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Progressive - Applying out of pocket costs towards a deductible?
Windshield had some severed cracks that started to spider out and had to be fully replaced/recalibrated.
Before having it fixed, I filed a claim with my insurance company (progressive). My claim was denied as I hadn’t yet met my comprehensive deductible and didn’t have glass coverage at the time. I added the glass coverage a couple weeks after the claim was denied to make sure I’m covered in future events.
I finally saved up enough to have the windshield replaced and recalibrated just this week.
My question: Is the amount I paid out of pocket for this replacement eligible to go towards my comprehensive deductible for any future issues?
My biggest concern is that I just don’t want it to look like I’m trying to commit insurance fraud by submitting a second claim for the same thing after just adding the glass coverage.
Appreciate any help.
Ohio Insurance Company - Should I sue my hospital?
Age: 37
State: Ohio
In December of last year, I was recommended to get a colonoscopy due to family history. When I spoke with the specialist doctor, he said that "since you'll be under (anesthetics), we could also do an EGD." He then asked if I ever get heartburn, and I said sure but it was infrequent and I knew the triggers and how to take care of it, but if, like the colonoscopy, my insurance completely covered it and I wouldn't be paying, I'd be okay with that. He said sure, they could do that.
Fast forward a month later and the hospital is charging me because they submitted the EGD as diagnostic. So the doctor ignored the condition under which I agreed to the procedure.
I've been fighting this ever since then. The hospital investigated and since they don't keep audio with the cameras, and don't have call logs (the doctor's assistant called me a few days beforehand and said they convinced my insurance to cover the EGD, and I confirmed with her that I wouldn't have to pay for it), they're refusing to do anything about it. The bill is about $1,900.
I've filed a complaint/appeal with my insurance, but that takes up to 60 days, and is still going through the process (I had called them the day before the procedure and confirmed it's "covered," and the CSR said yes, she sees that that's been approved). I e-mailed the state department of health, talked with the state hospital association (they have no legal authority and can't do anything), filed with the BBB, filed with the state attorney general, filed with the Centers for Medicare and Medicaid, sent my story to the local newspaper, left a Google review, and am waiting to hear back from the state insurance department (they can't do anything until my insurance appeal gets resolved).
My last option is to sue them in small claims court. The lawyers in my area said they don't handle cases like mine. What umbrella term would this fall under? Misrepresentation / promissory estoppel? The only lawyer who agreed to a consultation said it's better to go after the insurance company, but I don't see this as their fault. I can also call the hospital and negotiate a lower repayment, but I'm angry I have to pay anything at all when a promise was made to me that I wouldn't owe anything. Is this something I just have to bite the bullet on?
Edit: Thank you to the 20% of people who explained what the hospital staff should have explained to me, gave me options to pursue, and ideas on how to protect myself in the future. The rest of you, I hope you understand that the vast majority of people don't work in this industry, and blaming the victim of a convoluted and broken system is real shitty.
insurance carrier - How to rent-out a low-power electric pontoon boat as optional feature at my lakefront short term rental?
I am purchasing a lakefront second home that I will use primarily as a short term rental in PA (and will use about 10% of the time personally and the home will be in my name). The sellers are transferring to me a low-power electric pontoon boat to go along with the sale. They currently also rent the home and pontoon boat as an optional add-on. The boat rental has been very popular for them and has generated a significant amount of additional rental income that I'd like to reproduce. I spoke to them about how they insure the boat and themselves from liability while renters use the boat. They provided the name of an insurance carrier that they use for the home policy and indicated the same carrier provides a personal umbrella policy that they use to cover themselves for the boat rental.
As it turns out, I use the same insurance carrier so I reached out to my agent about getting similarly set-up. However, my agent, after consulting with underwriters, told me that not only do they want nothing to do with covering the boat when used by renters, but that they will not even insure the home as long as the boat is on the premises and now require proof of sale of the boat before they will insure the home even if we were to forbid renters' use of the boat.
I'm suspecting that the sellers are operating a very risky operation where they didn't disclose everything to their carrier and they would not be covered in the event of an incident.
So, I'm looking for advice for how I may be able to rent the home and the boat but still be legitimately covered by insurance.
It was suggested to me that perhaps I could start an LLC, sell the boat to the LLC, and then operate the boat rental arm through the LLC. However, a brief search through chatgpt seems to indicate that because I would be closely tying the optional boat rental into the rental of the home, that I would be potentially stepping into all sorts of issues and the LLC would not function to "limit liability" as intended in its name.
Has anyone found a solution to this and could share their experience/advice for how to make this a reality?
**TLDR: How do I get liability insurance to cover me renting a low-power electric pontoon boat as an optional add-on feature for the renters of my lakefront short term rental home?**
Progressive - Progressive told me not to worry about the fact that I'm going over my limits by ~$9000....
When the adjuster was going over the fact that their car was going to be a total loss, a 2022 Kia Sorento, that they were valuing at $34,000, $9000 over my limit.
I hit them doing like 7 miles an hour, but it must have done frame damage... I just didn't see them, and t-boned them as they were making a left turn, while I was trying to make a left turn.
They told me that they were going to have them file a claim against their own insurance, and its "progressive versus progressive; so, it's not like they're going to fight it", and to not worry about it.
I'm not about to get blindsided with a $9,000 past due bill after being told to, "not worry about it", am I?
his insurance company - Insured driver cant be found
Was in an accident 2 weeks ago, brand new (to me) car and havnt even made the first payment. the at fault driver had an expired "limited term" drivers license. after police report and information exchanged i have been given the runaround by his insurance claiming that they cannot reach him for a statement so they will deny and close the claim. is this even legal? do i need a lawyer like right now?
Thank you everyone for the replies, sounds like i was overthinking alot of this. proceeding with my insurance company to let them go after him or his insurance company and just have the car back.
Blue Cross - Marketplace dental coverage that doesn’t really exist
Location, North Carolina
Our family has a marketplace health plan with Blue Cross. It includes free dental for children under 18. I bought a marketplace dental insurance for my husband and I but didn’t include the kids because they had the free dental on the health plan.
I have been trying to make dental appointments for the kids, and of course, there is a very limited number of dentists on the list that are in network. I have called a couple to make appointments and I keep getting told the same story. Blue Cross completely ghosts the dental office when they try to submit claims so the dentists won’t bother billing them anymore.
If I had known this, I would have just added the kids to the dental policy I purchased for my husband and myself. Of course open enrollment is over so it’s too late now and they haven’t really had a change in circumstance except that their coverage only exists on paper and is impossible to use. Now my only option is to pay out-of-pocket for their dental care.
Anyone else experienced this? What are my options?
Allstate - Question about insuring new driver - getting ripped off?
I have a 2022 Toyota Corolla Hatchback insured with Allstate. My older son used to drive it, but he's now away at college (out of state) and only occasionally drives when he's home. My younger son is about to get his license, and when I asked Allstate about adding him to the policy, they said my monthly premium will essentially double.
This seems excessive since their overall risk exposure isn’t really doubling—my younger son is essentially replacing my older son as the primary driver, not adding a whole new vehicle to the policy. It feels like a shady business practice.
Is this a common experience with teen drivers? Am I getting ripped off, or is there a way to negotiate this? Any advice on dealing with Allstate or switching providers?
Enterprise - Other party (Enterprise rental) denying liability insurance claim, what can I do?
Got hit and run on the freeway in California a couple of months ago. Other party was at fault. My car is badly damaged in the front with paint transfer from the other car. I wrote down the license plate #, make, model, color, and went to file a police report and insurance claim the next morning. I don't have collision insurance so all my insurance could do was follow up with the other party's liability insurance and see what they said.
Turns out the other party was a rental car from Enterprise. Enterprise called me recently to get more details and my side of the story. They finally just emailed me saying "After a thorough investigation of the facts, we do not believe the operator is legally liable for the damages being claimed in this loss. The renter claimed no accident occurred at the time of rental. Upon returning and inspecting the rental car, there were no damages reported to the vehicle. There has been no evidence provided proving our renter hit your vehicle. We must therefore respectfully deny your claim."
What recourse do I have, if any? :(
Healthy Paws - Healthy Paws Increased Premium from $160.49 to $519.67 (by 323%!!!)
I opened my bank account yesterday and my jaw dropped to see a hefty bill of $519.67 from Healthy Paws!! I have been their customer for more than 10 years and they took care of my pets....They covered an expensive procedure about 3 years back and I felt nothing but grateful...Their claim submission process is very simple....No recent high amount bills from my end (just regular procedures in the last 2 years!!) ....I referred my friends to them...And I was a happy customer until today...I understand that companies sometimes need to increase their rate but to increase it by 323% !!! ...
I am just sad and devastated...You value your kids'/pets' health more than yours...I just paid $160.49 a month ago..if they had to increase the rate to $200.00 or $215.00, I would have understood...But this rate hikes is truly unjustified...I am planning to report it...My heart is broken....I wanted to let people know..
Farmers - Insurance company leaves me with shortfall to remodel bathroom
I own a condo, which I reside in. The unit directly above me is a rental property.
So, a pipe was leaking from the unit above me. HOA says the upstairs unit is fully responsible for any costs incurred in repairing the pipe and restoring my bathroom due to the water damage it caused.
The breakdown in cost for my Master Bath is as follows:
\*Demolition: $2,879.00 (already completed)
\*Remodeling: $4,554.39
TOTAL COST: $7,433.39
The upstairs neighbor’s insurance company, Farmers, just paid me a total of $5,570.51 to cover all costs associated with the completed demolition and for the not-yet-started remodeling.
That leaves a shortfall of $1,862.88 to make my bathroom “whole” again.
Farmers explained that there is depreciation. My condo was built in 1986. I believe the bulk of the cost associated with restoring my bathroom is labor. Not the materials. Right? Since you can't depreciate labor costs, how can the insurance company justify paying out a significant amount less than what is needed to return my bathroom to the condition it was in before the water damage?
For example, one item on the list the contractor submitted to the insurance estimate was $290 to hook the toilet back up and reset it. I asked the contractor how much the cost would be for the material to do that. He said all it takes is some wax.
I asked him for a breakdown of material costs vs labor costs, and he said he can't come up with that because it's complicated, and the computer spits out the pricing already bundled together.
This is my first time buying a place to live. So, I am not as familiar with all of this, and if I am being denied something I am entitled to from the upstairs owner's insurance.
Here is a summary of what the General Contractor submitted to Farmers:
Recap by Category
O&P Items Total %
CABINETRY 710.40 15.60%
CLEANING 158.33 3.48%
GENERAL DEMOLITION 182.82 4.01%
DRYWALL 732.75 16.09%
ELECTRICAL 214.02 4.70%
FINISH CARPENTRY / TRIMWORK 280.02 6.15%
HEAT, VENT & AIR CONDITIONING 13.28 0.29%
INSULATION 49.76 1.09%
LIGHT FIXTURES 58.29 1.28%
MIRRORS & SHOWER DOORS 191.83 4.21%
PLUMBING 581.01 12.76%
PAINTING 564.27 12.39%
O&P Items Subtotal 3,736.78 82.05%
Material Sales Tax 58.47 1.28%
Overhead 379.57 8.33%
Profit 379.57 8.33%
Total 4,554.39 100.00%
Should Farmers have to pay the full amount to restore the bathroom to its original state? If not, how do I go about getting the remaining amount if I am not responsible for costs?
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