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Progressive - Home Insurance Claim-Contractor ghosting
Context: Hail Storm on May 3 2024 and it damaged my roof, siding, and gutters. Filed claim with my insurance company Progressive. Progressive approved full roof repair, replacement of gutters, but only approved replacement of siding on 1 side of my house. On the siding my home policy didn’t offer matching so Progressive is only paying to replace 1 side and says to patch damage siding on other sides of my house with siding that will be taken down.
Signed contract with roofing company on June 7 2024 for them to do all the approved work. July 2024 the roofing company replaced my roof. Since then, they have not returned to place my gutters and do the siding. I’ve called the roofing company at least once per month to follow up and they say I’m in their Que and they’ll get to it when they get to it.
Roofing contractor says insurance companies give 2 years after claims are filed to complete work. Can someone confirm if this true/accurate? What other options do I have? Can/Should I file a complaint with BBB?
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!
Aetna - Reverse a processed claim - Aetna
I got a MRI done two weeks ago. When I scheduled the appointment the staff told me they didn’t know the amount to be billed since my insurance is a high yield deductible and no copay. They mentioned that if I want to pay out of pocket without using my insurance it would be $500.
Fast forward I received a processed claim from Aetna saying that I need to pay $920 and that the X-ray company billed them $1,200.
Is there any way to reverse this? I feel scammed by both the X-ray company and Aetna. Can I fight back a processed claim?
Pet Plan - Insurance help for a jack Russel with an elderly owner.
Hey everybody, I hope it's alright to post as I'm from the UK but we are in the south west and my elderly grandmother (I think she is around 87 but she hates telling us her age)
Has been being charged 85 pound a month according to her bank statements by pet plan. He is an elderly jack Russel now but she would have got him insured a lot younger but I'm not sure of his age exactly.
He has no pre-existing medical conditions and my grandmother is not very good at managing online but she wants her independence. Can anybody recommend a pet insurance company in the UK that is easy to use/acsess the details of?
TLDR: What is a good easy interface/acsess pet insurance company for a senior jack Russel?
Progressive - Insurance broker misunderstood Progressive auto quote, telling me a different price, which Progressive deemed ineligible
Hi guys,
I am a foreigner who arrived to the US last year due to work. I had auto insurance for 4-5 months and wanted to change and see if I could get something cheaper.
In March I finally found one who could half my monthly insurance cost which we settled the same day.
The broker confirmed all details that I am a foreigner, with an international license, 7 years driving experience OUTSIDE the US.
2 weeks ago, Progressive sends me an e-mail that a automatic payment will be made in April of $1107. I had no clue what this was, as the broker told me the cost would be $106 monthly.
I immediately call Progressive and they inform med that the broker most likely inserted incorrect information or misunderstood how to fill out their quoting system. They also tell me, that they send me physical mail to my address that the insurance was not eligible and the policy was updated to reflect my correct details. But I am yet to receive this mail, which according to them was sent the day after I approved the quote I was sent.
What concerns me a lot…
- Why did Progressive not send anything in regards to this change?
- only my State ID was given to the broker and as I understand with my prior insurance company, they require my international- and foreign driver’s license to insure me
- can they update it without me confirming/agreeing to this change?
I have called and mailed the broker which is yet to answer and pending their response.
What do you do, in this case?
Location: North Carolina
Blue Cross Blue Shield - Insurance Canceled While on FMLA [TX]
TL;DR: Employer canceled insurance benefits without notice while on FMLA due to nonpayment, despite efforts to pay.
Hi, there. I’m currently on a medical leave of absence from work, and have been experiencing some difficulties with my FMLA/insurance benefits. I’m new to this, so any input would be appreciated!
My leave began the last week of December and I’m set to return on 3/24, the last day of my FMLA protection. Since my leave started, my main priority was getting my insurance premiums taken care of so as not to lose my benefits, especially since I’ve racked up substantial medical bills over the course of my leave.
I reached out to my benefits department, and was instructed to reach out to a third party (WEX) to make payment, which I did. WEX informed me that there was no balance due reflected on their end, and to reach back out to benefits. This back and forth has gone on for months now. At one point, they told me to reach out to BCBS to make payment, and BCBS acted like they had no idea why I was directed to them in the first place.
I’m over 10 weeks into my leave, and have not received a single correspondence about my health insurance until today. Not a phone call, email, or letter. I did, however, receive a bill from WEX for my vision and dental coverage, but nothing whatsoever in regard to my medical coverage. Once I received the dental/vision bill, I called same day to make payment and was told, again, that there was nothing in the system to apply payment towards.
Reached out to my benefits department again, and they said they could see the unpaid premium for my dental/vision. Called WEX again, and after escalating and speaking with a supervisor, was told that the reason why I was unable to pay my dental/vision is because the plans had been cancelled due to nonpayment. When I reiterated several times that I’ve been trying to pay for quite some time by that point, I was told that if I mailed the payment ASAP, there is a “strong possibility” they might reinstate the plans. I mailed the check the following morning, and am hoping it works out in my favor.
What I’m most concerned about, though, is my health insurance. I spoke to someone in our benefits department in February, and was told that because I’d exhausted my PTO the first half of January, my insurance premium would have been deducted from one of those paychecks. According to the representative with whom I spoke, “January was covered.”
I told him I’d received bills for my dental/vision coverage, but still hadn’t received anything for my health insurance. He told me to just wait a little bit longer for it to show up in the mail. Over 10 weeks later of non stop calling and trying to stay on top of things, and I still haven’t gotten anything. I expressed that due to the nature of my leave, I really needed to keep my insurance coverage, and was terrified the third party was going to cancel my policy for nonpayment. He reassured me that the only one able to cancel my insurance would be my employer, and they would “of course” provide me with ample notice prior to that. When I told him it didn’t make sense that I’d receive bills for my dental/vision but not my health insurance, he told me to not worry because my health insurance will remain as is regardless. That my account would just go in a rears and my employer would deduct the unpaid premiums accrued during my leave from my future paychecks once I’m back to work.
A supervisor from benefits called me today (10 weeks after my initial call), letting me know that the reason why WEX didn’t have my balance due in their system was because my health insurance was cancelled on 1/28. When I told her that I’ve been calling for help for months now, and continue to get the runaround, she just kept saying it was my responsibility to cover my premiums while on FMLA. When I told her that benefits told me no one would cancel my health insurance without notification, she disregarded it. Same when I mentioned the rep telling me that my account would just go in a rears and they’d deduct the premiums from future paychecks. She told me that I owed for January, February, and March, and that there is a 10-day grace period where I can get caught back up to “hopefully” have my coverage reinstated, but couldn’t be for certain. I checked my last paycheck from January, and the deductions are reflected on it. I’m just very confused because she was adamant I owed for January still too.
I just don’t see how they can cancel my insurance:
1. Without notice, and
2. After I’ve made an effort to get it paid since the very beginning of my leave.
Someone had mentioned this being problematic because of potential FMLA violations, but I’ve never gone through this before and I’m honestly unsure of the process, and obviously don’t feel comfortable reaching out to my employer given the misinformation I’ve received thus far.
Our market is experiencing mass layoffs right now, and I was hesitant to go on leave in the first place because of it. I don’t know if it’s worth mentioning or not, but the day before my leave was set to begin, thought to call Alight just to make sure I was not going to be reprimanded for not coming in. The representative informed me that my LOA request had been cancelled. This gave me pause, as the only ones who knew about the LOA request was my immediate supervisor and Alight. I’d have been no call, no show and subsequently terminated had I not thought to call beforehand.
I’ve just been worried so much about all of this, and honestly regret taking the medical leave even though it was necessary. I’ve spent more time going back and forth with my employer than I have with my physicians and it’s been hell.
Does anyone have any input regarding this situation? Is this just an HR issue and nothing more or should I consider seeking legal counsel?
Thanks so much ❤️
Florida Healthy Kids - Florida Healthy Kids (Florida kid care)
I’ve been paying for this insurance for my daughter since November. She has simply healthcare under the Florida kid care plan, and I can not get the member ID or even log into the simply website.
FLhealthykids has been 0 help, how do I obtain this information? It’s crazy to me that it’s this hard to get. We never received a welcome letter/packet or anything :(
Blue Cross Blue Shield - Doctor is in network but Hospital is not? Procedure is covered under insurance since it's ACA complaint.
I went in for my sterilization a few weeks ago and was SO excited to finally have it done. I have BCBS and my doctor's office said that insurance will cover the procedure 100%. But when I got to the hospital they said it would cost $10,000 because the hospital is not in network. Is the hospital correct on this or do I need to contest it because my insurance is ACA compliant? Can I contest it before the surgery so I'm not potentially stuck with a stupid huge bill?
American Family - Overhead&Profit Dilemma
For context, this is in reference to a claim with American Family homeowners policy in AZ.
Long story short, we had a claim for our shower 6 months ago. Contractor gave estimate for $8700 (ish) and I was paid $7700 (ish). Our responsibility is our $1000 deductible. Our contractor is auditing our account to make sure our final bill is correct and he’s saying that O&P was only included on a few line items and not all of the line items. He thinks we are owed more money because it wasn’t properly calculated. The adjuster is saying that O&P is only paid when 3 or more trades are used and we had more than 3, but somehow there is a disconnect and the adjuster is stonewalling him. I don’t know how to approach this situation. We’ve used this contractor before on a previous claim years prior so I trust him and his expertise about insurance claims and what’s “right” and not fraud. And if this is how he deals with other claims, how is it that American family is causing such a headache? I just don’t know what to do. He also thinks that if he was dealing with an experienced adjuster this wouldn’t even have been a discussion and it would have been handled correctly. Any insight would be great. Thank you.
United Healthcare - Looking for advice on next steps regarding backdated insurance termination and denied medical claims (Texas)
I was insured through United Healthcare via my employer in Texas. My employer paid premiums monthly to cover the following month’s insurance (monthly payroll).
On March 12, 2025, all employees were notified via work email that we were being placed on unpaid furlough effective immediately. We were told we would still be paid for work performed from March 1–11, with payroll running as usual at the end of the month.
I didn’t hear anything else from my employer until April 2, when I received a letter in my personal email stating that we had all been officially terminated effective March 21, 2025.
The issue is that I saw a specialist and had exams done on March 24, unaware that I had technically been laid off on March 21. The same day I received notice of separation (April 2), I called United Healthcare to check on my coverage. They told me my insurance appeared to be active and didn’t show any indication that it had ended.
However, when I checked the United Healthcare app today (April 5), it now says my coverage ended March 21, and they have denied the claims from my March 24 visit.
I had no way of knowing my coverage (or job) had ended at the time of the appointment. I’m concerned my employer backdated the termination or insurance cancellation, and I’m now stuck with bills for services I reasonably believed would be covered.
Has anyone dealt with something like this before?
What are my options here? Should coverage have continued through the end of March?
Additional information: I have since found out my employer filed for bankruptcy, without letting any of us know, and none of the employees were paid for their time worked in March 1 - 11th.
Any help or guidance would be appreciated I’m unsure how to navigate this situation.
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