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Typical Insurance FRAUD

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wilt the stilt Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-14-10 11:21 AM
Original message
Typical Insurance FRAUD
Edited on Tue Sep-14-10 11:28 AM by wilt the stilt
This year our company went to a large group policy from a small group policy in February. The insurance company did not transfer any of the charges made in January and tried to get us to pay two deductibles. Each member had to call to get their amount spent to apply to the new policy.

The second story is so typical. My daughter went to get some warts off. They of course denied it and then sent a questionnaire out to see if it could be a preexisting condition. Of course they had no actual reason to believe it but the system automatically triggers a denial and an inquiry to see if they can squeeze out of not paying.
It took over 3 months to process this claim and countless wasted time. Any way to deny is their Method of operation. What is also unbelievable is before I joined this company I had been personally insured by then under my own policy. They have covered me for over 9 years in a row.

What kind of a system do we have that all purpose is to deny payment.
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Whoa_Nelly Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-14-10 11:24 AM
Response to Original message
1. A broken system
and one that isn't going to help millions of Americans for a long time to come :sad:
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madrchsod Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-14-10 11:41 AM
Response to Original message
2. that three month delay also means that...
no one else involved with that procedure was paid.

one more year and i`ll have medicare so no more preexisting conditions.
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valerief Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-14-10 11:47 AM
Response to Original message
3. It's the best system they can pay our govt for. We get what they pay for.
And what our bought-and-paid-for govt buys.
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