I had surgery on May 8th. At that point, I had not yet met my deductible or out of pocket max. I was told that I would owe $3,500. $150 to go towards my deductible and the remaining going towards everything else. I paid them $2000 as a deposit before the surgery leaving me with a balance of $1,500. I was told at that time that as long as everything was covered by my insurance. If at any point I met my max out of pocket, that I shouldn’t owe the hospital any more money, even if there was still a balance remaining. I also had another surgery on May 12th. I knew that between both surgeries, I would cover my out of pocket max for my insurance. I got two bills in the mail about a month later one for the first hospital for $1,500 and one for the second for about $2,000 I called my insurance and explained that I met my max out of pocket so I shouldn’t owe anything. They said they submitted claims to both hospitals and that it should be taken care of. I was still receiving bills for both hospitals so I called my insurance again and they said that the second surgery was covered and the claim was being finalized but that they weren’t seeing anything for the first surgery as far as claims go and that I needed to contact the hospital and have them give my insurance a call. I contacted the hospital and they said they would not contact my insurance because everything looks right on their end and that my insurance needs to contact them. I have since contacted both my insurance and the hospital and they are saying that the other needs to be the one to call and that “we don’t call them, they need to call us.” The only thing is that the hospital suggested that maybe I put them on a 3 way call. Anyone who knows about insurance and what I should do, please help. Also I’m sorry this is so long 😅

Location: I live in California Hey guys! Wondering what you thought. In summer of 2022, my mom and I were visiting some extended family in Switzerland. My Swiss cousin drove me and my mom to Paris, France in his car. The last night I was there, my cousin asked me if I wanted to go take pictures at the Eiffel Tower. I said sure. He drives his car, I am in the front passenger seat next to him. No other passengers in the car. We are on the street right next to the Eiffel Tower at a red light, sitting in traffic with all cars stopped. He says "OK you can get out here and get to the sidewalk, I will pick you up in a few minutes." As I open the passenger door, a motorcycle who had been weaving in and out of traffic going maybe 15-20 mph, slams into the car door. The driver and passenger fall over and the car door is smashed. We pull over, traffic around us is stopped. An ambulance comes and help arrives. Unfortunately (worst timing ever), I had a plane to catch to go back to the US. My cousin told me to leave, he would take care of it. I found a cab, took me back to where my mom was staying, and we went to the airport and flew home. I followed up with him a few days later and he said the motorcycle driver and passenger were fine, they had suffered some cuts/bruises and a sprained ankle. I told him to please keep me posted. He never really had anything to report. Fast forward to last Friday. I get an email from an insurance company detailing the incident from 2022, with the correct date and what exactly had happened. They found me liable and at fault because I opened the passenger door and caused the injuries of the motorcycle passengers. The insurance company said they had to compensate the other party, and requested that I reimburse the full amount. It's nearly $10K USD. I know this is definitely not a scam because my cousin verified his policy number on the letter they sent me. He also informed me they called the police that night and the police never came. He took it on himself to give the other party the insurance information so that his insurance would help out. He never imagined his insurance trying to recoup the money, especially from me. What do you guys think I should do? Shouldn't the insurance cover the driver and vehicle?Am I liable as the passenger? How would an insurance company in France enforce that I pay this? Can they take me to court? Is it possible that they might try to retaliate with my cousin instead, if I ignore the letter? Thanks in advance!!!

I had an MRI arthrogram ( contrast for hip labrum and joint) and it was coded 27093, 77002, and 73722. And then the pharmacy drugs. My insurance is trying to bill this a surgery as they say code 27093 is under the surgical code section in the CPT guidelines. Normally I would have 100 percent coverage for any outpatient clinic ( non hospital) MRIs. My insurance says even though this was not done at a surgical centre or with a surgeon ( only a radiologist), they can charge me as if it was a surgery and therefore also charge the radiologist as surgeon fees. Does this make any sense at all? That way they say I have to pay 20 percent of the whole package of MRI ( 73722), Radiology diagnostic ( 77002) , and the local anesthetic used by the radiologist prior to the iodine injection ( 27093). So even though my work insurance normally would cover radiology diagnostic and all imaging at 100 percent, they say because of 27093, this is now a full blown surgery and only covered at 80/20 rather than 100 percent. Is this true? I will post in CPt code section.

So I have just passed my full A license test and as such now am a fully qualified rider in the UK. I was previously on a CBT so a learner. I phone my insurance company to update them, and they have said that because of my license change they would no longer cover me, as now I'm a "new rider" and my cover will end in 7 days. This policy is at 10 months, so because of me being MORE qualified to ride, I lose almost a full year no claims ? How can that in any way be fair/right ? Is there anything I can do ?

Hey all, Ran across something weird today. I was notified by my son’s pediatrician office that his provider was not covered under our insurance plan. We have been going to this provider without issue and picked this provider based on the fact that when we searched him on our insurance website, it listed him as in network. I contacted my insurance company, and they reported to me that on initial search based on NPI, he was a covered provider. I called the billing office back and they said to give the insurance company the tax ID to search. I did this, and my insurance said the tax ID was not covered, but when the tax ID and NPI were provided, it was listed as covered. My insurance called the billing department, and they told my insurance that they do not accept my insurance plan, only certain policies under my insurance provider, but not my specific plan. The medical office told me they would be resubmitting the prior claims since they should not have been processed as “in network” and that I would be responsible for payment since it’s out of network. I can’t make any sense of this. All prior claims from the visits were processed and covered by my insurance, but now the medical office is claiming that they have always been out of network? Why would they have been billing my insurance if they were in fact out of network? Any help or insight would be helpful!

Last week I got my settlement value for my totaled car which was very very undervalued due to them not comparing the same vehicles. Their excuse was “we go off of the VIN, they did not have any ST models in the area for comparison so that was the closest model to your vehicle” that was word for word from an email I received. For context I have a ford focus st and they compared to the ford focus se, the two cars are VERY different in build and price. They are saying I can invoke my appraisal clause and get an independent appraiser at my expense. What should I do? Any advice would be greatly appreciated! Thanks everyone!

I was in a car accident other driver t boned me they ran a red light stated in police report today I got a denial letter from their insurance saying their party isn't at fault they said their driver states their light was green even though on police report states other also witness statement said my light was green and she ran red light unsure what to do I have liability unfortunately. In VA I want to sue her I just don't know where to start I suffered a concussion my son suffered minor injuries but we do have 5K in medical bills my car was towed which tow company took possession since I didn't pay to take it out they auctioned it off.

I recently lost all my belongings due to mold in my house that I lived in July 2023-February 2025. I got insurance starting August 2024. I became very ill and moved in with family Dec 2024, returned to the room in Feb 2025 to find it covered in mold after a bad storm. I was not aware that the mold was causing my illness or that there was even mold in my home until Feb 2025. It’s looking like an almost complete loss of my belongings. My insurance company manipulated me into stating that the date of loss was Feb 2024, when I made a maintenance request to fix a leaky window. I didn’t understand the implications of this and the agent was kind of pushing me to agree that Feb 2024 was the “date of loss” and not Feb 2025, because that was the first documentation I had of a moisture issue in the house. The next day she tells me it’s unlikely I can recover any claim money because I got insurance in August 2024, and the loss happened before that date. Can anyone help? Id like to make an appeal if my claim is rejected but I’d like to know how I can defend myself here.

I recently ran into some medical issues and just got my blood sent in for testing, which my office said they'd run through my insurance. Then today at work my coworker got a call from her doctor saying that her appointment had to be rescheduled or cancelled because her insurance policy came back as having been cancelled. I immediately went to check the status of my insurance and found that it had been "termed" as of a month and a half ago. According to my insurance provider, I have no medical, dental, or vision insurance. My paychecks are still having money pulled for insurance payments and I received no notice of a cancelled plan (checked emails, messages, and physical mail) but when I call my provider they tell me I'm not insured. This is the same for every other coworker I've spoken to this afternoon. I've already reached out to my employer about this and am waiting on a response, but my question is: if my medical bills come back higher because I'm "not insured", am I legally able to make my employer pay for the difference as it's their responsibility to maintain my (and my other coworkers') health insurance?