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    Reopened Claim Insurance

    November 23, 2021

    Reopened Claim Insurance

    Reopened Claim

    Posted: 23 Nov 2021 05:36 PM PST

    Hi everyone,

    I have a quick question regarding my auto policy. I'm going to get a real answer from my claims rep tomorrow, but since it is now after COB there and I've consumed more White Claws than I can count on 1 and a half fingers, I just thought I'd ask the Internet for an answer I will totally 100% take as truth until the day I die no matter what else anyone tells me. Anyway, here's some background info:

    My at-the-time newly purchased car of 2 sweet, innocent, blissful weeks was in an actual god damn flood last year, but my insurance company didn't total it. The shop "repaired" it by like blowing big ass fans on it for 4 days and then I paid my deductible to that shop.

    Fast forward to the dystopian future of last mont, I went over a railroad crossing and even though I slowed down, the vibrations were strong enough that basically the whole exhaust system fell apart like my relationship with my parents did after I told them I wanted to pursue my music career, due to the insane amount of rust on the undercarriage of the car.

    After some initial confusion involving opening a new claim, getting ghosted by claims reps like they met me on Tinder a week ago and finally saw me in person, and a lot of thumbs down on the insurance company's app, they closed the new claim and reopened the initial claim from the flood to get my vehicle fixed at a completely different shop from the first incident.

    My question: Will I have to pay my deductible again? Since this is now the original claim that I already paid a deductible on, is it possible I'll have to pay the deductible again?

    Thanks in advance!

    submitted by /u/Obtuse_Platypus
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    [NC] Anaesthesiology claims to not be affiliated with my insurance and are under no contract/obligation to adhere to the "plan discount" from insurance.

    Posted: 23 Nov 2021 08:01 AM PST

    I'm basically stuck in the middle of two organizations saying "we are correct" about how much I need to pay.

    Insurance says that there is a plan discount applied to the total, so insurance only paid a small portion, which according to them covers all the necessary costs.

    Anaesthesiology essentially says "we are no longer affiliated with that insurance company, we have no contract with them and do not care about their claimed discount. You owe the rest".

    I already went to my insurance company and asked to do an evaluation/appeal to see if their data is correct. They came back and said "yeah we are still right, looks good".

    So either I have to pay up, or...? I don't know any other options.

    submitted by /u/CastorDaedalus
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    Dental Insurance And Overpayments

    Posted: 23 Nov 2021 08:21 PM PST

    Long story short, I prepaid for a dental procedure me a few months ago and after looking at my explanation of benefits and confirming with the dentist that everything had been billed out, I WAY overpaid. Both dentist and office are in network so they cannot balance bill me. I emailed all of my explanation of benefits and my payment amount to the dentist and basically said "looks like you owe me $x".

    The dentist office just left me a voicemail saying they would like to discuss this in person (call me a skeptic but that sounds like a red flag).

    In preparation for that, I'm thinking about the possible reasons or explanations they'll give me for why they do not owe me roughly 2/3 of what I paid back. So my questions to you all are:

    1 - can they bill me for something they did not submit to my insurance? I understand some things may not be covered by my insurance, but do they have to at least submit it to check for coverage or contract rates? Bonus points if you can cite some kind of legal code or professional code with your answer.

    2 - am I missing some other explanation for why they would expect me to pay more than my insurance says I "may owe"?

    Thanks for your help!

    submitted by /u/Plum-UnImportant
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    My car insurance has my car’s odometer reading listed as 20,000. The actual number is 150,000. What is gonna happen if I change it?

    Posted: 23 Nov 2021 08:16 PM PST

    I have my car insurance with Geico, and I was just reviewing my policy. It's only me and my one car on this policy. It says that my car's odometer reading is 20,000 miles. I have no idea how that happened because I got the car at 115,000 miles. But the car now has 150,000 miles. So I have a few questions:

    A high mileage car is worth less. Therefore, would my premium possibly go down if I report the actual mileage? (I'm not talking about my miles per year. I know that high mileage per year makes your premiums go up. I'm talking about the overall mileage on the car)

    Is this going to trigger a red flag in their system? I've only had insurance with them for 2 years, and I don't know how my odometer reading was reported at 20,000 because I definitely wouldn't have put that. But if I put that the current reading is 150,000, I'm worried that they're gonna see that as a 130,000 mile increase, and subsequently charge me as if I drive 65,000 miles a year, which I definitely don't

    submitted by /u/ImBrokehahahahahaha
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    Car insurance company want to charge me more because I live with a G2 licensed friend?

    Posted: 23 Nov 2021 03:09 PM PST

    Hi, I'm trying to get a car insurance. The point is I'm sharing an apt with my friend, and the agent said they have to add my friend on my quote because she's holding a G2 license and didn't have any her own car insurance yet, and they gonna charge extra for that because of their policy. But only me drive the car, why should I be charged extra? Will anything happen if I lie I'm living by myself only? Because it sounds so stupid for me.

    submitted by /u/Kris-P-333
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    I was involved into a chain reaction crash.

    Posted: 23 Nov 2021 06:46 PM PST

    3 weeks ago, I was going to work when a car crashed into a car behind me and then the other car crash into me. Car C --> Car B --> Car A

    I was Car A, the last car into the chain reaction. Since my car wasn't that damaged just a few scratches on the paint and some minor back pain (which I do not have anymore) i decided to followed with my insurance and provided all the details to them and I forgot about it. Then today got a letter from my insurance and the owner of car B is presenting an injury claim against me. My insurance is asking if I agree to release my policy limits information.

    Could someone give me an advice on what to do? I felt sorry for the lady in the middle who got injured due to the other car crashing into her but if she wants to get her lawyer to go against me that I did not do anything wrong, I will hire one as well.

    Thank you

    submitted by /u/anonymousg33k
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    I was recently in my first crash. What do I do? Any tips?

    Posted: 23 Nov 2021 06:33 PM PST

    I was in a crash. The person that hit me ran a stop sign and hit me on a road where I have the right of way. I immediately called the cops and they handled everything for me. I got a police report with the other person's insurance information etc. I then submitted a claim online with GEICO and they stated I can open a claim with their insurance or go through them pay my deductible and they will go after them for costs. What is the best choice in this scenario? If I go through GEICO do I still need to contact their insurance? I have never been in an accident before.

    submitted by /u/imyourbroda
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    [CO] X-post from /r/legaladvice, I believe another party's insurance is acting in bad faith. What kind of recourse to I have?

    Posted: 23 Nov 2021 10:28 AM PST

    Here's the link from legaladvice.

    https://old.reddit.com/r/legaladvice/comments/r0izja/other_partys_insurance_is_denying_an_auto_claim/

    basically, other driver is saying someone hit him into me. I am saying that that's insane. I believe a judge would agree with me based on the pictures. Where should I go from here? I have liability insurance only, so my insurance isn't helping me.

    submitted by /u/JerryFartcia
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    Comprehensive insurance claim and Premium price

    Posted: 23 Nov 2021 05:26 PM PST

    Hello all! I have a quick question. Just for background, I'm insured with GEICO full coverage auto insurance.

    Visited a friend and left my car parked in their area, woke up to my front bumper slightly hanging off. Looked like someone was in the process of removing them until the tabs broke off (unscrewed wheel well screws). So now I am planning on filing insurance but worried about my premiums increasing as this is my first claim (14 years driving record) . It sounds like I would be covered under comprehensive (250 deductible), but anyone know? Thank you.

    submitted by /u/meganaxx
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    Onlia Auto Insurance - Review

    Posted: 23 Nov 2021 05:14 PM PST

    Did anyone had to claim auto insurance with Onlia? I am getting great rates with Onlia on my auto insurance but there are very few reviews about claims processing experience. Please share your experiences and feedback about the company well.

    Ontario

    Thanks in advance :)

    submitted by /u/forever_dota_noob
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    Other party won’t provide documents for claim, causing issues. Advice needed.

    Posted: 23 Nov 2021 04:58 PM PST

    Hello, A few months ago my wife had a fender bender, the guy claimed he wouldn't press charges or file for a claim, but she called the police anyway to be safe and it ticked him off. They showed up and assessed that there weren't damages and told my wife there shouldn't be any grounds for a claim. Her insurance said the same thing. A week or so later the man tried to file a claim for a bunch of medical bills and claimed he had injuries.

    The issue now is that the man won't provide any documentation/bills/ etc and the claim is just staying open. Also, my wife is trying to swap car insurances but cannot since the claim isnt closed. What should we do to get this taken care of and done with?

    submitted by /u/ryanandrew6
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    State Farm Comprehensive Auto Policy in Regards to Rodent Damage. Urgent info needed!

    Posted: 23 Nov 2021 04:38 PM PST

    About a week ago I started to get a fouls odor in my car. It kept getting worse and I concluded it was a dead rodent somewhere. I spent sometime searching around but could locate anything.

    I decided to take it to a shop (a Toyota Dealership) that could look at it ASAP, and figured my insurance will hopefully cover some of the cost.

    They confirmed something is dead and that the smell is quite terrible. They looked around for a couple hours and couldn't find it in the easier locations. They said this was about $380 worth of work. They told me the rodent must be under the dash and it would be like $3000 to get it out!!!

    So my worry is that if they do this work State Farm won't reimburse me for the work. What happens if they find the rodent but no visible damage? Would the smell be considered damage? Could mouse urine be damage?

    Any information will be greatly appreciated!

    submitted by /u/AdMysterious7652
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    Tree in city-owned parking lot crushed my 2021 Camry and 29 other cars.

    Posted: 23 Nov 2021 12:03 PM PST

    I've been talking to insurance agents and trying to understand, but things are moving incredibly slowly and phone calls are going nowhere.

    My biggest question is - how much will I be responsible for?

    My insurance agent let me know that a check will be cut to myself and the lien holder, since I took out a loan in order to purchase this car. The $1000 deductible will be taken out of this check,

    But I do not understand how I will be able to purchase a new car, or how I am supposed to be able to commute to and from work until I am able to purchase a new car. Is the city of LA responsible for a rental car for me? Who do I contact in order to find these things out? Thank you!

    submitted by /u/JayAr-not-Jr
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    Manulife group insurance in Canada - coverage of orthopedic boots

    Posted: 23 Nov 2021 03:47 PM PST

    Hello everyone, please be gentle, I don't post often.

    Question for those who are in the know. My podiatrist prescribed orthopedic shoes, and since it's winter now on the east coast, I'm trying to take advantage of the $200 that Manulife says they would pay for stock item orthopedic footwear.

    The thing is that they have already declined a few brands I sent in an estimate, and it's totally unclear what they cover and what they won't. They won't provide any information whatsoever, not regarding approved providers or footwear brands.

    Yesterday and today I went to a medical provider store, Medicus, and they issued formal estimates for Manulife. The thing is that those medical providers carry the brands I saw at regular stores, and some of those were already declined in my first estimate.

    Anyone on here know how to navigate this maze with Manulife?

    submitted by /u/yabadaba3
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    Not reporting a accident to my car insurance?

    Posted: 23 Nov 2021 11:49 AM PST

    I was involved in a 3 vehicle accident… 2 of us refused a breathalyzer and one was arrested for DUI. My car was infront and I was hit from the back which caused me to spin out of control and was hit by the other 2 cars. I have a friend who works in car insurance and her advice is "keep paying your insurance like nothing ever happened"…. Wtf? There is absolutely no way I'll actually get away doing that ….is there?

    submitted by /u/redbottom12
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    Questions about how my insurance is handling my accident…

    Posted: 23 Nov 2021 03:11 PM PST

    So I was rear ended on November 3rd in Springfield Missouri and when I got hit, I didn't see a third car or anything, all I know is the car rear ended me going 30-40 MPH cause it has bent my frame on my Jeep and broke my mirrors off cause I was at a dead stop. The fire department was there to witness everything, but didn't give me a fire station number, she then stated that her brakes were bad and pulled a fresh pair of brake pads from her glove box. and the person who hit me, left with her boyfriend who came and picked her up, but left the car in the accident there, before the police arrived, and after the fire department left….

    No police report has been filed yet, but I have the paperwork to do so..I thought the other person would admit fault and it'd be okay, right!?? Wrong. Aparently they're blaming another car that ran away from the scene (to which I did not see or hear) taht pushed them into me…this was not stated at the time of the accident, and the fire department didn't say they saw anyone either..there was ZERO rear end damage, not even paint scuffing, there's a bit of damage to the rear side of the car, but that's it…I've gave all the evidence I have to try and prove they just rear ended me, but I have been told by my adjuster that they do not claim responsibility for it, so I'm so confused…

    What are they seeing that I'm not!?!?! And I haven't even got the info on a third person if there even is one!!!! I'm so confused and baffled that they think someone pushed her into me when there's no rear end damage to her..

    I guess I'm asking, what would be a good idea to ask the insurance adjuster tommorow when I call them again to try and understand how they think she isn't at fault, and also is it illegal to leave before a police officer arrives if she left the car at the scene? Cause I'm very confused on everything, this is my first accident and my only vehicle and it's currently inoperative due to excessive frame damage that's putting stress on the suspension. I just wanna know what I can do to understand the situation cause they didn't give me an answer when I asked how they came to that idea, they just kinda said the same thing, so I just want ideas and thoughts please!!

    submitted by /u/Darkmagician4242
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    What kind of things should i mention and avoid to get a decent car quote?

    Posted: 23 Nov 2021 02:59 PM PST

    I will try to keep this short, im a new driver in the uk and need car insurance. I have no claims or tickets or anything that would bump up my insurance prices other than my age and inexperience. My current quotes sit at about £5000 a year, obviously not happy with that so i want to work on that. The thing is im in the navy and wont even be able to drive my car for at least 6 months a year anyway, what are my options?

    submitted by /u/Ted_E
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    Can I ask my insurance company how much my doctor charges them?

    Posted: 23 Nov 2021 10:53 AM PST

    I just started a new job and I'm looking through their healthcare package options. One of them had a big deductible (1500) but cover literally everything short of a facelift after that. I have epilepsy which means that once a year I get some expensive stuff (MRI, EEG) and about 3-4 neurologist visits, + meds. Other than that I'm about as healthy as most and rarely get sick or need anything that isn't OTC.

    My old insurance (under my parents) covered everything. I never even knew how much those services cost, so how can I know if they were expensive enough to get me past the deductible and have my insurance actually kick in?

    submitted by /u/racoongirl0
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    Claim Denied on Bathroom Water Damage

    Posted: 23 Nov 2021 02:35 PM PST

    Background info:

    House is almost 7 years old. Almost 3 weeks ago I noticed a section of the floor next to the tile shower had water leaking/accumulating next to it. I stopped using the shower & set up fans to dry it out, but it became apparent that there was swelling in the flooring under the vinyl and perhaps in the wall behind the baseboards.

    I called a contractor who surmised that the shower was leaking, and water damage had permeated the floor, and the shower would have to be removed to find the problem, fix it, and replace the tile shower.

    I opened a claim with my insurer, and heard nothing back for almost 2 weeks. Left multiple voicemails for the claims adjuster.

    I directed the contractor to begin demolition since he advised black mold can set in within 48 hours & colonize quickly, and told his crew to document everything with pictures. They offered to write up a report with their findings. They did so, concluding that it was impossible to determine the root cause of the original leak/failure point, but that the flooring & sub-flooring had to be removed under the corner of the bathroom that held the tile shower, and that black mold had settled into the base-plates under the walls of that corner of the house, and would need to be replaced. The swelling hadn't spread far, and the mold hadn't set into the joists or the wall boards, so we'd apparently caught it pretty early.

    State Farm finally called me back almost 2 weeks after filing the claim & 4-5 voicemails. Explained the above, and put them in touch w/ my contractor, who submitted his report to them, labeling the root cause an undetermined accident/leak.

    Without even sending an appraiser (adjuster?) to look at the house & bathroom, they immediately denied the claim over the phone. I asked them on what basis were they denying the claim. They said because black mold had set in, it had to be because of existing long-term damage. I pointed out that my contractor, the architect that lives in my house, no less than 2 other restoration specialists who looked at the damage and a quick google search for "black mold" all tell me that it sets in within 48 hours, and spreads aggressively within 2 weeks; and that since she'd taken almost 2 full weeks to call me back & hadn't actually even sent anyone from State Farm to look at the damage or pictures from my contractor yet, how could she have any idea how long the black mold had or hadn't been there? Loooong pause. She just started repeating herself, and said that her understanding was that black mold took a very long time to start.

    I told her I wanted to appeal her decision, and to send out their own adjuster ASAP before it gets too cold & I'm forced to begin the repairs/restoration, if they want to see it for themselves. It'll be another week & a half before all the replacement repair materials arrive, but since the bathroom has no floor & is exposed to cold winter air from the crawlspace, I can't leave my home like this for long.

    My questions for this subreddit & people who know the insurance world are ...

    • What's the best way to proceed here with the insurance company to get coverage? Is this a "normal" part of the claims game, and this is where they just start negotiating? I've never filed a homeowners claim before, I've just paid my premiums on time for 32 years. :P

    • Since there is damage to the horizontal "base plate" (is that the right word?) that runs under two exterior walls of the house, would this fall under the "structural damage" clause of the policy, which (I've been told) doesn't have all the caveats & loopholes that a "general bathroom water damage" claim does? Contractor says they need to be replaced, and they support load-bearing walls.

    • What actions should I be taking or questions should I be asking that I'm not?

    Edit: Deductible of ~$1700+, repair estimate after the demolition came in at ~$18,000.

    submitted by /u/GreyRobb
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    Florida Blue HMO D-SNP plan?

    Posted: 23 Nov 2021 02:22 PM PST

    Does anyone here have any experience with the Florida Blue HMO D-SNP plan? Trying to find out if 2022's vision benefits will reimburse you for orders online (like Zenni), and apparently nobody in their call center can tell me this until the plan is active in January, after I'm locked into it for a year.

    submitted by /u/Suspicious-Willow307
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    Geico calling me about a claim when I'm not insured with them.

    Posted: 23 Nov 2021 08:11 AM PST

    Long story short. I crashed my motorcycle about 3 months ago. Just me, no other vehicles, no property damage, no others involved. The strange part is that I am insured with State Farm not Geico. I was insured with them about 3 years ago. This seems very odd. They gave me a claim number and a seemingly legitimate phone number. State Farm has already paid out everything and I was under the assumption it was done. Any ideas what this is about? Seems like a scam.

    submitted by /u/emptydesigns
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    Car got totaled, I want the insurer to locate a substantially similar vehicle.

    Posted: 23 Nov 2021 08:02 AM PST

    Hello, I live in NJ and was told that if I was unable to purchase a substantially similar vehicle for the value listed (the valuation of my totaled car) the insurer will locate a substantially similar vehicle for me. Has anyone been through this process and can offer me some tips, when I asked my claim representative about it, she said "I have no idea what you're talking about, I've never heard anything like that before". Even though the information was included in my settlement. I have to notify them in writing within 30 days, and they didn't even tell me an address to write them to.

    submitted by /u/moneypussyw33d
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    Can I choose to total a car?

    Posted: 23 Nov 2021 01:49 PM PST

    So my car was hit a few weeks ago and the collision place I took it to just got the estimate back to the insurance. They approved the costs and now the only problem is the collision company can't do the repairs until mid December. My dad said I can call USAA and tell them I want to just get the check for the price of the work and total the car. Is this something I can do?

    I am in AZ.

    submitted by /u/Bmw5464
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    Homeowners insurance requiring roof replacement. Options?

    Posted: 23 Nov 2021 01:03 PM PST

    I purchased my first home last April and originally had insurance through Hippo. They sent out an inspector to do a visual inspection from the street and asked me to replace the roof. Friends and family I talked to about this seemed surprised as they had never experienced an inspection from their homeowners insurance provider.

    So I got a quote from AAA for the same coverage and it turned out to be cheaper anyway so I switched. A few months passed and I got a letter from AAA saying they had done a drive by inspection and demanding I replace the roof.

    The roof is certainly old (20+) and I know it probably needs replacement within the next 5 - 10 years. But, it's not leaking and there is no water damage that I can find or that the home inspection from when I purchased found. Really the only thing wrong with it as far as I can tell is that the shingles are starting to deteriorate a little and you will knock a little sand out of them as you walk around.

    Based on some previous post I found on this sub I called and asked if they would do an 'actual cash value' endorsement on the roof and remove the requirement that I replace it. The guy laughed at me and said he's worked in insurance for 20 years and that's not a thing.

    Money is pretty tight for me at the moment. If it was really the only option I could probably get the roof replaced, but I would prefer to wait a couple of years if possible. Do I have any options to get a delay? Will all insurers require the roof to be replaced? It's unclear to me what is triggering this assessment from drive by inspections.

    submitted by /u/pumpkin1986
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