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Cigna - Hospital bill should cover out of pocket max but two months later claim isn’t processed
My wife recently had sinus surgery, and we paid a $3,000+ hospital bill before the surgery as they said she couldn’t have the procedure without paying it. That covered the rest of her OOP max. Cigna still hasn’t processed the claim two months later, and meanwhile other bills and late fees are stacking up because her OOP max isn’t shown as being met.
We contacted Cigna and they said it finally processed last week (not reflected on their website) and that we need to allow 21 days for it to go through. How do we handle this with other providers calling and threatening additional late fees? My wife wants to pay but I think we should wait for the claim to go through.
null - On the hook for deductable after Dr. changed claim details
So I've been going to a psychiatrist practitioner for more than 2 years now. I've paid a $25 copay each visit. I've never had to pay a deductible, it's always been the same practitioner as well. Out of the blue in January I get sent a bill that is many many times the cost of my copay, with the bill stating that it's my deductible.
I called my clinic and they tell me nothing's changed, that the insurance was sending back that it was out of network and that they'll resubmit. I called the insurance and they let me know that in the past they were filing claims as a family practitioner, but now they're filing as psychiatry/specialist which is subject to my deductible. They mentioned that I could file a dispute, but that everything did look accurate and they're not sure how or why it was charged as general practice before. When I called my clinic back they told me they'd been bought out and that the practice is a specialist clinic and told me basically they don't care how it was charged before.
I am very frustrated. I went ahead and cancelled my next appointment and am looking for options to continue on my medicine. I'm hoping my old family doctor might be able to pick up the prescription. Not sure what else I can do.
I would not have went in for my visit had I known it was going to cost me multiple months of rent. And all just so she can ask me 3 minutes of questions and write the same prescription I've gotten for the past year.
Is there anything I can do to get out of paying this bill? I was not told before hand that anything was changing. I know it's more complex than this but I can't help but feel like I'm being scammed out of my money.
Also does this not sound borderline fraudulent? How can a practice go from being general practice to specialist without undergoing major changes. If they are a specialist now, how were they not before??
Anyways, I just needed to vent this out I guess. Any help or suggestions are greatly appreciated. God bless the American Healthcare system.
my ins co - In which states are balance billing waivers illegal?
I reported a provider to my ins co for balance billing. The provider wanted me to sign a waiver allowing them to balance bill me. I asked the rep if this waiver is illegal, and/or would it get the provider kicked off for violating their contract. I really couldn't get a straight answer. I was just told that unfortunately a lot of providers do this, and there's no guarantee of what will happen to them.
Is it worth it to also report them to my state's insurance division? I don't want to waste my time if these balance billing waivers are legal.
State Farm - $399 for two cars and renters…am I getting screwed?
I’m in Illinois and have a pickup truck and a minivan. I also rent a house from my in-laws. I have State Farm for my policies and they have been going up and up and up the last few years. My coverages are standard and I have no claims or tickets on record.
State Farm - Does anybody know or have had an awful experience with State Farm?
Does anybody know or have had a awful experience with State Farm? They have kept my car at a body shop. It was a front end collision. They fixed all the outside of the car. Even things that did not need to be replaced. When went to pick it up it was not drivable. We told them at the time of the crash that they stability. Track went out. They refused to fix that. They told me to have it towed to my dealership. And guess what? I can’t get a hold of their roadside assistance. And every time I call they act like they don’t even know Like there is no claim! How can that be? They still have my vehicle at the shop.
At Faults Insurance - At Faults insurance won’t pay enough for rental
I drive a large suv and I was hit. The other party was 100% at fault. Their insurance company had me send in photos of the damage, and called me today with an estimate. He explained they will mail me a check for their estimate amount and that they will pay $25 a day for a rental. In my area the smallest economy car is $60 a day so what they are paying won’t even cover that. What can I do? I am in no way at fault and I don’t believe my insurance should pay anything
renter's insurance - Mold in apartment, not sure what to do next
Location: Washington State
I’m dealing with a housing situation that has gotten increasingly serious, and I could use advice on whether I have a legal case and what my next steps should be. I don’t qualify for free legal aid, but I also can’t afford to hire a lawyer outright. I’ve already spoken with the Tenants Union of Washington State, who suggested I update my complaint with the city’s code enforcement office on Monday because the situation has escalated significantly since I first reported it. They also mentioned I might be entitled to compensation that my landlord isn’t disclosing (either intentionally or not). I’m wondering if I should wait to hear from code enforcement again or if I need to start pursuing legal representation now.
My story begins at the start of the new year. On January 6, I submitted a service request because the floor in my entryway was visibly warped and I was having trouble closing my front door. On January 8, maintenance came out, removed the weather stripping from the bottom of the door, and marked the request as complete even though no inspection was done and the root issue wasn’t addressed. At that point, I figured I had at least documented the damage in case they tried to blame me later, but I had no idea how bad things were about to get.
On March 26, I submitted another repair request because there was now visible water damage and possible mold along the baseboards next to my front door, along with the floorboards becoming even more warped. In my bathroom, there was a significant colony of black, furry mold that had grown between the wall and a small stepstool I had propped up against it. I had also noticed that there were "blisters" in the paint on the walls in the hallway leading up to my apartment where water had obviously started to pool. Maintenance showed up the next day, told me they would "call someone," and once again closed the ticket without fixing or really even looking at anything. On March 29, I went into the leasing office to speak with someone in person because I felt like the issue was not being addressed properly and I wanted some answers. I explained the problem to the leasing agent and he asked me to send him an email describing the issue (which I did) and that I should open yet another repair request for the issue (which I also did.)
On April 1, the maintenance person showed up again. This time, he brought a pipe wrench and literally tried to hammer down the warped floorboards (no joke). Then he sprayed two sprays of mold inhibitor on the wall next to the front door “just in case.” That afternoon, I was told that a water restoration company would be out the next day to inspect the unit.
The water restoration company came first thing on April 2, while I was still in bed. They found significant moisture behind the walls and suspected the presence of mold. The property manager came by a few minutes before noon, took photos, and informed me that my apartment was currently uninhabitable. He told me to file a claim with my renter’s insurance for a hotel. I work from home and was in the middle of my work day when he told me that the water restoration company would be arriving shortly to start dismantling my bathroom to start looking for the cause of the leak. I ended up making a claim with my renter's insurance (even though I believe property management is responsible for the cost of temporary housing) but without a statement of cause, my insurance wouldn't help me find a place to stay so I had to make arrangements on my own for myself and my dog. I'm currently staying in a hotel down the street from my apartment building that is being charged to my credit card.
On April 3, the leasing manager called me to inform me that my apartment is unlivable and they have no timeline for repairs, so I have the option to either break my lease with no penalty or move into another unit (with them paying the moving costs). I asked him to send the offer via email because I needed a written record of the offer before I would even consider anything. He sent me an email the next day (April 4) briefly outlining my two options: either I transfer to another one-bedroom unit in the building at my current rental rate, or I break my lease with no penalties. That’s it. He didn't even include the offer to cover moving expenses to the new unit.
I'm stuck in a frustrating situation with no real solutions. My renter's insurance isn’t covering my hotel costs because they won’t pay without a statement of cause, which I still don’t have. Even if they do cover it, I’ll still be out $250 because of my deductible. I expect the property management company to take responsibility for that since the damage was caused by their neglect. The options they’ve offered don’t even begin to address the full scope of the inconvenience and stress I’m dealing with. There’s no mention of covering the moving costs, or even offering rent relief for the time I’ve been displaced. Neither of these options account for the impact this situation has had on me and my dog.
What should I be doing next? I’ve already filed a complaint with the city’s code enforcement office and plan to follow up on Monday, but I’m not sure if I should be waiting for them or moving ahead with other options, including legal advice. I know I can’t afford to hire a lawyer outright, but I also feel like I’m being jerked around by the property management company and my renter's insurance. Any advice on what steps I should take next?
USAA - USAA Paid Less Than The Estimate That They Requested
Hey y’all, my truck got hit in the parking lot of my work a couple of weeks ago and there was some damage near the drivers rear wheel. The lady who hit me left a note with her information so I submitted a claim through her insurance company. They asked me to get an estimate from one of three shops and then after they would pay. I requested to cash out as I’m planning on painting my truck myself within the next month or two. The shop returns with an estimate of about $2,300. After about a week I receive payment of $1,700… I asked why there was that high of a discrepancy and the adjuster said:
“The cost difference between the estimates is due to the first one being written without regard for insurance rates. We can only pay out on the official insurance estimate.”
My question is, why did they have me go get an estimate in the first place. I had to take a half an hour’s drive each way just to get to the shop. Not to mention the time I spent there waiting to be helped. I’m just frustrated because it seems like that was an active waste of my time. If they already had their own “official insurance estimate”, why did they have me go drive 2-3 towns over to get a meaningless one from a shop!
Progressive - Progressive randomly added a driver to my policy making it go from $120 a month to over $600 a month. How?
I noticed my bill in an email was way more than normal and checked my payment history only to find out it’s the second time they billed me for that amount since I missed the first time (I was on vacation).
I called and apparently they added some random guy. I finally figured out it was a guy I had in my car when I volunteered at World central kitchen delivering free food to hurricane victims. This guy rode in my car once for half the day.
They said they emailed me and sent regular mail telling me about the change. I never got them because the vacation. They will not tell me how he got added to my policy and at one point hung up on me and I did not raise my voice and was polite but firm in asking what happened. I still have no answer. And instead of refunding me the money they just paid my bill for the year with the fund they took. I pay monthly normally.
I did not share phone info or have them track my driving with progressive so I cannot understand how they added this dude to my insurance. I remember this guy rode a bike everywhere and since my insurance went up so much I’m guessing he has a bad history.
How did they add this guy to my policy?
I’m planning to change insurance providers any suggestions?
Thanks for any info
homeowners insurance - Condo water leak question
Very long story short, condo had a water leak 4 months ago. My homeowners insurance says that based on the HOA bylaws, the HOA is responsible for the damage. HOA is saying the opposite. So I’m at a stalemate. What do I do? I’m assuming an attorney is my next step but who pays those legal fees if I win? Condo is in South Carolina if that matters.
To make it more complicated, my insurance sent in water mitigation contractors that completely ripped my kitchen out. They did this before asking me for a copy of the HOA policy and determining they’re not responsible for yet it was their contractor that came in. Now I have no kitchen and both parties saying they’re not responsible. Ugh.
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