Other Insurance Claims

36 Responses to “Other Insurance Claims”

September 28th, 2008 at 3:20 pm #nancy

What about travel insurance? My foster son has been having horrible sensory problems and is in a study at the University and would not be able to tolorate flying in a plane. We have cancelled our trip ( other family memeber going has to have hip replacement) and we got all these forms and confused by it all. With Dr. sign off will we get some of our money back or will they fight this all the way?
September 29th, 2008 at 1:44 am #admin

Hello Nancy,

Are you saying you had to cancel a flight because of a medical emergency and you are making a claim to the airline to refund the ticket cost? If so, all I know about this is that I have heard that some airlines will give a discount or a free flight to go to a funeral if you provide a copy of a death certificate.

Normally “travel insurance” is something you pay extra for when you buy a travel ticket, and it does refund the ticket money if you have a medical problem. Did you buy travel insurance?

I’d also think that if they sent you claim forms to fill out that maybe you do have the insurance. That’s good. Let your doctor fill in the form and see what happens.
November 28th, 2009 at 5:42 pm #Sandy

Golden Eagle! do they pay out claims quickly? I was injured at a place of bussiness, this month went to emergency very bad! Tec Shot,two A/B’s I don’t wont an atty but! was told by the Ins Company I don’t need one it will just make the case go slower.

I have all the med records, that I got from Hospital and my Doc info bill, I have wage lost that was submitted also.

Question, I would like to have this close before Xmas, do you think this will happen?
November 29th, 2009 at 6:38 pm #admin

Sandy,
If you want it closed before Christmas, you will probably get low-balled. If you want the most money, you should get a lawyer and wait a year if necessary for your money.
January 6th, 2010 at 5:18 pm #charles gookin

i have a homeowners 2 policy with a personal property endorsement for
my camera equipment.this endorsement is an inland marine coverage im-206 (09-08) on christmas morning i loaded my car to visit my son and his
children i placed my camera bag on the ground behind my car and went back into my house to check for additionl items and forgot the camera
equipment.i then returned to my car and backed over the camera equipment doing $8,520 damage.
all equipment was scheduled and there is no deductable.i insured this way under the understanding that i was insured for all risk and replacement cost.
the insurance company is elling me that the loss is to be determined at time of loss and actional cash value.

i would appreciate your comments.

thank you

charles gookin
January 8th, 2010 at 1:42 am #admin

Charles,
You will need to read the endorsement for yourself. While it may be excusable not to read your main HO2 policy book word for word, I think most courts would expect you to read a 1 page endorsement to confirm your expectations at the time you purchased the endorsement. Not all personal property floaters read exactly the same for all companies.

FYI, even most HO3 policies pay acv on contents unless you get an RCV endorsement. So thats all the more reason to read your camera endorsement before a claim.
June 12th, 2010 at 7:17 am #Joe

Dear Admin

Iam a UK citizen with a DBA policy provided by ESIS ACE. I have a spinal injury which occurred whilst protecting USACE in Iraq 2007 and am currently being paid monthly by them as well as my medical bills taken care of by Esis.

My problem is that they will not release a copy of my policy with them. The company I worked for will also not release a copy. I feel it is very strange to have a policy and not know what’s in it. I do not know what my future holds as the insurance company are holding all of the cards as well as my life in their hands.

Your advice would be much appreciated.

Many thanks
Joe
June 13th, 2010 at 11:02 pm #admin

Joe,
contact your government agency that regulates insurance companies and read the regulations for yourself. if they say you are not the policy holder, but you paid the premiums, you or your lawyer should look for case law that gives you policyholder rights.
October 6th, 2010 at 10:06 am #Owen Bell

i always make sure that we have adequate travel insurance when going out for a vacation.`,
April 13th, 2011 at 5:22 pm #Kelda Fontenot

I have a question about a Renters insurance claim. My claim was made due to water damage resulting from condensation on my floors since there was a structural problem with the house (which has since been fixed). At first, I was told this qualified under my poicy, and an adjuster came out and did a partial inspection, asking me to email him further photos. He said again that this was covered under our policy. I was mailed a letter stating that my claim was denied because the extent of damage was under my deductible, but that was it. He explained that was not final, the claim would be ammended by the photos and quotes I was sending him, and not to worry.
However, now that he has all the information he needs, and the total is more, my adjuster tells me that this kind of water damage is not covered in my policy. How can the rules change like that, when I have in writing that the only reason the claim was initally denied was for being under the deductible?
Any insight would be appreciated. Thanks!
May 31st, 2011 at 7:53 pm #matt

Dear Admin – I had a piece of jewelry insured on a rider with an appraisal of $3800; the jewelry was lost and the insurance company said they could replace it for $2700 + tax and just cut me a check.

Can I fight this as I have been paying for years based on $3800 but they say jewelry appraisals are over-inflated? I’m not trying to pull a fast one here but feel if I cash the check I’ll be conceding my case…
July 27th, 2011 at 7:26 am #TIM

Dear Admin, was wandering if it is legal to have a must work 30 hours a week to be eligible for benefits clause in a credit disability policy. I don’t think it would be relevant in this kind of policy due to the fact that the term of policy and the maximum monthly benefit are already determined when i signed contract agreement on automobile loan.It seems that it would belong in a employer/employee group policy,STD/LTD policy so they could calculate the amount of monthly benefit of loss of wages. Would appreciate it if you could answer that question. Just got denied benefits because of that exclusion clause.Thanks for your help.
July 27th, 2011 at 10:51 am #admin

Tim,
Don’t know. Perhaps Jason or someone else here knows. BTW, if something is real important and its not clear in the policy, get the agent to fax you a note ahead of time saying what wil happen if there is a claim.
August 3rd, 2011 at 3:59 pm #Jason

Tim,
I don’t see why it’s not ok to have that requirement in the policy. It’s an agreement and if they want the covered claims for only the people that work over 30 hours per week, then that is what it is. I assume you didn’t work 30 hours per week. If you entered this contract, then you should have a copy of this document that you signed. Were you able to read it before you had to make a claim? If you did, then you should have known what the outcome of your claim would be even before you submitted it.
August 3rd, 2011 at 4:05 pm #Jason

Matt,
The insurance company is able to buy the jewelry at wholesale prices while you as an individual purchaser have to pay retail prices. If you want that same piece of jewelry, you can get it because the insurance company will acquire it for you. If you don’t and want the cash, the cash you can get is what they would have to spend to get that piece of jewelry. Please don’t focus on the concept that you are paying premiums on $3800. You are paying premiums on that specific piece of jewelry that will cost you $3800 and will cost the insurance company $2700. Dollar amounts should be meaningless if the ring is actually something of value to you.

If they would not have given you the cash option and just replaced the ring for you, would you even have any concern?
September 14th, 2011 at 9:07 am #Kelly

Can anyone help with some advice?! I took my son to speech therapy with a pediatrician referral. The PT dept. called my healthcare insurance and was told my son had 90 visits per year. Then they asked for the referral. I began taking him to therapy in May it is now Sept. and I got now got the co-pay bill which is fine….but when I called to pay it. I was told I had 2 other large bills waiting????? Turns out health insurance denied his speech. I was never told. They read me something about restrictions about the speech therapy that my son didn’t fall into….anyway……the insurance paid 2 of the claims?! strange….now they are denying the 3rd….and are reviewing everything?! can they deny claims that are already paid for? i am worried!!!!
September 25th, 2011 at 6:38 pm #Jason

Kelly,
Yes, they can deny claims that are already paid. That happens all the time.
October 5th, 2011 at 5:00 pm #admin

Dear website visitors,

Most of our questions and answers for October 3rd and 4th were lost as a result of a malware attack on our website. In addition, some of our pages were “redirected” to malware websites. We have now incorporated stronger security measures.

While we have no proof as to the original source of the hackers, suffice to say that this website had never experienced hacking problems until shortly after we posted the page “BOYCOTT FARMERS INSURANCE?” which exposed criminal acts by Farmer’s CEO and their Los Angeles based attorney Richard O Knapp.
November 21st, 2011 at 6:16 am #Cathy Durant

Is it illegal to use a health insurance check issued to the subscriber to pay other bills other than medical bills from the provider of services?
November 21st, 2011 at 6:53 am #Jason

Cathy,
No
December 1st, 2011 at 7:24 pm #admin

test testing123@yahoo.com
December 1st, 2011 at 7:35 pm #Jason

The test e-mail, testing123@yahoo.com, doesn’t open an e-mail message box for me like it’s supposed to.
December 2nd, 2011 at 11:27 am #CM dahiya

I had bought a health insurance from Seven Corners in IN. The insurance company continuesly insured me from Sept 1 2010 untill Aug 31 2011 and due to my travel it lapsed but I renewed it again on Sep 3rd 2011 with a effective date of coverage start date on Sep 4th 2011 so there was a gap of 3 days. As the luck would have it I was hospitalized due to heart complications on the night of 4th and had to stay in the hospital for 3 days and was subsequently diagnosed with Cancer which was causing the hear issues also. The insurance company denied the claim citing Pre-existing condition. I appealed and they denied that also, I am 66 year old, can you please suggest some options for me, what i can do.

Thanks in advance for this great site and advice you provide to people.
December 2nd, 2011 at 2:09 pm #Jason

CM,
You weren’t insured when the cancer was discovered and that is needed for coverage to exist. We don’t know what to suggest.
December 15th, 2011 at 9:06 am #Mom

I had lost an insured ring over a year ago which I had no problems with my claim. I recently discovered while that a ring set (as I was taking it to update an old appraisal) is gone. My husband and I have searched everywhere, interrogating our oldest child 7 an unable to with our 2 year old. I last had the ring in my jewelry box (seen @ June) and discovered it missing early December.
Upon initiating a claim I was treated extremely rude. I just received a call from the SIU – what do I do now? I’m not gonna be bullied by insurance people for a non-fraudulent claim!
December 15th, 2011 at 9:37 am #Jason

To Mom,
You have a couple of choices. If you don’t want to be involved with SIU, simply withdraw your claim. That won’t look good because, regardless, this the 2nd missing ring claim you’ve had in 2 years.

The other choice is to cooperate with SIU because that is all part of the claim process.

You’ll have to agree that SIU is doing their job. We’re pretty sure your 7 year old does’t like the interrogation you put her though but we didn’t notice a post on here by her about how she was treated.

It is very unlikely your 2 year old had anything to do with your missing ring. Unless you had a break-in, the ring’s misplacement can probably be attributed to you or your husband. You didn’t indicate how the interrogation of your husband went.
December 28th, 2011 at 4:45 pm #Jenny

Here’s the first scenario: You win a medical malpractice suit and receive money for future healthcare but you lose your funding (this happened recently to a quadriplegic who had invested with Bernie Madoff. Can you get coverage with another insurer even though technically you were already compensated for the health issue?

Here’s the second scenario: You win a medical malpractice suit and receive money for future healthcare. I assume if you have received this money, you cannot submit a claim for the healthcare covered under the med malpractice suit to another insurer, even if you have coverage via your spouse through their company’s insurer. Correct? (It feels correct and morally the right thing to do. But they never ask if the health issue was a result of medical malpractice, only worker’s comp. Why is that?)

Here’s the third scenario: You win a medical malpractice suit and receive money for future healthcare. Now you have a medical issue, which is on the “gray” area of whether it should be covered or not. Say for example, the injured person has to take medications as a result of their injury and now have a complication. It took some time for this complication to appear and it is an indirect health issue to the original claim. Can you submit that claim to another insurer? (Keep in mind, though with a medical malpractice case, the patient was still insured under the spouse’s health care plan.)

Thanks and sorry to submit so many questions. If you are not a good resource to answer this, but knows someone who is, please let me know. I do have attorneys and they know the law, but I sense an adjuster would know how the business-side of insurance works. I understand the advice you give me is just that and I take all the risks if I use the advice or not.
December 28th, 2011 at 5:54 pm #Jason

Jenny,
We are going to decline addressing these scenarios. We have no idea who could best answer them for you.
January 5th, 2012 at 3:59 pm #austin

My grandfather died 10 years ago naming me the cobenificiary of a policy. It has been on hold by the insurance company until now, I am now eighteen. The policy paid my mother’s claim upon his death, so it has been “approved”. Now I am getting the run around. I have faxed all the documents, which they acknowledge. But I can’t get a straight answer from their customer service. I keep getting redirected and told they will call me. I am ready to call a lawyer. How long can they give me the run around…The insurance company is Monumental Life.
January 5th, 2012 at 5:03 pm #Jason

Austin,
What kind of run-around are you getting? If they are going to call you, did you give them a reasonable amount of time to return your call? Do you know who is supposed to be calling you? Do you have this person’s number that you can call that person directly to address your concerns?
January 5th, 2012 at 5:36 pm #austin

At first they seemed helpful. They said it should only take up to 14 days to get the check because it was already approved. After 14 days they said it was in progress and would take a little longer but would be on the way soon. Then a week later I got the same response. Finally I spoke with someone that told me that it is a supplemental policy handled by another office in another department. She said she was unable to reach that department by telephone, so she sent an email to them requesting that they call me directly about the claim. A week later they said they are still waiting for them to call me, and they could not give me that phone number. They had no further information. I called back a week later and they said they would resend the email requesting them to call me. I am waiting on a phone call that may never come. I cannot call them directly. I cannot email them. I figured they wanted to wait until 2012, but I still can’t reach them.
January 5th, 2012 at 5:59 pm #Jason

Austin,
It doesn’t make sense that they need to reach you by phone. What they need to do is reach you by sending you a check.

Get on the phone with the numbers you have and request that you talk to a manager about getting your funds. If the manager can’t help you to your satisfaction, request his manager. Take a proactive approach and find out exactly what the hold up is. Ask them exactly why they need to reach you by phone instead of cutting a check to you. You might have to be a little direct with them to get some results.

Oh, by the way, I looked at this insurance company rating of another company called Minnesota life. Minnesota’s Life’s ranking was that 48% of the people responding to a survey said they were unsatisfied of very unsatisfied with the company. For Monumental Life the same category was at 67%. Both these rankings are rather sad.

If you can’t get the results you want from asking for a manager call the president of Monumental Life,

Henry G. Hagan, CLU
4333 Edgewood Road N.E.
Cedar Rapids, IA 52499
319-355-8511

Let him know about your problems getting your money that has already been approved for a long time.
January 11th, 2012 at 9:13 am #sandy

I had workplace supplemental health insurance. I diagnosed with heart problems. I did not use my claim because of confusing application. Is it too late to file a claim now.
January 11th, 2012 at 4:50 pm #Jason

Sandy,
We don’t know. You provided no dates or years and how long ago your policy was in force and how long you have to make claims. If you want to provide some important information concerning that, we might be able to answer your question.

But, after you find this information to post another question on here, you will already likely know the answer because we need the information you left out in order to provide the answer you seek.
February 5th, 2012 at 6:25 am #Daral

Part II of question started under Auto Insurance questions. Briefly car was demolished in windstorm. I was transporting (and this is no lie I have pictures) a 42″ Plasma Screen TV and a BIAMP 420 (an expensive piece of sound system equipment) The BIAMP was ruined and no longer works. The TV does turn on but the body and case has been severely dented and cracked as well as the screen scratched. I was in California (where I am moving) at the time but the policy is in Texas (where I rent.) I know when having a car repaired I can specify I want all damaged parts returned to me. Is this the same with Renters? In short can I keep the beat up TV for a spare room AND get the claim and payment for a new one or do I have to turn everything over and do I have to haul it back to Texas to do so? Thanks.
February 5th, 2012 at 8:30 am #Jason

Daral,
When the insurance company pays for the damaged items, they technically belong to the insurance company. Sometimes it doesn’t make sense for the insurance company to take possession of an item such as it’s weight to value, it enormity, the lack of substance (80 lbs. of packaging peanuts for example), etc. If you give the adjuster a reason to keep one both the items, for a constant remember of your irresponsible accident in your bedroom that you can see every morning, (for example), he might say yeah. If he doesn’t, be prepared to offer him a few dollars for that lasting memory that will last a life time.

Sometimes the adjuster’s automatically place a threshold of 10% for example on the damaged items just to keep things simple. If that is the case, you might not want to pay $200+ for one or both these items.

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