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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.
Vodafone - BPO for Vodafone
Hi
Few years ago I had Vodafone broadband which was absolute shite, i had numerous engineers out to try fix the issue but they didn't fix it so I decided to cancel the direct debit and go elsewhere.
I've been paying the amount back to BPO on a payment plan which isn't long off done ive made my own payment notes as I don't trust these people.
Today I've opened a letter from BPO who say Vodafone has passed them the debt and I need to contact them to make repayments, the amount is also higher to what I had left
What annoys me I've been paying these clowns for over 11 months and after checking my standing orders it shows it's still set up and is being paid every month the reference number is the same on my standing order to what's on the letter today
What do I do ignore them or email them ?
Location: UK
State Farm - Umbrella coverage; SF discontinuing rental property policy
State Farm is discontinuing the policy for my 3-unit multifamily rental property. My umbrella policy is also with State Farm. My agent told me umbrella will cover the rental property if a new policy I find is A-rated (i.e. by AM best, JD power, etc) and underlying liability limit of $500k is purchased. Is it really true that the new policy for my rental property must be an A-rated insurer? What if it is less than an A-rating or not even rated at all? Insurance is insurance, isn't it? It is becoming extremely difficult to find a good, quality top-rated insurer that will write a new policy for rental property (building) that is 70 years old.
Travelers - Home Insurance Claim in Appraisal, Insurance Company Hired Lawyers
Hi all,
(Reposting because I didn't know how to format)
TL;DR: Insurance denying approximately 40K worth of costs (approved line items, just more expensive in the region than their estimate), went to appraisal with adjusters, umpire selected, month later learn that insurance company is now represented by lawyers.
We experienced a water damage claim impacting a 3-story townhouse, all continuous wood flooring, walls, and kitchen cabinets, counter, backsplash, with Traveler's in Dec 2023. We are located in King County, Washington; the house is built into a slope not directly accessible to the street and is stand-alone (no shared walls) on a plot with 3 other homes.
My initial quotes from contractors up to 100K. I went with a contractor who quoted around 80K, good guy. Escalated through several Traveler's adjusters in Winter 2024 until an adjuster came in person in late Winter and agreed with our contractor and the work moved forward. The insurance company adjuster recognized that the costs were going to be pretty high and was working well with our contractor, it seemed.
I handled cabinets, backsplash, and counters directly with a subcontractor and my contractor handled drywall, paint, flooring, pack-out and move in, and more. I got approval from insurance adjuster along the way and ended up getting approval for all of the kitchen work, fully covered, around 33K.
Due to delays from Travelers and subcontractors, with materials being hard to come by, our kitchen floor was unfinished with nails sticking out until May 2024. We wanted to keep things moving and settled on cheaper flooring than an exact match that was available sooner than the Fall, so we moved out in May (I had gotten approval for housing costs in early May from insurance for several weeks). Then, for whatever reason, their adjuster stopped responding to my contractor for a few weeks in, approximately, late-May and June.
The flooring and painting work was finally done and the cabinetry, counters, etc. mostly got done in mid-late July. The work was mostly completed by August except for a few small things. The final costs of the new installation of cabinets, counters, backsplash in the kitchen, which I had handled and which had been covered, was approximately 33K which has all been paid out and completed. Mitigation was done for 6.6K with a separate company. The remainder of the tear down, pack out, dry wall, painting, flooring, cleaning, plumbing, electrical, etc., onwards from my contractor ended up being 105K. With the previous adjuster, the claim was sitting around 70k estimate from the insurance side with an expectation that it would go up conveyed verbally with their adjuster several times.
In this period, since the insurance adjuster had stopped responding, my contractor had reached out directly to Traveler's. At some point a new adjuster was assigned and then, in June/July, the case was passed through, I believe, 3 more adjusters. The final adjuster basically went through and wrapped up the claim, including recoverable depreciation, but didn't really acknowledge the actual costs of the materials, labor, compared to their estimate and essentially closed the claim at approximately 95K total, which included mitigation, kitchen, and the contractor's work. That left a gap of approximately 40K still due to my contractor.
After a month or so of back and forth, we agreed with the final insurance adjuster, to go to appraisal in November. We selected an adjuster. It seems that nothing was happening for several weeks and then eventually Travelers selected their adjuster and he actually came to inspect the house in December. Then per our adjuster, unable to be reached/unresponsive for several weeks. Once they did get into contact and went back and forth in late February, they finally agreed on an umpire. Then, out of nowhere, in mid-March, the third party adjuster representing Travelers informed our adjuster that Traveler's had assigned or hired lawyers to handle this claim and they were no longer continuing the appraisal as previously agreed upon.
Here is the policy language regarding appraisal:
...7. Appraisal. If you and we fail to agree on the amount of loss, either party may demand an appraisal of the loss. In this event, each party will choose a competent and impartial appraiser within 20 days after receiving a written request from the other. The two appraisers will choose an umpire. If they cannot agree upon an umpire within 15 days, you or we may request that the choice be made by a judge of a court of record in the state where the “residence premises” is located. The appraisers will separately set the amount of loss. If the appraisers submit a report of an agreement to us, the amount agreed upon will be the amount of loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of loss.
Each party will:
a. Pay its own appraiser; and
b. Bear the other expenses of the appraisal and umpire equally.
My question is - why did Travelers go with attorneys after there was an umpire selected?
- Could it be something as simple as the timeline being so protracted? We have emails showing the umpire was agreed upon a month ago.
- I am concerned that, as I see in this community, our adjuster was filling the costs to try to get a better negotiating position... Not sure if that would play into this...?
- The work was expensive and challenging to complete but there are no line items that were not previously approved - they just cost more than what the insurance company estimated.
I have not heard anything directly from Travelers. My contractor has been wrecked in this process, it's been tough for me as well. The idea that we need to face an attorney is rough.
Appreciate anyone's insights or guidance!
TL;DR: Insurance denying approximately 40K worth of costs (approved line items, just more expensive in the region than their estimate), went to appraisal with adjusters, umpire selected, month later learn that insurance company is now represented by lawyers.
Aetna - Insurance/Auth help
I hope the flair is correct.
So I have Aetna POS II through my employer and my prescriptions are handled through OptumRX.
I previously had Cigna health insurance for 2024 and was forced to Aetna cause plans changed and this was the cheapest one (even though it’s not cheap)
I had an auth for Zepbound valid until 3/16/25 that was initiated in September 2024. Well my provider submitted a new auth and it was denied. Optum is telling me it’s my health insurances problem. Then Aetna tells me they have no control, contact Optum. My provider is supposed to submit an appeal but I’m feeling really confused. Who has control over the prescriptions then? How have I gotten two refills since January even with my health insurance changing? (Optum rx has not changed and I had them in 2024 too)
Can anyone help me understand?
Blue Cross Blue Shield - Collections called asking for payments but did not charge me correctly
Last June, I went to urgent care because I was leaving for a vacation out of the country the next day and started feeling sick. I couldn’t get into my primary doctor before leaving and just wanted a steroid shot or antibiotics to avoid being miserable during my trip. I went to an urgent care near my job, knowing it would be more expensive than my normal copay. I usually pay a $25 copay at my primary doctor, but urgent care costs $50. When I arrived and checked in, the receptionist asked for my insurance cards, which I provided. I’m double insured, as I’m still on my parents' insurance, but I use my insurance as primary and my parents’ as secondary. I’ve never had any issues with this setup and typically don’t have medical bills because of it. The receptionist asked if another name (I assumed it was another patient) was on my insurance policy. I confirmed that I’m the only one on my insurance policy and explained that my parents’ insurance is secondary. Both of my insurances are Blue Cross Blue Shield, though I’m not sure if that matters.
The receptionist seemed confused but said, "Okay, it’s going to be expensive, but your copay is $50." I agreed, since I felt awful, and paid with my HSA card. I was only tested for strep and flu (both negative) and was diagnosed with a sinus infection, for which I received a steroid shot.
Fast forward to my trip abroad, where I had to visit a doctor at my resort, pay $500, and was diagnosed with bronchitis and the flu. Last week, I received a call from a collections service saying I owed $244 for my urgent care visit. I asked how that could be possible since I was double insured, but they couldn’t answer. I called the urgent care, and they directed me to their billing number. After waiting for an hour and a half on hold, I was told I owed the amount. I asked again why, given my double insurance, and they said they only had my parents' insurance on file, and that their insurance had denied the claim. I asked why it was denied, explaining that my primary insurance at the time was through my job and my parents’ was secondary. They asked to put me on hold to investigate, but the call was dropped.
I called back and was on hold for 45 minutes. I then received a call from an unfamiliar number, and the voicemail said the call had been disconnected and to call back to resolve the issue. I called back and reached a different urgent care I’d never heard of. I asked for the person who left the voicemail, and they said they didn’t know anyone by that name. I explained the situation, and the person said they had been receiving similar calls from others and advised me to be careful with the information I shared, as they were unsure if their office number had been linked with spam.
I then went to the original urgent care, which is 10 minutes from my job, and asked for clarification. They explained that my primary insurance was never added to my account, but when I went in for clarification, they added it to my file. Since their billing has been outsourced to a third-party company, they can no longer access statements or accept payments. They directed me to that number but said they would speak to their manager and call me back since they’ve received multiple complaints since moving to this company.
I’m unsure what to do now, as the urgent care never billed my insurance correctly, and the bill has now gone to collections. Any advice on how to proceed?
Pets Best - Pets Best Claim Time
For those of you with Pets Best, how long does it usually take for them to finish reviewing a claim? I feel like they are taking forever lately.
State Farm - State Farm: Ensuring that vehicle modifications would be covered in the event of a total loss?
Greetings, I have State Farm insurance on my truck, which I've been gradually making improvements to for off-road use over the past 2 years I've had it. As of right now, I have about 18k invested into it excluding labor.
I've asked my SF agent aboput gettin an endorsement and they verbally said that my current policy should cover it as long as it's bolted to the vehicle and that I've kept photos and receipts, but I still worry I could end up in a situation where the vehicle is stolen or wrecked in an accident, deemed total and I'm offered far less then it would cost to purchase a similarily equipped truck used on FB marketplace. I'm a bit skeptical of whether or not this is accurate or whether i'd be severely low balled.
I live in a fairly urban area where property theft and unisured reckless drivers have been sharply increasing.
I skimmed over my policy but nothing stood out to me in reguards to modifications, but perhaps I missed something? I'm just trying to make sure that I'm not screwed . One scenario I'm worried about is getting a low ball offer for the vehicle and then hoping there is an avenue to buy it back so that I can transfer the viable parts to another vehicle of the same model, selling whatever is leftover for part and taking a huge loss.
Allstate - AllState Approving Only Partial Roof Claim Because of Past Damage That was Fixed
Recently a storm blew through and did a ton of damage in the neighborhood. Adjustor came out and declared the roof a total loss, however all said they were exploring possible negligence. Couple weeks later they declared that the could only pay for half the roof because they had pictures of roof damage 2 years ago (damage was just a dozen or so 3 tab shingles that had torn off, nothing major, which was since repaired). The next day they just deposited the money in my bank account, however I haven't signed or agreed to anything.
Is it possible or worthwhile to fight this? Unfortunately I don't have a paper trail of the roof repair because a friend of mine fixed it to return a favor.
I spoke with a roofing company with good reviews on Google who said they will fight it for us. That a good idea? Also reaching out to my friend to see if he has any companies he recommends.
Healthy Paws - Healthy Paws' "Escalation to HQ" Canned Response As Predicted re: Price Increase
**Context:**
Policy Information
• Protected Since: 06/08/2011
• Current Monthly Premium: $431.58
• New Monthly Premium Starting in 63 Days: $1,207.12
Posted yesterday here: [https://www.reddit.com/r/Pets/comments/1jttro5/healthy\_paws\_pet\_insurance\_warning/](https://www.reddit.com/r/Pets/comments/1jttro5/healthy_paws_pet_insurance_warning/)
*"I understand that premium increases, like any increase in something we use or pay for regularly, can be a stress financially. Our goal is to keep your premiums as low as possible while still providing the policy’s features and benefits. Premium rates are based on many factors, including the increasing cost of veterinary medicine, the pet’s age, breed, sex, and zip code. Insurance regulations require us to charge a premium that is sufficient to cover anticipated claims. Premium increases are filed and approved, where required, with your state’s insurance regulator.That being said, you do have options for decreasing your monthly premiums. If you would like to decrease the cost of your monthly premium, you can do so by assuming more financial responsibility in the cost of your pet's health care. You can do this by increasing your pet's coinsurance and/or annual deductible. If you would like more information on those options and what those premiums are, just let me know via replying to this email and I will be happy to send those over to you.If you would like to speak with me to review the matter further, you can simply reply to this email noting a few dates/times that work best for you, and I will be happy to call you back at your desired time. Please note that I am available Monday through Friday between the hours of 8:00 am - 4:00 pm Pacific Time."*
United Healthcare - Out of network reimbursement
I went to an out of network Health specialist. I had 2 visits for around $200 per visit paid via credit card. They told me to send my invoice/receipt to my insurance company and they would reimburse me. I submitted 2 claims to United Healthcare and they were approved as out of network which went towards that deductible. I just assumed that after that approval, a check from UHC would be sent in the mail to me. It wasn’t.
I chatted with UHC customer service today and they said to contact the health specialist business to resubmit the claim as in network. Talked to the specialist business representative and they don’t deal with insurance AT ALL. They are out of network for everyone and leave it to the patient/customer to handle insurance reimbursements if applicable.
I’m at a loss for what to do now. I know I have to get it sorted with UHC but idk what to say or do at this point. How do I get reimbursed? Was I not supposed to submit a claim? Should I have gone through a different process and submitted something else? I’ve never had to deal with this kind of situation before and I cannot afford to not be reimbursed. Any tips or help would be much appreciated. Thank you!
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