I filed a claim with my insurance company (Liberty Mutual) for wind damage to my roof back in early January. Now it's late March, and I still haven’t received a decision. The adjuster is not responding to my calls or emails. Meanwhile, my roof is in bad shape. I’ve had multiple roofers take a look—some warned that roofing material prices will increase 6–10% after April 1st (I confirmed this independently). I'm torn: should I go ahead and replace the roof now, or wait for the insurance company to respond? **Background:** * I live on the southeast of MA, where we had multiple wind advisories and high-wind warnings through Jan/Feb. * My roof is over 20 years old. After one windy day, I found shingles (including ridge shingles) in my yard. The attic started leaking during rain/snow, so I had to build a makeshift water catchment system. * I contacted two roofers. One said it looked like clear wind damage and advised filing a claim. * I filed the claim, and per the insurer's request, I had temporary tarps installed by the same roofer who suggested filing a claim. * The adjuster and their inspector came, acknowledged the damage, but said it wasn’t wind-related—claiming it looked like "mechanical" damage. They seemed skeptical of the roofer I hired(4.8+ rating with years of view history on google). * Waited another 2 weeks, they brought in a third-party engineer, who inspected the roof and told me he believed it *was* wind damage and saw no signs of mechanical damage. He submitted his report to the insurer. * Since then, another week passed. I contacted the engineer, who confirmed the report was sent, but said I’d need the insurance company’s approval to view it( so no access to the report). It’s now been over 10 weeks. I can’t wait much longer with such a vulnerable roof, especially with prices going up. I understand it’s an old roof, and some might argue insurance shouldn’t cover it. But it was functioning fine until the storm, and I *do* have replacement coverage. (Also worth noting—my premium is over $2,800/year.)

The patient is enrolled in the Moda Health Beacon EPO plan, and the provider is listed as participating in the Beacon network. However, the claim was denied by the payer, citing that the provider is not a participating provider. Could you please clarify whether participation in the Beacon network includes all plan types such as PPO, HMO, and EPO?"

Posting to hopefully shed hope on people in similar situations! One year ago today, we were involved in a MVA. From the start, Allstate began the claims process incorrectly, failing to send a field adjuster out to inspect the vehicle for hidden damage before beginning repairs. Several months later during repairs, the body shop found hidden frame damage. This led to the vehicle being deemed a total loss. We have fought with Allstate for well over 8 months, trying to get responses from our adjusters, managers, and the ombudsman with virtually no responses. 3 months ago, they provided a settlement offer. The amount was low. They specifically advised us that we could send comparables that were listed through Autotrader and other local sources ONLY. The car was a specialty sports car, with comps not widely available. I sent comps from alternate sources, not accepted by the insurance company. After a long silence and a lot of frustration, they agreed to the sources I gave and eventually settled with an amount 40% higher than the original offer. I know that there is normally about 10% wiggle room on settlements however, with a lot of time and patience, we were able to get them up above what we even believed the vehicle was worth, in addition to a reimbursement of all premiums paid on that vehicle post-claim while they wasted time by not replying. I hope this is motivation to those dealing with similar issues to not give up, even when things are bleak. It took a year between screw ups, lack of communication and delays but we got there. And please, do yourself a favour and avoid Allstate!

I'm in a pickle with a doctor's office billing after insurance says they paid. What are my next steps? Appointment in Sept 2023 with a verified in-network provider. Doctor office submitted an insurance claim under a different OON provider who I never met/saw/knew about when I went to my appointment. Insurance didn't pay but applied it to my OON deductible. Then a couple weeks later Doctor office submitted a new claim (NOT A REVISED ONE) for the same date but listed an in-network provider. Insurance covered it 100% less copay. Even though it was under a different provider, I know he works closely with the PA I saw so figured it was accurate enough for insurance purposes. I thought this was settled. From my view of EOBs it looks like insurance paid my bill and I paid my copay. Fast forward to now, I get a bill from my doctor office saying you owe us for the original appt. I had no idea there was a balance and I've been to this practice about 30 times since the original appointment in Sept 2023. I told them I have EOBs showing that they were actually paid by insurance, I forward them to them to verify. They are sticking to their guns saying I owe. I called insurance. They said it is too long ago for them to re-work the claims but from their point of view, they believe I should not owe anything beyond the initial copay. Doctor's office billing will not go over details on the phone. They want all communication to go through email, of which I've sent 2 (one with the 2 EOBs and one asking them to please look again at the second EOB which shows they were paid for the appointment), both emails they responded "please pay your bill". Where do I go from here? Insurance doesn't seem interested in stepping in to help since it's an almost 2 yr old charge. And doctor office is being very difficult to deal with. ETA: if it matters the doctor's office was recently or in the process of being bought out by a private equity company from a different state when I went in 2023. The OON provider they initially billed insurance with is the owner or CEO or something with the private equity.

Hey guys I'm with fetch pet insurance Australia due to the fact because they advertised they would pay directly to my vet and I would only have to pay the excess to fetch.. it’s called direct to vet Well I'm learning now no vets are set up with them at all most vets aren't wanting to hand over there vet details so the vet can pay them directly I feel like they are scamming there customers If anyone is with them how do you guys do it?

I'm going to keep this as short and to the point as possible.. Before my job forced us to change insurances, my BCBS plan had an all inclusive copay, meaning when I visited my specialist(or anyone for that matter), I paid $70. That was it. I had been getting bimonthly infusions that cost just under $10,000. All covered under the $70 copay. Rad. When we were forced to switch, we had our choice of hundreds of plans. I tried SO DAMN HARD to get insurance plans to tell me what my infusions would cost under their specific plans and got stonewalled every step of the way. I had all of my billing codes and everything. Long story short, I ended up choosing one that I believed had a similar setup to my last plan: all inclusive copay. Turns out, it is, but they are trying to bill me for the prescription used during the procedure($9,000+). I have to pay for that($300 specialty tier med) AND the copay. They couldn't explain why that is a loophole. My infusion is a buy and bill, which means it is billed under MEDICAL, not prescription benefits. What am I missing here?? TLDR: "All inclusive copays" have loopholes apparently?

My wife and I have car insurance through Progressive. We moved to CO 6 months ago and are paying ~$475 for 2 cars for the first 6 months. However, our premium went up to ~$625 for the next 6 month payment, and that’s after the lump sum payment discount. No clue why it raised in price because we haven’t gotten any tickets or been in any accidents and I haven’t modified the coverage at all. We did Snapshot and it says we’re going to be saving another $55 by continuing with snapshot, so I can’t imagine our driving patterns have increased our premium by $150. Online, it doesn’t say why it’s increasing. How can I reduce my premium without changing coverage? When I call and ask why my premium went up, will threatening to leave for another insurance provider force their hand to give me a lower rate? If so, what information should I come prepared with?

Hey all, I’ve been having issues with my insurance trying to approve a surgery. My surgeon submitted a prior authorization and they denied it. They resubmitted it with a different diagnosis to meet the criteria. They usually take 5-10 business days. But within 48 hours I checked my UHC account and it said “cancelled”. What does it mean when it’s been “cancelled” and not actually denied? I have United Healthcare through my mom’s work. Thanks!

Who do you guys recommend for insurance? both of my policys personal & commercial are with progressive, our renewal literally went from 2k a month to 5K a month smh - we have had no incidents, or any history for that matter.

I will try to make it brief but can answer any additional questions. My wife and I started the process to have a baby. I was insured with Kaiser Permeante (KP) and went to my KP OB. I requested a specific genetic test to be completed (in writing). The DR ordered the wrong test, and instead of the largest panel I received the smallest panel. The records that were sent to me with the results have the name of the largest genetic test despite it actually being the smallest genetic test. I did not realize the error until a couple of months later when my wife and I had selected donors and had to go to a genetic counselor to ensure we did not have any of the same diseases. I was unable to move forward with me selected donors because I did not have the appropriate genetic test. At this time, I was no longer insured with KP and was now insured with BCBS. I went back to KP a requested they proved the correct test, they were unable to without drawing blood again. I proceeded with obtaining the correct genetic test under my new insurance. While waiting for the results both of my two donors were no longer available for purchase and I am now in the process of locating another donor. My wife and I are black, and we are only interested in a black donor. There is a national shortage of black donors and the two donors that we selected were high quality donors (attorney and a doctor). KP has acknowledged their mistake (in writing) and reimbursed me for the cost of the incorrect test. Can I sue the doctor for ordering the wrong test?