Have an issue with your insurance?
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Insurance companies are constantly reviewing us. Are we too old? Do we live in the wrong place? Is our credit score high enough? Well, now it's time to turn the tables. Do you charge too much? Will you pay my claim quickly? Is your coverage worse than it seems? We can review you too.
Northwestern Mutual - Life and disability insurance question
Hi everyone, I got to this forum after seeing some "NW mutual life insurance is a scam" posts and i'm not sure if I got scammed. I was in medical training when a financial adviser told me about getting disability and life insurance.. with NW mutual... I'm 35 years old, very healthy, I pay about 87$ for 2M Term to 80 policy with no annual dividend. And my premium for disability is $110.. Looking for advice if I should switch to a different broker (if thats an option) or just general advice.
Blue Cross Blue Shield - Billing mix up
Not sure if I tagged this right, but basically I was covered by a MA ConnectorCare (CC) plan until January 31st of this year, and now I am covered by my employer's BCBS plan as of February 1st. I received my first Gardasil shot on January 31st, the last day my CC plan was active, but my doctor billed BCBS (I added it for my second shot on Feb 28th) and now I'm getting a $700 bill for the office visit and the shot because that coverage wasn't active yet. Is it possible to tell their billing department they need to retroactively bill the CC plan as that's what I was covered by on the date of service? I actually work at the office where I got my shots, and I have a pretty good idea of what my plan will cover with or without a copay, and this is not correct.
Budget Rent-a-Car - Budget promised a refund verbally over the phone and are now denying they ever promised it.
Location: Denver, Colorado
This happened at Budget Rent-a-Car at DIA.
So this has been dragging on for around 2 months and the amount of lies upon lies that we've been told would make this post ridiculously long, so I'll keep it as short as possible.
Budget wrongly denied a prepaid rental booked through a third party, claiming that it was against their T&Cs, and sold another agreement at 3 times the price for a lesser car plus extras which were specifically not asked for. After finding out the original rental was wrongly denied, we contacted them to ask them to honor the original rate. At first they argued, wrongly citing their T&Cs again, but eventually agreed to honor the original rate. This was promised verbally and by email.
The inflated rate was still charged at the end of the rental, and subsequently a refund was promised verbally on 2 separate occasions, explicitly stating the amount and timeframe. The refund did not happen and they are now denying ever promising it.
On top of this, the car they claim we returned is not the car we rented, and they've added a fuel charge. I have email evidence of agents lying about what their T&Cs say, and proof that contradicts what they claim on the phone. We also know the desk agent receives a commission for upselling because there are job listings for the same location which state this.
The issue is, their customer service is impossible to deal with. They pick and choose what parts of the emails they want to reply to, disregarding they key points of my email each time, and it takes days to get a half hearted response. Calling is no use because they later just deny what was said.
We have filed reports with BBB and disputed the CC charge, so other than waiting on the outcome of that, what can be done? They have taken a four figure sum from us and are constantly contradicting themselves and misleading us, and there is no urgency from them at all. 6 hours+ of waiting on the phone and explaining things, plus a chain of around 30 emails, many not even getting replies, speaking to probably around 15+ different CSRs and we are back to square one even after they admitted we were right. It's infuriating.
Because the amount is only 4 figures and the case is becoming so long and complex with insane amounts of law violations, taking it to court might not be economically viable, but the complete disregard for the law can't be allowed to slide. Even a full refund wouldn't be justice at this point. I'm not sure what to do as it's becoming a full time job trying to keep a timeline and stay on top of evidence etc.
Highmark Blue Cross Community PPO - Denied coverage 1 week before surgery
I am scheduled for surgery next week with a specialist. I’ve waited a very long time to get this care and am chronically ill from my health problems. I received notice from the hospital billing department today that in fact the hospital is out-of-network with my insurance. This is after at least 6 months of appointments at this hospital and with this surgeon’s office. My insurance was billed for the other pre-op appointments. The billing office informed me today that I would have to pay about 49k up front to even be seen by the doctor for the surgery at this point. I pressed both my insurance and the hospital as to how this could happen. According to the hospital billing office, they had my insurance numbers but not my card on file (I’m quite sure I gave them my physical cards at one of my in-person appointments). They said someone had entered the wrong plan into the system (one that was covered by the hospital) and just discovered this. Something feels very wrong to me, not to mention the psychological stress of having been preparing for a hopefully life-changing surgery that is likely to be off the table. I have the option to file an out-of-network gap exception or use another recommended surgeon, but I am enraged that this mistake was made. I don’t understand how the hospital could just now find out that my insurance is out-of-network. Can anyone advise—is this fishy? What might I do to get my surgery next week? My FMLA is approved, my friend paid money to fly to stay with and take care of me, and childcare and meals are organized. I find the whole thing unacceptable but don’t know how to advocate for myself.
My plan is Highmark Blue Cross Community PPO.
TriWest - ED out of pocket pay
Hello,
So last year I got bit by a stray dog and had to go get my rabies shot. I went to urgent care first where they told me to go to the ED (nonprofit) down the road to get the shots. I went to the ED, got the shots, and went on my merry way.
I got a bill yesterday for the shots where my insurance (TriWest as a dependent) paid for $25,000 of the $28,000 and the hospital left the $3,000 balance to me.
Is there any way I can find out if the hospital gives assistance? I’m a college student and I can’t afford such a high bill with every other bill I have so I just want to pick your brain on ways I could possibly reduce this. I am in Texas, and I currently have no income.
Thank you!
MetLife - Mini Aussie 6Y - Insurance Reccomendation
Hi guys !
I'm considering switching pet insurance plans for my 6 year old mini Aussie. I currently have MetLife Pet Illness and Injury, but with one minor shoulder injury - maxed out my benefits after one visit. As my baby gets older - I want to make sure I have the best coverage for him - especially with ortho treatments ( ie. PRP injections) Any Recommendations would be very appreciated !
Progressive - LexxisNexxis won't remove erroneous insurance claims
In 2022 I made a small insurance claim for water damage, $2k, with Progressive. Since then, every time I get quotes for homeowners insurance I get denied, or have to accept high rates, because the Lexxis Nexxus database shows I made 3 claims. A year ago I disputed these several times, and got a letter from Progressive that confirms I only made 1 claim. When I talk to LN, they tell me they've removed the claims, but over a year later I'm still getting denied by insurance quotes and told they are still showing up by the insurance companies. Is there an agency like the CFPB I can submit a complaint to about Lexxus? Or do I need to get a lawyer letter involved? I already have to deal with living in a hurricane prone area with high rates and these higher rates are crippling.
LOCATION: TEXAS.
unknown - Insurance Help
Hey all,
Ran across something weird today. I was notified by my son’s pediatrician office that his provider was not covered under our insurance plan. We have been going to this provider without issue and picked this provider based on the fact that when we searched him on our insurance website, it listed him as in network. I contacted my insurance company, and they reported to me that on initial search based on NPI, he was a covered provider.
I called the billing office back and they said to give the insurance company the tax ID to search. I did this, and my insurance said the tax ID was not covered, but when the tax ID and NPI were provided, it was listed as covered.
My insurance called the billing department, and they told my insurance that they do not accept my insurance plan, only certain policies under my insurance provider, but not my specific plan.
The medical office told me they would be resubmitting the prior claims since they should not have been processed as “in network” and that I would be responsible for payment since it’s out of network.
I can’t make any sense of this. All prior claims from the visits were processed and covered by my insurance, but now the medical office is claiming that they have always been out of network? Why would they have been billing my insurance if they were in fact out of network? Any help or insight would be helpful!
TD Insurance - Could I possibly be reimbursed for the deductible I paid, since I was not at fault in the accident?
[Ontario, Canada] Might not be the best place to ask this, but I was unable to find anywhere else.
Following a car accident that was not my fault, my vehicle was totaled. My insurance provider, TD Insurance, paid off the car loan, and during the process, the agent proposed deducting my deductible from their payment to the finance company, with the understanding that they would later recover this amount from the other party's insurance. However, almost six months have passed, and I have yet to receive the deductible reimbursement. When I inquired, the TD agent explained that they have had difficulty contacting the other insurance company, citing a recent instance where they were on hold for over an hour without success. As this is my first experience with such a situation, I would appreciate guidance on how to proceed.
STD company - STD Overpayment
Located in Oregon, USA
Short Term Disability insurance related to parental leave
I took parental leave from work in 2024. My job/company is entirely remote, so my employer uses a benefits manager, JW, for payroll and insurance, and a third party administrator, Sparrow, specifically to manage short- or long-term leave, kind of like a concierge service for employees (because rules vary significantly from state to state). I signed the things that Sparrow told me to sign.
I was supposed to be paid from the state, from private STD, and topped up by my employer. I didn’t have a STD policy of my own; I was told that my employer took out a STD policy on its employees. Payments were confusing, delayed, and as a new parent I was not paying attention. I didn’t tally things up until recently to do my taxes. I’m missing a 1099 from STD so I called Sparrow, who said go to STD, who said go to JW, who said there was no STD policy for me… but if there was it should be in my W2. Taxes were withheld from STD so I said regardless of how we got here, I need an accurate W2, which is in the works. And it looks like I was overpaid by the STD amount.
Lo and behold, today I got a call from the STD company saying my STD claim was denied and submitted for overpayment. I kinda laughed… I’d just been signing paperwork and living my life. How the heck did they approve and pay a claim on a policy that does’t exist? And why did Sparrow/JW request that money? And why was I told it was my company’s policy? So I told the STD company that they can recoup the money from one of the benefits managers. This strikes me as an unenforceable request for repayment from me, but I don’t know what I don’t know and would appreciate any insight about how to navigate this. Thanks in advance.
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