My company moved from Aetna to Cigna self-funded open access. Every month I submit claims for reimbursement with an out of network provider. The diagnostic codes never change but at least 2-3 a year, they play this game with me where they either lose the claim, claim is pending for weeks or the superbill is "missing" information even though its the same info every month with different dates. Of course, we all know they are just playing a game and trying to weasel out of paying me. Is there any where I can go to escalate these issues? My companies care advocate is useless but it feels like that is my only recourse.

Hi all, I have been losing my mind trying to figure out which coverage would be best for my pup. He is a 1YO chihuahua/poodle mix who was rescued off the side of the road at 3 months with a broken hip. He has had FHO surgery which did seem to help reduce his pain and allow him to put more weight on the limb (left hindleg). He loves running and jumping around and generally acts like a happy puppy, but will likely always walk with a limp. I'm aware he may develop issues as he gets older from compensating. We currently have Pets Best, which we have not had a good experience with. We have sent them the same documents three times and every time they said they did not receive it, even when I'm actively looking at the email to their claims department while on the phone with them. Then it takes a full two months for them to review the documents, only for at the end of two months for them to close my claim because they did not receive my documents.... and thus the cycle continues....... Which insurance would you recommend? Should I just suck it up and accept that I'm likely going to have to pay in full for any orthopedic issues? I'm happy paying on the higher end ($70-$100 a month) for more full coverage that would include exam visits, medications, etc, but I'm having a hard time figuring out which insurance would work best for my pet. Any advice y'all have to give would be greatly appreciated and save me hours of going down this rabbit hole!!!

So this is a bit long and involved. I’m a 25M who just moved back home to take over a family business after a family member was diagnosed with Alzheimer’s. We have a block of commercial units we rent out, most of them under one roof, and two units disconnected from the main building. In total we have about 75,000 SF of commercial retail space. Problem is when the landlord has Alzheimer’s they forget to do important things like carrying insurance on the main building with 65,000 SF. So I went to the insurance agency we’ve always went through for literally everything commercial or otherwise. They insisted for two months that I had coverage on all the properties (unfortunately I don’t have that in writing) despite being unable to provide a bill or declarations listing the units. It took me ambushing the agent at the office an hour away and showing her a map of the property for her to understand that despite the disconnected units being covered, the main building and parking lot carried no coverage. She had never even audited the property or looked at it on maps nor visited it. She finally says she’ll get working on adding the main units to the policy, and today she emails me right before she leaves to tell me there is no way possible for auto-owners to cover us as we have two restaurants on the property (my gf used to work as a receptionist at a different agency auto-owners does do commercial coverage for restaurants in my area). So now I’m stuck here with no insurance on a multimillion dollar lot because I get the feeling the agent doesn’t feel like rewriting the policy. All of my families coverage for everything is through this agency and auto-owners but the agency is incompetent at the very least and it’s evident I need to switch agencies at least. The only experience I have with insurance prior to this is renters insurance and personal auto, I’m really at a loss for where to start or what I should be switching around. Any advice or guidance is appreciated.

Had a house fire, insurance adjuster said i get 5000$ a month for up to 12months for a rental equivalent to my house (3/2 2000sqft) Well 3 months went by and I decided to move into my own rental house , it’s a 1/1 while the repairs on the house are being worked on. Now he’s saying he will only give me the going rate of a 1/1 … which is somewhere around 1500-2k, which is a big difference from 5k. My question is if that 5k per month mine? Something I can fight for? Or do I only get the exact displacement fund I spend , up to 5k

I was in an accident back in April. At the time I did not have insurance on my car. The driver who hit and totaled my car admitted fault. Since I didn’t have insurance at the time I contacted their insurance company(Corvel) myself. After 2 months of constantly calling I was able to get in contact with an agent and she was able to compensate me for the car damages and towing charges. She later said she would take care of my medical. I was supposed to gather my medical records from the day of the accident and my medical bills and email them to her. I sent them back in the beginning of June and have not heard back since. Ive emailed and called and have heard nothing. Is this worth pursuing or should I just call it a day and be grateful for what I have received?

I got a cat in November and enrolled her under Spot, starting a plan at $17.87 / month. I took her to the vet in December to check why this otherwise healthy cat had no interest in chewing food, and they said they said she had a bad case of FORL and they recommended removing the impacted teeth, which were most likely causing her pain. I submitted two claims to Spot, one for the first visit in December and one for the expensive teeth removal surgery in February. For both, I only attached the vet invoices which included the vet medical notes. Initially, both claims were rejected for lack of inclusive information about my cat's health, meaning the SOAP notes. I ended up finding and submitting the form that was given to me from the shelter when I got her, which only contained her vaccinations, record of spaying and a mention of medicine for diarrhea. I explained to Spot that was all I had, and no one knew anything about my cat's health in her life prior to the shelter. Just a few days later, I got notified that they had approved both claims reimbursing me $21 out of the $78 visit and $288 out of the $697 surgery. **That means that my total annual billing for the insurance is $214 ($17.87 x 12) and by March alone I have already been reimbursed $309. I'll take it.** https://preview.redd.it/si7w4q5tcipe1.jpg?width=887&format=pjpg&auto=webp&s=2b08b2273dc1ac812143cbdbe683b8f30d65722d

I wanted to share my experience, as reading other people’s stories on reddit is what made me go with this company and i’m so glad I did. I’d heard lots of good reviews, and my partner had no issues with reimbursement with PetsPlusUs so I decided to try them out for my dog and cat. After my cat had surgery to remove an obstruction, they paid me back the exact amount I expected to be reimbursed, and it was very straightforward! I even forgot to update my address for my insurance so it didn’t match the bill, and it was fine (I think partially because I only moved 5 minutes away so my premiums weren’t affected). The only slight annoyance was I needed to give them ALL vet records, and they wouldn’t process my claim until I did (so please keep all your pet records safely in one place), but I suspect the same would be true for all pet insurance companies. My cat is about 1.5 years old, and her insurance is $35 a month and they repaid $2,100, so it’s been absolutely worth the money. While at the ER, a dog came in that was hit by a car and trupanion wouldn’t cover a penny. I overheard the staff talking about how terrible trupanion is for repayment (and its way more expensive than pets plus us).

I had some large expenses come up that I couldn't afford, so I used the "Plan it" feature on my platinum card. Basically, you pay a fee, and then Amex lets you make installment payments on the charges. What I did not know at the time is that you pay interest on these payments in addition to the fees! The fees themselves were a couple hundred bucks, and I picked a 6 month payment plan under the assumption that I was paying the fees instead of interest. Am I overlooking something, or is the payment plan completely useless? I would have just carried the balance if I'd known what I was actually signing up for Edit: I confirmed with amex that I am using the "plan it" feature and not "Pay over time" so I shouldn't be paying interest, but because I have carried a balance that isn't part of the payment plan, I'm being charged interest on both. This feels pretty scummy and deceptive

I live in a condo in Los Angeles. My unit had a leak that caused some damage in a neighbor's unit, but when I filed the claim with my HO6 insurance, they found me "not negligent" and so "not liable." It took a while, but I eventually got paid to fix the issue on my end—but my neighbor was left to fix their damages through their insurance. Of course, they're now threatening to sue. I understand that my insurance will defend me should there be a suit (they confirmed that I have coverage, but they won't pay because I'm not liable). My concern is that they sent me a non-renewal notice over this claim. My policy will expire in two months. This means the claim needs to be closed so I can shop and secure a new provider... So, what happens if the lawsuit comes after the claim closes and I'm insured somewhere else? Who takes care of the lawsuit then? Am I being screwed over somehow by my current insurer right now? I mean, the non-renewal surely felt so, but if I'm going to be left to handle a potential lawsuit by myself, I don't know what I'll do. :-( Thoughts?

Last Sunday, I was having dinner with family when a drunk driver left the restaurant parking lot and decided to take my parked truck with him. Thankfully, nobody was in the vehicle, but the damage was significant — around $6,000 according to the repair shop. The other driver's insurance accepted liability and is covering the damages to my truck, which is good. But here’s where it gets frustrating. I live alone in a rural area and have no other transportation. I work weekend shifts (Friday–Sunday) with regular overtime (usually two extra 12-hour days). Because I had no vehicle, I missed work this weekend. The truck was towed to the shop, but they can’t begin repairs until *two Mondays from now*. The insurance company told me they won’t cover a rental car until repairs actually begin, even though their policyholder was 100% at fault and drunk. How is that fair? I'm out two weeks of transportation and potentially $1,800 in lost wages because of this. I’ve never filed a claim before, and I feel totally lost in this process. Some questions: 1. Can I push the insurance company to cover a rental now, not just when repairs start? 2. Is there a way to claim lost wages due to this incident? I have no PTO, and this is directly affecting my livelihood. 3. Should I be speaking to an attorney about this, or is there another route to escalate the claim? Any advice or guidance would be really appreciated. Update- I live in Maine but the accident happened in new Hampshire if that makes a difference.