST My SUV is just over 8 years old with 68k miles. Catalytic converter broke off spontaneously at a factory weld, making my car sound like a motorcycle and creating a check engine light. I paid to have it replaced at dealership; they said it was not covered by warranty so I paid in full. Later, after reviewing my warranty (vehicle service contract, actually), the exclusions include exhaust, but covered components includes exhaust manifold/catalytic converter. I talked to the dealership and they said it was still not covered, and to talk to corporate. Corporate said it was not covered but did not explain why, and told me to talk to dealership. Dealership stated that they cover exhaust manifold/catalytic convertor combos, but not catalytic converters, which seems like an arbitrary distinction that I was not told about when I bought the VSC. I asked for explicit information on what is not covered at the time I bought the VSC, and the dealership stated to just look at the component coverage list, which explicitly stated exhaust manifolds and catalytic converters, and converter gaskets are covered. They suggested I talk to corporate again. I've been going in circles and I am wondering what to do here. It seems clear that the component coverage list explicitly covers catalytic converters, but not the rest of the exhaust system. Is there any avenue for appealing this decision? It seems to me that any reasonable person upon seeing this component coverage list would assume the catalytic converter was covered. I am being sent in a wild goose chase and it's getting tiresome, especially as I am dealing with another insurance problem in which home insurance is denying coverage for a burst pipe due to the recent winter storm. [link] [comments]  |
| Posted: 25 Feb 2021 04:25 PM PST California, USA. I was involved in a car accident in August 2019, it was my fault (my car was totaled and the other's back bumper was mildly dinged, that's as much as I know) and I do believe it was ruled that way by my insurance but I was never contacted again by mail or phone after around October of that year and assumed that the other party didn't really seek anything much from my insurance. I literally just forgot and didn't care about any of this. I'm now under a different car insurance and today I received a letter in the mail from the other party's insurance company, apparently they have opened a claim. What am I supposed to do? Do I contact my current insurance? Do I contact my old insurance (AAA)? I called the number on the letter and they just said that someone will be calling me soon to ask questions, should I seek legal advice before talking to them? What am I supposed to do lol? [link] [comments]  |
| [Canada] Can I submit a claim when spouse is provider? Posted: 25 Feb 2021 12:22 PM PST I have benefits with Canada Life through work. My partner is a massage therapist and also has benefits through me as my spouse. Am I going to run into any kind of trouble if I go to her at her clinic for a massage, pay her for it, and then claim it? She's really the only person I want to see for a massage, and in the past 5 years of her working I have barely touched my massage benefits because I'm nervous they'd say it was insurance fraud. Anyone have any experience with claiming with a provider who is their spouse? Or perhaps there is someone here who works in group benefits who might know. Thanks! [link] [comments]  |
| Posted: 25 Feb 2021 04:02 PM PST I crashed my bike. If insurance wants to take my bike and give me money. Is it insurance fraud to take and keep things like exhaust or bar ends? And give the bike to them but not the extras? [link] [comments]  |
| MAss health dental/ dentist ripped me off? Posted: 25 Feb 2021 03:55 PM PST Im not sure if this is where this should be posted but if not please move it...regardless this last year(October 2020) I had some serious decay on one of my molars so i went to the dentist in order to get it extracted( I'm on MAss health and they didnt cover root canals and crowns at this time) however i ended up deciding to sink all of my savings in order to save the tooth and get a root canal and crown procedure done anyways, all out of pocket. Mind you i started all of this in OCtober 2020 and yet when all was said and done my final crown wasnt in place till January 15th 2021(even though i paid in cash for it back on 11/24/2020...the day i was supposed to have it done). The dentist gave me the run around for months, literally canceling my appointments last minute and post-poning the procedure numerous times. Literally one of the times near the end(11/24) i went in to get my crown in place and they waited till i was in the seat to tell me they didnt have the crown yet and that i would have to come back in again to get it finished( almost 2 month later on 01/15/21). Now here is where I feel like i was ripped off, because recently starting January 6th, 2021(i believe) MAss Health changed its coverages to include root canals and crowns where before they only covered fillings and extractions. That being said i paid 1350 for the root canal and 1275 for the crown, i understand that i paid for and had my root canal procedure done before the change this year, but however the crown, although it was paid in full on 11/24/2020 it wasnt finished until 10 days after the change(1/15/2021). Wouldnt that mean that my dentist owes me my money back on the crown since it wasnt completed till after MAssHealth changed its coverages? Honestly whether or not I am i refuse to go back to that dentist regardless, so many red flags. For one when i decided to go forward with the root canal i was told it would only take 2-3 visits for the whole procedure...make that more like 6-7 with all of the times i went in and didnt get anything completed. For example when they finished the root canal i asked if they could prescribe me antibiotics because i smoke and i knew that i was more likely than not gonna have a minor infection. Well i was told not to worry that i would be fine without. Fast forward to the next time i went in and complained of pain did she really ask me if i completed my course of antibiotics from last time(the time she declined me from having them), like wtf? Even now its been a little over a month after the crown and im having pain in the tooth and swelling, andi honestly feel like they did a sub par job ontop of ripping me off from the money i could have saved if mass health covered the crown. Idk what to do, apart of me has thought about suing but idk. IF anyone can help or give me advice itd be greatly appreaciated, and sorry for the rant. Edit: location Massachusetts, USA [link] [comments]  |
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